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Breastfeeding, Family Stress, and Climate as Key Determinants of Atopic Dermatitis Severity in Children: A

Amr Molla1, Salman Althobaiti2

  • 1Department of Medicine, College of Medicine, Taibah University, Madinah, Saudi Arabia.

Clinical, Cosmetic and Investigational Dermatology
|April 2, 2026
PubMed

Insights

Breastfeeding and stable family structures protect children from severe atopic dermatitis (AD). Cat exposure and mountain climates increase AD severity, highlighting modifiable factors for better management.

Area of Science:

  • Pediatric Dermatology
  • Environmental Health
  • Clinical Epidemiology

Background:

  • Limited multicenter data exists on atopic dermatitis (AD) severity determinants in Middle Eastern children.
  • Biological, environmental, and psychosocial factors influence pediatric AD severity.

Purpose of the Study:

  • To identify early-life, familial, and climatic factors associated with clinical severity in pediatric atopic dermatitis.
  • To provide evidence for risk-stratified management strategies in the Middle East.

Main Methods:

  • A multicenter cross-sectional study of 600 children with atopic dermatitis (AD).
  • Disease severity assessed using the SCORAD index (mild, moderate, severe).
  • Ordinal logistic regression analyzed determinants including breastfeeding, family structure, climate, and animal exposure.

Main Results:

  • Breastfeeding for <6 months and ≥6 months showed strong protective effects against severe AD compared to bottle-feeding.
  • Separated/divorced/widowed households and mountain climates were linked to higher AD severity.
  • Cat exposure was an independent determinant of increased AD severity and SCORAD scores.

Conclusions:

  • Breastfeeding, family stability, residential climate, and cat exposure are significant determinants of pediatric AD severity.
  • These factors are potentially modifiable and should guide risk-stratified, context-aware management of pediatric AD.
  • Findings emphasize the need for culturally relevant and individualized approaches to managing childhood eczema.
Abstract

Keywords:
atopic dermatitisbreastfeedingclimate factorsdisease severitypediatric dermatologypsychosocial stress

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