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The influence of breastfeeding in breast-fed infants with atopic dermatitis
Hao-Pai Lin1, Bor-Luen Chiang2, Hsin-Hui Yu1
1Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
Insights
Discontinuing breastfeeding for infants with atopic dermatitis (AD) and switching to a partially hydrolyzed whey formula (pHF-W) may improve symptoms. This approach can shorten the duration of AD, irrespective of infant or family history.
Area of Science:
- Pediatrics
- Dermatology
- Allergology
Background:
- Atopic dermatitis (AD) is common in infants.
- Breastfeeding is often recommended, but its role in AD management is debated.
- Evaluating the impact of breastfeeding cessation on AD is crucial.
Purpose of the Study:
- To determine if discontinuing breastfeeding improves atopic dermatitis in exclusively breast-fed infants.
- To compare outcomes between continued breastfeeding, partial formula feeding, and formula-only feeding.
Main Methods:
- Prospective observational study of 87 exclusively breast-fed infants with AD.
- Infants divided into three groups: breastfeeding only, partial breastfeeding with partially hydrolyzed whey formula (pHF-W), and pHF-W only.
- Atopic dermatitis severity assessed using the Patient-Oriented SCORing Atopic Dermatitis (PO-SCORAD) index at baseline, 3, and 6 months.
Main Results:
- All groups showed decreased PO-SCORAD scores over time.
- Stopping breastfeeding was significantly associated with improved PO-SCORAD scores at 3 months and reduced topical corticosteroid use.
- Partial breastfeeding also showed association with improved scores at 6 months.
Conclusions:
- Discontinuing breastfeeding and switching to pHF-W may improve AD symptoms and duration in infants.
- The benefits of discontinuing breastfeeding appear independent of sex, age, or parental history of atopy.
- Partially hydrolyzed whey formula may be a beneficial alternative for infants with AD.
Background:
The aim of this study was to evaluate whether breastfeeding should be discontinued for exclusively breast-fed infants with atopic dermatitis (AD).
Methods:
Eighty-seven exclusively breast-fed infants with AD were enrolled in a prospective observational study. The infants were divided into 3 groups: breastfeeding only (BM group), partial breastfeeding and partial partially hydrolyzed whey formula (pHF-W) (Partial group) and pHF-W only (DC group). The extent and severity of AD were evaluated with the Patient-Oriented SCORing Atopic Dermatitis (PO-SCORAD) index at enrollment and 3 and 6 months later.
Results:
There were no significant differences in parental atopy history, PO-SCORAD scores, and medication scores at baseline. At month 3 and 6, the PO-SCORAD scores were significantly decreased in all groups. PO-SCORAD scores at month 3 and 6 and at the last time point when topical corticosteroids were given were significantly different among the groups. Stepwise multiple linear regression analysis showed that baseline PO-SCORAD scores and stopping breastfeeding were significantly associated with month 3 PO-SCORAD scores (p < 0.001), after adjusting for sex, age, baseline medication scores, partial breastfeeding and parental atopy history. In addition to baseline PO-SCORAD scores and stopping breastfeeding, partial breastfeeding was significantly associated with month 6 PO-SCORAD scores. Long-term follow-up showed that only stopping breastfeeding was significantly associated with the last time point when topical corticosteroids were given (p = 0.014).
Conclusion:
For exclusively breast-fed infants with AD, discontinuing breastfeeding and shifting to pHF-W might help to improve symptoms and shorten the duration of AD regardless of sex, age and parental atopy history.
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