Exposure to cow’s milk as a prognostic factor for atopic dermatitis during the first three months of life
Abstract
Background The incidence of atopic dermatitis has increased inthe early life of children. Cow's milk, the first foreign protein to
which infants are exposed, is predicted to be a prognostic factor
of atopic dermatitis.
Objective To determine if exposure to cow's milk is a prognostic
factor for atopic dermatitis during the first three months oflife.
Methods We performed a cohort study involving 136 newborns
from families with and without histories of atopy in Sanglah
Hospital, Denpasar, between April to August 20 12. Subjects were
allocated into 2 groups, those who were exposed to cow's milk
(n=68) and not exposed to cow's milk (n=68). We analyzed
the impact of several possible prognostic variables on atopic
dermatitis at 3 months of age including exposure to cow's milk,
birth weight, sex, gestational age, exposure to cigarette smoke,
early solid feeding, and history of atopy in the mother, the father,
or both, as well as maternal consumption of chicken eggs when
nursing. Data were analyzed with Cox's proportional hazard
function. The cumulative incidence and incidence rate in each
group were calculated.
Results Exposure to cow's milk in the first 3 months of life
resulted in a cumulative incidence of atopic dermatitis of 17 .6%,
with an incidence rate of atopic dermatitis of 54.5%. However,
multivariate analysis showed that cow's milk exposure was not
a significant prognostic factor for atopic dermatitis (HR 1.3 7;
95%CI 0.22 to 8.43).
Conclusion Cow's milk exposure is not a prognostic factor of
atopic dermatitis during the first three months of life
References
Beck LA. Atopic dermatitis. In: Lichtenstein LM, editor. Curren t therapy in allergy, immunology and rheumatology. 6th ed. Philadelphia: Elsevier Inc; 2004. p. 88-94.
Sicherer SH, Sampson AH. Atopic dermatitis. In: Stiehm RE, editor. Immunologic disorders in infants and children. 5th ed. Philadelphia: Elsevier Inc; 2004. p. 980-1.
Leung DYM. Atopic dermatitis. In: Leung DYM, Sampson HA, editors. Pediatric allergy, principles and practice. Philadelphia: Mosby; 2003. p. 561-6.
Williams HC. Clinical practice: atopic dermatitis. N Engl J Med. 2005;352:2314-24.
WolfRL. Atopic dermatitis. In: Shanahan], editor. Essential pediatric allergy, asthma &immunology. New York: McGraw Hill; 2004. p. 38-40.
Yunginger JW. Outdoor allergen. In: Leung DYM, Sampson HA, editors. Pediatric allergy, principles and practice. Philadelphia: Mosby; 2003. p. 252-9.
Terr AI. The atopic diseases. In: Parslow GT, editor. Medical immunology. l0th ed. Singapore: McGraw-Hill; 2001. p. 349-66.
Finlay AY. The burden of atopic eczema. In: Ring J, editor. Handbook of atopic eczema. 2nd ed. New York: Springer; 2006. p. 31-3.
Warner JO. Allergy practice worldwide, a report by the world allergy organization specialty and training council. Allergy Clin Immunol Int. 2006;18:4-10.
Sugiyama M, Arakawa H, Ozawa K, Mizuno T, Mochizuki H, Tokuyama K, et al. Early life risk factors for occurrence of atopic dermatitis d uring the first year. Pediatrics. 2007;119:71 6-23.
Scafer T. Epidemiology of atopic eczema. In: Ring J, editor. Handbook of atopic eczema. 2nd ed. New York: Springer; 2006. p. 21-7 .
Host A, Halken S, Jacobsen HP, Christensen AE, Herskind AM, Flesner K. Clinical course of cow's milk protein allergy/ intolerance and atopic diseases in childhood. Pediatr Allergy Immunnol. 2002;13:23-8.
Laubereau B. Effects of breast feeding of the development of atopic dermatitis during the first 3 years of life-results from the GINI birth cohort study. J Pediatr. 2004;144:602-7.
Greer FR, Sicherer SH, Burks AW, American Academy of Pediatrics Committee on Nutrition. Effects of early nutritional interventions on the development of atopic disease in infants and children: The role of maternal dietary restriction , breastfeeding, timing ofintrod uction of complementary foods, and hydrolyzed formulas . Pediatrics. 2008;121:183-91.
Shinohara M, Saito H, Matsumoto K. Different timings of prenatal or postnatal tobacco smoke exposure have different effects on the development of a topic eczema/dermatitis syndrome (AEDS) during infancy. J Allergy Clin Immunol. 2011;12:813-7.
Gdalevich M, Mimouni D, David M, Mimouni M. Breast-feeding and the onset of atopic dermatitis in childhood : a systematic review and meta-analysis of prospective studies. J AmAcad Dermatol. 2001;45:520-7.
Gustafsson D, Lowhagen T, Andersson K. Risk of developing a topic diseases after early feeding with cow's milk based formula. Arch Dis Child. 1992;67:1008-10.
Liu AH, Martinez FD, Taussig LM. Natural history of allergic diseases and asthma. In: Leung DYM, Sampson HA, editors. Pediatric allergy, principles and practice. Philadelphia: Mosby; 2003. p.10-1.
Budiastuti M. Hubungan antara pemberian ASI eksklusif dengan kejadian dermatitis atopi pada bayi risiko tinggi alergi [master's thesis]. [Yogyakarta]: Bagian Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Gadjah Mada; 2008.
Moore MM, Rifas-Shiman SL, Rich-Edwards JW, Kleinman 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.
Snijders BE, Thijs C, van Ree R, van den Brandt PA. Age at first introduction of cow milk products and other food products in relation to infant atopic manifestations in the first 2 years oflife: the KOALA Birth Cohort study. Pediatrics. 2008;122:115-22.
Morgan J, Williams P, Norris F, Williams CM, Larkin M, Hampton S. Eczema and early solid feeding in preterm infants. Arch Dis Child. 2004;89:309-14.
Zutavern A, Brockow I, Schaaf B, Bolte G, von Berg A, Diez U, et al. Timing of solid food introduction in relation to atopic dermatitis and atopic sensitization: results from the prospective birth cohort study. Pediatrics. 2006;117:401- 11.
Trahms CM. Nutrition during infancy. In: Mahan LK, editor. Krause's food, nutrition, & diet therapy. 11th ed. Philadelphia: Saunders; 2004. p. 220-2.
Lopez N, de Barros-Mazon S, Vitela MM, Silva CM, Ribeiro JD. Genetic and environmental influences on atopic immune responses in early life. J Investig Allergol Clin Immunol. 1999;9:392-8.
Vadas P, Wai Y, Burks W, Perelman B. Detection of peanut allergens in breast milk of lactating women. JAMA. 2001;285: 1746-8.
Lovegrove JA, Hampton SM, Morgan JB. The immunologic and long-term atopic outcome of infants born to women following a milk-free diet during pregnancy and lactation: a pilot study. Br J Nutt. 1994;71:223- 38.
Lack G, Fox D, Northstone K, Golding, Avon Longitudinal Study of Parents and Children Study Team. Factors associated with the development of peanut allergy in childhood. N Engl J Med. 2003;348:977-85.
Yi O, Kwona HJ, Kim H, Ha M, Hong SJ, Leem JH, et al. Effect of environmental tobacco smoke on atopic dermatitis among children in Korea. Environ Res. 2012;113:40-5.
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Accepted 2016-08-16
Published 2014-02-28
