The appearance and course of serum immunoglobulin E-antibodies (IgE-ab) to egg-white (EW), cow's milk (CM) and inhalants (pollen, danders and mite) were followed from birth to 12 years of age in 84 children unselected for family history of atopy. During the follow-up 36 children developed atopic symptoms and 48 children did not. IgE-ab to EW and CM reached a peak prevalence at 8 months of age--with high concentrations almost exclusively in atopics and disappeared successively during childhood. IgE-ab to inhalants appeared from 2 years of age and then in increasing frequency during childhood. Similar to the pattern of IgE-ab to EW and CM, transient low levels of IgE-ab to inhalants were commonly encountered in non-atopic children while high concentrations without tendency to decline were almost exclusively seen in atopics. High responders to EW-antigen during infancy were usually also high responders to inhalants during childhood. Clinical allergy to EW and CM and subsequent tolerance appeared early in childhood, whereas allergy to inhalants appeared later and did not disappear. The temporary low-grade IgE antibody response in non-atopic individuals to eaten and inhaled allergens is similar to the results of animal studies demonstrating a transient IgE production followed by tolerance.

Summary The appearance of symptoms suggestive of allergy through the first 4 years of life was studied prospectively in eighty‐six healthy newborn babies. Blood samples were obtained at birth, at 3,8,25 and 48 months of age and analyzed for levels of total serum IgE and for IgE antibodies to some common foods. The occurrence of IgE antibodies was related to atopic manifestations and to a detailed history of infant feeding and family history of allergy. All infants with elevated cord blood IgE (more than 1.3 kU/1) developed manifestations of atopy. Specific IgE antibodies against egg, cow's milk and soy were demonstrated at 3, 8, 25 and 48 months in nine, twenty‐three, six and two children respectively. Egg was a more potent sensitizing agent than cow's milk, IgE antibodies to egg being present in thirty‐one samples, to cow's milk in eleven and to soy in five samples. Nine infants developed IgE antibodies to eggs or cow's milk before the introduction of these nutrients into the food. The IgE antibody levels were generally low in healthy non‐atopic children and did, with one exception, not reach RAST class 1. In contrast, the levels of IgE antibodies to egg or cow's milk were higher in eleven blood samples from atopic children. We conclude that transient low IgE antibody responses to food proteins appear relatively often even in healthy infants. High concentrations of IgE antibodies however are almost exclusively seen in infants with atopic disease. Sensitization may appear early in infancy sometimes even before the offending food has been introduced into the diet.

SummaryA group of eighty‐six children followed from birth to 4 years of age and previously reported was now re‐investigated at the age of 7 years. The prevalence of atopy/allergy was 15%. All of the children with current atopy/allergy had had previous manifestations during their first 4 years of life. No child was allergic to milk at the age of 7 years and only two of the six children with a previous allergy to eggs retained their allergy. No other children had developed allergies to milk or eggs. Only one of the eight children with an elevated level of IgE antibodies to egg white (RAST class I or more) during infancy still had increased concentrations of such antibodies. No child had developed an elevated level of IgE antibodies to egg white or milk after the first year of life. Clinical allergies to inhalants had increased from 1% at 4 years of age to 7% at 7 years. Children with elevated levels of IgE antibodies to inhalants had increased from 7% at 4 years of age to 10% at 7 years. The majority of them had had increased levels of IgE antibodies to egg white during infancy. The specificity of an elevated level of cord blood IgE, i.e. above 0.9 kU/1 for predicting atopy/allergy during the first 7 years of life and for current atopy/allergy at 7 years of age were both 95%. The corresponding figures for presence of elevated levels of IgE antibodies to egg white (positive RAST) during infancy were 98 and 97%, respectively. The sensitivity of the cord blood IgE predictor was 14 and 17%. respectively and for a positive RAST to egg white during infancy 32 and 50%, respectively.

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Atopic/allergic manifestations and skin-prick tests (SPT) to egg white, cow's milk (CM) and fish were evaluated during the first 18 months of life in two matched groups of infants with a family history of atopy/allergy. In one group (n = 65) the mothers had a diet free from eggs, CM and fish during the first 3 months postpartum, whereas the mothers in the other group (n = 50) consumed an ordinary diet. The diet of the infants was similar in both groups, i.e. CM was not supplied until 6 months of age, and eggs and fish not until 9 months of age. The incidence of atopic dermatitis was significantly lower in the maternal diet group during the first 6 months postpartum (10.8 and 28%, respectively) but not after that age. Other atopic/allergic manifestations did not differ and the number of positive SPT to egg white, CM or fish at 9 months of age was similar in both groups.