Fascinating - thanks for the long explanation and the citation!

Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre Ltd
6540 Cedarview Ct, Dayton OH 45459
ph 937-438-9458 www.BFLRC.com 


-----Original Message-----
From: Rachel Myr [mailto:[log in to unmask]] 
Sent: Monday, March 15, 2004 3:07 PM
To: Lactnet
Cc: 'Linda Smith'; [log in to unmask]; 'Naomi Bar-Yam'
Subject: CS and food allergy

Here is the *one* reference I have for my sweeping claim about food allergy
and cesarean section.  I heard the primary author (Eggesbø) present this in
a short talk at the European Congress on Perinatal Medicine in Oslo in June
2002 and through a miracle, managed to find her name and lo! it turned up on
PubMed, which is where this is cut and pasted from.  All the authors seem to
be associated with the Norwegian Institute of Public Health, Division of
Epidemiology, Oslo, Norway.  I hope the abstract comes through the listserv
without creative punctuation getting added; if not, you can access it
through PubMed.  I had to search for articles by 'Magnus P' to find it.

Eggesbø M, Botten G, Stigum H, Nafstad P, Magnus P. Is delivery by cesarean
section a risk factor for food allergy?  J Allergy Clin Immunol 2003
Aug;112(2):420-6
BACKGROUND: Cesarean delivery might delay the colonization of the newborn
intestine. A delayed or aberrant colonization process has been offered as an
explanation for the increase in allergic diseases. OBJECTIVE: The aim of
this study was to examine whether cesarean delivery and the use of
antibiotics were associated with subsequent food allergy. METHODS: In a
population-based birth cohort of 2803 children, information regarding mode
of delivery, maternal or infant use of antibiotics, and information on
potential confounders was obtained prospectively from parental reports and
the Norwegian Birth Registry. Parentally perceived reactions to egg, fish,
or nuts, as well as objectively confirmed reactions to egg at the age of 2
1/2 years, were chosen as outcomes. RESULTS: Among children whose mothers
were allergic, cesarean section was associated with a 7-fold increased risk
of parentally perceived reactions to egg, fish, or nuts (odds ratio, 7.0;
CI, 1.8-28; P =.005) and a 4-fold increased risk of confirmed egg allergy
(odds ratio, 4.1; CI, 0.9-19; P =.08) in a logistic regression analysis,
adjusting for pregnancy complications, birth weight, gestational length, and
socioeconomic factors. Among children whose mothers were not allergic, the
association was much weaker and not significant. Maternal or infant use of
antibiotics was not associated with an increased risk of food allergy.
CONCLUSION: The results indicate that in predisposed children cesarean
section might increase the risk of development of food allergy, which
supports the theory that factors interfering with the colonization process
might play a role in the development of food allergy.


This study made me wonder whether we were barking up the wrong tree in
looking at what babies are fed when searching for the cause of allergies.
At the same time that breastfeeding was increasing in exclusivity and
duration here, women were being meticulously disinfected just before birth
with something we call chlorhexidine, which I think may be hexachlorophene.
It was in an aqueous solution and I was taught to fill a sterile basin with
it and wash like crazy around the introitus to prevent there being any gut
bacteria near the baby at birth.  Every 'therapy' has effects and side
effects.  Perhaps one of the side effects here was delaying colonizing the
babies with their mothers' gut flora, and perhaps that is why allergic
disease really took off in the last 20-30 years here.  We don't wash with it
any more, haven't for about 10 years where I work, but I believe there are
some hospitals that still use it and at least one prominent obstetrician has
previously advocated DOUCHING with it every 4 hours in labor, to prevent
Group B Strep infection in the newborn.  At the hospital where she was in
charge, it was mandatory practice for all women in labor, if you can imagine
that.  Like the placement of the birth canal was just some kind of design
flaw or something.  Sheesh.

Rachel Myr
Kristiansand, Norway

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