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[Prevention of allergy in infants. A prospective study of 159 high-risk children]
1Odense Sygehus, paediatrisk afdeling.
Insights
This study found that early infant feeding and environmental interventions significantly reduced allergy symptoms in high-risk infants. These preventive measures lowered the incidence of atopic dermatitis and wheezing by 18 months.
Area of Science:
- Pediatrics
- Allergology
- Environmental Health
Background:
- Infant allergies pose a significant health concern.
- Identifying high-risk infants is crucial for early intervention.
- Previous studies suggested a link between early life exposures and allergy development.
Purpose of the Study:
- To evaluate the effectiveness of a combined dietary and environmental prevention strategy for allergies in high-risk infants.
- To compare allergy incidence in a prevention group versus a control group.
Main Methods:
- Prospective study of 105 high-risk infants from birth to 18 months.
- Prevention group: breastfeeding and/or hypoallergenic formula, avoidance of solids for 6 months, and advice on environmental factors (tobacco smoke, pets, dust).
- Control group: 54 high-risk infants with no specific dietary or environmental advice.
Main Results:
- Significantly lower cumulative incidence of atopic symptoms in the prevention group (32%) compared to the control group (74%) at 18 months.
- Reduced incidence of recurrent wheezing, atopic dermatitis, vomiting/diarrhea, and infantile colic in the prevention group.
- Significantly lower cumulative incidence of food allergy in the prevention group (6% vs. 17%).
- Daily tobacco smoking exposure increased the risk of recurrent wheezing in both groups.
Conclusions:
- Combined dietary and environmental interventions are effective in preventing allergy symptoms in high-risk infants.
- Early avoidance of allergens and irritants can significantly reduce the burden of allergic diseases.
- Tobacco smoke exposure is a significant risk factor for wheezing in infants.
Abstract:
A total of 105 infants at "high risk" for developing allergy born in 1988 were studied prospectively from birth to 18 months of age. The infants were recommended breastfeeding and/or hypoallergenic formula (Nutramigen or Profylac) combined with avoidance of solid foods the first six months of life. All mothers had unrestricted diet. Avoidance of daily exposure to tobacco smoking, furred pets and dust collecting materials in the bedroom was advised. This prevention group was compared to a control group consisting of 54 identically defined "high-risk" infants born in 1985 in the same area. All the infants had either severe single atopic predisposition combined with cord blood IgE > or = 0.5 KU/l or biparental atopic predisposition. The control group had unrestricted diet and was not advised about environmental factors. The cumulative incidence of atopic symptoms was significantly lower at 18 months in the prevention group (32%) compared with the control group (74%) (p < 0.01), due to reduced incidence of recurrent wheezing (13% versus 37%; p < 0.01), atopic dermatitis (14% versus 31%; p < 0.01), vomiting/diarrhoea (5% versus 20%; p < 0.01) and infantile colic (9% versus 24%; p < 0.01). The cumulative incidence of food-allergy was significantly lower in the prevention group (6% versus 17%; p < 0.05). In both high-risk groups exposure to daily tobacco smoking increased the risk of recurrent wheezing significantly (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)