Premature Birth May Alter Effect of Early Feeding Patterns on Allergy



NEW YORK (Reuters Health) Mar 24 - Delaying the introduction of solid food
does not seem to protect infants from becoming allergic unless they are
born prematurely, according to two separate reports in the Archives of
Disease in Childhood for April.

In one, Dr. Anne Zutavern at University Children's Hospital in Munich,
Germany, and associates prospectively followed 642 children up until 5.5
years of age. When children were 1 year old, their mothers reported when
different foods were introduced into the babies' diets. At final follow-up,
persistent wheezing was present in 18.9%, atopy in 16.7% and eczema in
35.4%.

Except for egg and milk, age when foods were introduced into the diet did
not affect the development of hypersensitivity. In contrast to other
reports, late introduction of milk or egg was linked to an increased risk
of eczema after correcting for parental atopy, smoking, gender, maternal
factors and breast feeding history. The adjusted odds ratio was 1.7 for
milk introduced after 6 months of age, and it was 1.6 for egg introduced
after 8 months.

These findings are in accord with those of a study reported at this year's
annual meeting of the American Academy of Allergy, Asthma and Immunology
(See Reuters Health report, March 23, 2004).

Their results "do not support the recommendations given by the guidelines
for the prevention of asthma and allergy in general populations stating
that the introduction of solids should be delayed for at least 4 to 6
months," Dr. Zutavern's group concludes.

There are no data regarding feeding practices for preterm infants to
prevent allergic disease, Dr. Jane Morgan and colleagues at the University
of Surrey in Guildford, UK, note in the second report. They studied 257
infants born before 37 weeks gestation, and took into account gender,
gestational age, parental atopy and smoking, and the presence of pets or
siblings.

For infants to whom four or more solid foods had been introduced by 17
weeks post-term, the adjusted odds ratio for eczema at 12 months of age was
3.49 compared with fewer foods introduced by the same time. Risk was also
increased nearly 3-fold by having an atopic parent or by introduction of
any solid food before 10 weeks of age.

Existing guidelines are based on limited evidence and on studies whose
findings are probably confounded by reverse causality, Drs. G. A. Khakoo
and G. Lack at St. Mary's Hospital in London suggest in an Archives
commentary.

"These studies add to the current conflicting literature, which taken as a
whole does not allow an authoritative statement to be made regarding the
relation between the introduction of solids and the development of
allergy," they add.

Arch Dis Child 2004;89:295,303-314.

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html