The Christchurch Child Development Study is a longitudinal study of a birth cohort of 1265 New Zealand children who have been studied over an 11-year period using data from multiple sources including parental interview, medical records, teacher questionnaires and direct testing of children. The article provides a review of the major lines of epidemiological research examined in the Study. These include: breast feeding and child health; parental smoking and child health; the effects of low level lead exposure; childhood asthma; nocturnal bladder control; the effects of early hospital admission; the distribution of child health services; and the consequences of private medical insurance. In addition a number of general topics (sample attrition, measurement error, individual differences and causal inference) relating to longitudinal designs are discussed briefly. It is concluded that the longitudinal design is a powerful and cost-effective method of gathering data for general paediatric epidemiological purposes but that research in this area would benefit from an increased use of emerging methods of statistical modelling.

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The relationship between parental atopy, breast-feeding, early solid food diet and the rate of eczema was studied in a birth cohort of 2-year-old children. Rates of eczema varied significantly with parental atopy and solid feeding: children of aiopic parents given solid food during the first 4 months had over two-and-a-half times the rate of eczema of children not given solid food and who had non-atopic parents. Further, rates of eczema increased in almosl direct proportion lo the number of diflerent types of solid food thai the child had been given during the first 4 months. Breast-feeding had no significant eflecl on rates of eczema.The resulls suggest that both parental atopy and diversity in early diet are factors which contribute towards rates of childhood eczema.

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SUMMARY The cumulative rate of childhood eczema during the first three years was studied in a birth cohort of 1265 New Zealand infants. A parental history of eczema was the strongest predictor of rates of childhood eczema but parental asthma was also related to childhood eczema. Children exposed to an early diverse solid-food diet also had increased risks of eczema, but there was no evidence to suggest that breast-feeding practices had any effect on rates of eczema. Analysis of the data suggested that the apparent association between exclusive breast-feeding and reduced rates of eczema reported in previous studies may be because exclusively breast-fed infants were not exposed to early solid feeding rather than to any beneficial effect of breast milk itself.There have been several studies of the effects of early infant feeding practices on rates of childhood eczema but these have tended to produce inconsistent results. Some studies have produced evidence to suggest that early breast-feeding practices-3 or the substitution of soy milk" may reduce the risk of eczema, but an equal number"-I have found no beneficial effects for breast-feeding or soy milk substitutes. A possible explanation of published inconsistencies was suggested by a recent study10 of rates of childhood eczema in a birth cohort of New Zealand children, which found that when parental atopy and early solid feeding practices were taken into account, there was no significant tendency for breast-fed infants to fare better than their bottle-fed peers. These results suggest that what has commonly been attributed to a beneficial effect of breast-feeding may have arisen because exclusively breast-fed infants are not exposed to solid food rather than to any particular benefit of breast milk.Many studies of the role of parental atopy on childhood eczema have combined such conditions as asthma, eczema, and allergic rhinitis into a single measure of atopy. It seems possible, however, that rates of childhood eczema will vary with the type of atopic response manifested by the child's parent so that children with a family history of eczema may be at greater risk than those with a family history of asthma or other atopic conditions.We report a further analysis of the rates of eczema in the birth cohort described above. The aims of the analysis were:(1) To examine the separate effects of parental asthma and eczema on rates of childhood eczema. 118(2) To examine the effects of early infant diet on rates of childhood eczema during the first three years of life.(3) To consider the role of early milk diet in the development of childhood eczema. MethodThe data were collected during the Christchurch Child Development Study in which a birth cohort of 1265 infants born in maternity units in the Christchurch (New Zealand) urban region has been studied at birth, four months, one, two, and three years.At each stage information on the child's health, social background, diet, and other factors was collected using a structured interview with the child's mother. Information on th...