Early allergy symptoms in infants aged 0-6 months on breast milk substitutes

  • Mulya Safri Department of Child Health, Syiah Kuala University Medical School, Banda Aceh
  • Aulia Rahman Putra Department of Child Health, Syiah Kuala University Medical School, Banda Aceh
Keywords: atopic disease, breast milk substitutes, infant atopy


Background Atopic diseases are common in children and a serious health problem worldwide. Atopic dermatitis, food allergies, asthma and allergic rhinitis, have been described as the natural progression of allergic diseases, also known as the “allergic marchâ€. Cow’s milk protein is known to be a common trigger of food allergies and hypersensitivity reactions during infancy. Objective To give an overview of the breast milk substitutes (BMS) and incidence of early allergy onset (allergic march) in atopic infants aged 0-6 months. Methods This cross-sectional study included a total of 40 atopic infants collected by consecutive sampling. A questionnaire was used for interview that inquired information on the type of BMS used, initial allergy complaints, the age of the emergence of early allergic symptoms, and the breakdown for BMS type. Univariate analysis was carried out to describe their characteristics as frequency distributions and percentages of each variables. Results Atopic dermatitis and wheezing were more common in boys (62.5%). Atopic dermatitis was the most common initial symptom to occur in atopic infants (52.5%). Atopic dermatitis and wheezing occurred together in 27.5% subjects. Early allergy symptoms that first occurred at the age of 1 month were seen in 42.9% for atopic dermatitis category, 37.5% for wheezing category, and 63.6% for both symptoms category, respectively. Cow’s milk was the most common type of BMS given to atopic infants in the first 6 months of life (47.5%). Conclusion Early symptoms of allergies, such as atopic dermatitis and wheezing, are more common in boys than girls. Atopic dermatitis is the most common early symptom to arise, but both symptoms occur at an early age, often during the first month of life. 


Novy R, Setiabudiawan B, Kartasasmita CB. The association between duration of breastfeeding and atopy in children with or without family history of atopic disease. Paediatr Indones. 2007;47:179-184.

Friedman NJ, Zeiger RS. The role of breast-feeding in the development of allergies and asthma. J Allergy Clin Immunol. 2005;115:1238-48.

Liu AH. The allergic march of childhood. MedSci Update. 2006;23:1-3.

Siregar PS. Peran alergi makanan dan alergen hirup pada dermatitis atopik. Sari Pediatri. 2005;6:155-8.

NIAID-Sponsored Expert Panel, Boyce JA, Assa’ad A, Burks AW, Jones SM, Sampson HA, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010;126:S1-58.

Vadas P, Wai Y, Burks W, Perelman B. Detection of peanut allergens in breast milk of lactating women. JAMA. 2001;285:1746-8.

Hóst A, Halken S. Approach to feeding problems in the infant and young child. In: Leung DY, Sampson HA, Geha RS, Szefler SJ, editors. Pediatric allergy: principles and practice. 7th ed. Missouri: Mosby. 2003; p.488-94.

Moore MM, Rhifas-Shiman SL, Rich-Edwards JW, Kleinmann KP, Camargo CA, Gold DR, et al. Perinatal predictors of atopic dermatitis occurring in the first six months of life. Pediatrics. 2004;113:468-74.

Purvis DJ, Thompson JM, Clark PM, Robinson E, Black PN, Wild CJ, et al. Risk factors for atopic dermatitis in New Zealand children at 3.5 years of age. Br J Dermatol. 2005;152:742-9.

Linneberg A, Simonsen JB, Petersen J, Stensballe LG, Benn CS. Differential effects of risk factors on infant wheeze and atopic dermatitis emphasize different etiology. J Allergy Clin Immunol. 2006;117:184-9.

Berz JB, Carter AS, Wagmillen RL, Horwitz SM, Murdock KK, Briggs-Gowan M. Prevalence and correlates of early onset asthma and wheezing in a healthy birth cohort of 2- to 3-year olds. J Pediatr Psychol. 2007;32:154-66.

Schoetzau A, Filipiak-Pittroff B, Franke K, Koletzko S, Von Berg A, Gruebl A, et al. Effect of exclusive breast-feeding and early solid food avoidance on the incidence of atopic dermatitis in high-risk infants at 1 year of age. Pediatr Allergy Immunol. 2002;13:234-42.

Spergel JM, Paller AS. Atopic dermatitis and the atopic march. J Allergy Clin Immunol. 2003;112:118-27.

Sangsupawanich P, Chongsuvivatwong V, Mo-Suwan L, Choprapawon C. Relationship between atopic dermatitis and wheeze in the first year of life: analysis of a prospective cohort of Thai children. J Investig Allergol Clin Immunol. 2007;17:292-6.

Lopez N, Barros-Mazon S, Vilela MM, Condino Neto A, Ribeiro JD. Are immunoglobulin E levels associated with early wheezing? A prospective study in Brazilian infants. EurRespir J. 2002;20:640-5.

Bellanti J, Barbara Z, Pung YH. Immunology of the fetus and newborn. In: MacDonald MG, Seisha MM, Mullet MD, editors. Avery’s neonatology. Philadelphia: Lippincott Williams and Wilkins; 2005. p.1148-9.

Protonotariou E, Malamitsi-Puchner A, Rizos D, Papagianni B, Moira E, Sarandakou A, et al. Age-related differentiations of Th1/Th2 cytokines in newborn infants. Mediators Inflamm. 2004;13:89-92.

Magnan AO, Mély LG, Camilla CA, Badier MM, Montero Julian FA, Guillot CM, et al. Assessment of the Th1/Th2 paradigm in whole blood in atopy and asthma. Am J Respir Crit Care Med. 2000;161:1790-6.

Benn CS, Wohlfahrt J, Aaby P, Westergaard T, Benfeldt E, Michaelsen KF, et al. Breastfeeding and risk of atopic dermatitis, by parental history of allergy, during first 18 months of life. Am J Epidemiol. 2004;160:217-23.

Safri M, Kurniati N, Munasir Z. Elimination and provocation test in cow’s milk hypersensitive children. Paediatr Indones.2008;48:253-6.

von Berg A, Koletzko S, Grubl A, Filipiak-Pittroff B, Wichmann HE, Bauer CP, et al. The effect of hydrolyzed cow’s milk formula for allergy prevention in the first year of life: the German Infant Nutritional Intervention Study, a randomized double-blind trial. J Allergy Clin Immunol. 2003;111:533-40.

Caffarelli C, Baldi F, Bendandi B, Calzone L, Marani M, Pasquinelli P. Cow’s milk protein allergy in children: a practical guide. Ital J Pediatr. 2010;36:5.

Alexander DD, Schmitt DF, Tran NL, Barraj LM, Cushing CA. Partially hydrolyzed 100% whey protein infant formula and atopic dermatitis risk reduction: a systematic review of the literature. Nutr Rev. 2010;68:232-45.

How to Cite
Safri M, Putra AR. Early allergy symptoms in infants aged 0-6 months on breast milk substitutes. PI [Internet]. 1Mar.2015 [cited 17Apr.2024];55(1):13-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/100
Received 2016-07-12
Accepted 2016-07-12
Published 2015-03-01