The review group concluded that breastfeeding seems to protect from the development of atopic disease. The effect appears even stronger in children with atopic heredity. If breast milk is unavailable or insufficient, extensively hydrolysed formulas are preferable to unhydrolysed or partially hydrolysed formulas in terms of the risk of some atopic manifestations.

The anthroposophic lifestyle comprises several factors of interest for allergy development and is here shown to be associated with reduced risk of IgE sensitization already in infancy. Identifying the factors responsible for this association would be of significant clinical importance.

Background Improved quality of life (QoL) after oral immunotherapy (OIT) in peanut allergic children is often reported by their parents, while the child's perspective is less clear. Objective We aimed to explore whether 2 years of OIT improved QoL in children with peanut allergy and to identify factors influencing change in QoL. Methods In the open‐labeled TAKE‐AWAY peanut OIT trial including children with anaphylaxis to peanuts, 57 were randomized to OIT and 20 to observation. The Pediatric Quality of Life Inventory Version 4.0 was completed by parents and children at enrollment (Y0), after 1 year (end of updosing; Y1) and after 2 years (Y2) of OIT. Minimally clinically important difference (MCID) is ≥5.3. Perceived treatment burden was recorded by visual analogue scales, including adverse events (AEs). An open food challenge (OFC) was performed at Y2. Results At Y2, 18 children had discontinued OIT and 2 of 39 OIT children refused OFC, while 35 of 37 were desensitized to 7500 mg peanut protein. From Y0 to Y2, the mean change (95% confidence intervals) in QoL was 4.4 (0.5, 8.3) among child self‐reports and twice as large among parental proxy reports (9.3 [4.3, 14.3]; both P < 0.0001), without significant improvement among the controls. The change in QoL was significantly different from the controls for the parental proxy reports only (P = 0.002). Neither treatment burden nor AEs significantly predicted changes in QoL. Conclusion Two years of OIT improved child‐QoL as reported by parents, but not by the children, suggesting that parents may overestimate improvement in child‐QoL by OIT.

Background: Thanks to a successful voluntary vaccination programme, measles, mumps and rubella are rare diseases in Sweden. Coverage among children 18 mo of age has been 99%, but the measles, mumps and rubella vaccination (MMR) has increasingly been questioned among parents. Aim: To study reasons why parents choose not to vaccinate their child against measles, mumps and rubella, and their opinions on vaccines and the diseases themselves. A secondary objective was to compare coverage at 18 mo of age based on parental report with the national statistics based on patient charts. Methods: The official statistics were compared with patient charts for two birth cohorts in the city of Göteborg, Sweden. Out of these children born in 1995 and 1996, 300 unvaccinated and vaccinated children were identified. Their parents received a postal questionnaire assessing the parent's views on vaccines and childhood diseases. Results: The documented vaccine coverage in this study was higher in 1995 and 1996 than official statistics indicated. The major reason, for both groups, for accepting respectively declining vaccination was strengthening the child's immune system. Parents with children unvaccinated against MMR were also more likely to have declined vaccination against diphtheria, polio, tetanus, Haemophilus influenzae and pertussis. One‐third of the parents with a child unvaccinated against MMR had not yet made their final decision 3 y after the vaccine offer. Few parents, both with vaccinated and unvaccinated children, had acquired vaccine information from the Internet. Both groups believed that insufficient time was allocated for vaccine information and discussion at the Child Health Centre. Conclusion: Our study indicates that official statistics on MMR vaccination uptake underestimate the number of vaccinated children. Vaccine safety is a major concern for many parents and needs to be addressed by healthcare professionals at institutions offering paediatric vaccinations.

The peanut taste and texture can be hidden in a challenge medium. The fat content was important for the availability of the allergenic protein in challenges. The availability of allergens must be taken into consideration when used for DBPCFC.

Aim: To evaluate the efficacy of two different Swedish screening procedures for early detection of congenital cataracts in comparison with no screening. Methods: Children born between January 1992 and December 1998 in Swedish regions with an established eye‐screening routine procedure, diagnosed with congenital cataract, and operated on before 1 y of age, were included in a retrospective study. Age at referral and age at time of the operation were compared between regions using different screening procedures: screening in the maternity wards (Region 1), at the well‐baby clinics (Region 2) and one region without any screening (Region 3). Results: Seventy‐two children were included in the study. Concerning early diagnosis and surgery, Region 1 differed significantly from Regions 2 and 3, which were more similar and were combined for further analysis. The difference in detected cases was greatest at 21 d of age (55% vs 18%; p < 0.001), but persisted even at 100 d of age (78% vs 64%; p < 0.02). Region 1 screening resulted in more and earlier cases detected than the other two regions (22 vs 15 per 100000 births). In 72% of all cases, surgery was performed in response to referrals from either the maternity wards (36%), or the well‐baby clinics (36%). However, half of the cases from the well‐baby clinics were detected too late, i.e. at >100d. Conclusion: Eye screening in the maternity ward is preferable to well‐baby clinic screening and to no screening at all, since it leads to early detection. Screening should also be performed routinely at well‐baby clinics within the period when successful treatment is possible.

These results suggest that time of introduction of gluten was not in accordance with the current recommendation. The results imply that there is a need to follow up if and how this feeding information is distributed to parents with infants and also to sharpen the information to the right target groups, otherwise implementation of preventive strategies will be less useful.

Serum levels of interleukin (IL)-4, interferon (IFN)-γ and soluble CD23 (sCD23) were analysed in a prospective study of 64 infants monitored from birth to 18 months of age. The levels were low at birth and then increased, reaching a peak at either 6 or 9 months and then decreased up to 18 months of age. The children who developed atopic disease during the first 18 months of life had significantly higher IL-4 median levels than those who did not. No relationship was seen between the levels of sCD23 and IFN-γ and allergy. Thus, the IL-4 levels in serum, but not sCD23 and IFN-γ, were associated with allergic disease in infancy. Elevated levels were recorded before the onset of clinical symptoms, indicating that atopic disease is associated with a primary deviation of T cell function.