Cow’s milk exposure and atopic dermatitis after six months of age

  • Surya Jayanti Kadek Udayana University
  • Dewi Kumara Wati Ketut Udayana University
  • Karyana Putu Gede Udayana University
Keywords: cow’s milk exposure, association, atopic dermatitis

Abstract

Background About 60% of individuals with atopic dermatitis (AD) develop their first manifestation during infancy. Cow’s milk (CM) exposure is considered to be a risk factor for AD.

Objective To evaluate for an association between cow’s milk exposure and atopic dermatitis in infants > 6 months of age.  

Methods This cross-sectional study consisted of subjects from a previous study and new subjects recruited in order to meet the minimum required number of subjects. Our study population comprised 120 infants, born between 1 February and 30 November, 2012 in Sanglah Hospital, Denpasar. Subjects were divided into CM and non-CM groups and analyzed for their risk of AD. Subjects were included to CM group if they were fed with cow’s milk/formula  and included to non-CM group if they were breastfeed exclusively in the first six months of life. Other possible risk factors were assessed by multivariate analysis. 

Results One hundred twenty subjects were enrolled and analyzed (59 in the CM and 61 in the non-CM groups). The prevalence of AD was 30%. Multiple logistic regression analysis revealed a significant association between CM exposure and AD, with odds ratio (OR) 2.37 (95%CI 1.036 to 5.420; P=0.04). In addition, maternal diet including eggs and/or cow’s milk during the breastfeeding period was significantly associated with AD in infants (OR 3.18; 95%CI 1.073 to 9.427; P=0.04).

Conclusion Cow’s milk exposure is significantly associated with atopic dermatitis in infants  > six months of age. 

References

1. Schoetzau A, Filipiak-Pittroff B, Franke K, Koletzko S, Von Berg A, Grubl A, et al. Effect of exclusive breastfeeding 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.
2. Liu AH. The allergic march of childhood. MedSci Update. 2006; 23:1-7.
3. Weinberg EG. The atopic march. Curr Allergy Clin Immunol. 2005; 18:4-5.
4. Chandra RK, Puri S, Cheena PS. Predictive value of cord blood IgE in the development of atopic disease and role of breast-feeding in its prevention. Clin Allergy. 1985; 15:517-22.
5. Kramer MS, Chalmers B, Hodnett ED, Sevkoskaya Z, Dzikovich I, Shapiro S, et al. Promotion of Breastfeeding Intervetion Trial (PROBIT): a randomized trial in the Republic of Belarus. JAMA. 2001; 285:413-20.
6. Friedman NJ, Zeiger RS. The role of breast-feeding in the development of allergies and asthma. J Allergy Clin Immunol. 2005; 115:1238-48.
7. Widyanti PA, Prawirohartono EP, Kumara Wati DK. Exposure to cow’s milk as a prognostic factor of atopic dermatitis in the first three months of life. Paediatr. Indones. 2014; 54:28-34.
8. Budiastuti M. Association of exclusive breastfeeding with incidence of atopic dermatitis on high allergy risk infant [master’s thesis]. [Yogyakarta]: Gadjah Mada University; 2008.
9. Jenmalm MC, Bjorksten B. Exposure to cow’s milk during the first 3 months of life is associated with increased levels of IgG subclass antibodies to β-lactoglobulin to 8 years. J Allergy Clin Immunol. 1998; 102:671-8.
10. Weston WL, Howe W. Pathogenesis, clinical manifestations, and diagnosis of atopic dermatitis (eczema). Up to Date Wolters Kluwer Health. 2013 June; [cited 2013 Aug 30]. Available from: http://www.uptodate.com/contents/pathogenesis-clinical-manifestations-and-diagnosis-of-atopic-dermmatitis-eczema?source=outline_link&view=text#references.
11. Oddy WH, Holt PG, Sly PD, Read AW, Landau LI, Stanley FJ, et al. Association between breastfeeding and asthma in 6 year old children: findings of a prospective birth cohort study. BMJ. 1999; 319:815-9.
12. Cantani A. Immunological properties of breast milk: a prospective study in 589 children. Interdiscip J Microinflammation. 2014; 1:1-14.
13. American Academy of Pediatrics Committee on Nutrition. Hypoallergenic infant formulas. Pediatrics. 2000; 106:346-9.
14. Lien TY, Goldman RD. Breastfeeding and maternal diet in atopic dermatitis. Can Fam Physician. 2011; 57:1403–5.
15. Ruiz RG, Kemeny DM, Price JF. Higher risk of infantile atopic dermatitis from maternal atopy than from paternal atopy. Clin Exp Allergy. 1992; 22:762-6.
16. Aberg N. Familial occurrence of atopic disease: genetic versus environmental factors. Clin Exp Allergy. 1993; 23:829-34.
17. Aberg N, Engstrom I, Lindberg U. Allergic diseases in Swedish school children. Acta Paediatr Scand. 1989; 78:246-52.
Published
2017-01-16
How to Cite
1.
Kadek SJ, Ketut DKW, Putu Gede K. Cow’s milk exposure and atopic dermatitis after six months of age. PI [Internet]. 16Jan.2017 [cited 29Mar.2024];56(6):325-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/441
Section
Pediatric Allergy Immunology
Received 2016-09-04
Accepted 2016-12-14
Published 2017-01-16