[Effects of feeding intervention on development of eczema in atopy high-risk infants: an 18-month follow-up study]

To assess the preventive effects of different dietary regimens on development of eczema and food allergy in infants at high-risk for allergy.

Forty-six infants whose parents were atopic and umbilical cord IgE > 0.35 kU/L were enrolled in the study. The infants were randomly assigned at birth to one of 2 dietary regimen protocols: those in intervention group (23 cases) were breast fed till more than 4 months of age, then followed by feeding with partially hydrolyzed formula (pHF), combined solid foods avoidance until 4-month of age, egg, fish, shrimp avoidance until 12-month of age. The other 23 cases in non-intervention group were breast fed for less than 4 months, or bottle fed with cow's milk-based formula, egg yolk was introduced at 4-month of age, and egg white at 6-month of age, besides, no any other dietary avoidance was applied. All the infants were followed-up for 18 months. The primary end point was the presence of atopic eczema. Food allergy was detected by fresh food prick-to-prick tests or in vitro sIgE or Fx5E.

At 6 months, 12 months and 18 months, the incidence of eczema in intervention group was 4.3% (1/23), 8.7% (2/23), and 17.4% (4/23), respectively, which was significantly reduced as compared to that of the non-intervention group, which was 26.1% (6/23), 34.8% (8/23), and 39.1% (9/23), respectively. Food allergy was found in 13.0% (3/23) of intervention group and 34.8% (9/23) of non-intervention group by skin prick tests or sIgE. Egg white was the most common offending food.

Early life dietary interventions which included breastfeeding, delayed solid food introducing, pHF feeding, and high risk food avoidance could reduce the risk of atopic eczema and food allergy development, and was probably an effective primary intervention method for infants at high risk for atopy.