A Prospective Study of Allergy in a Pediatric Population

Relationship of diet in the development of atopy in infancy

“…Fergusson et al (1983) have recently suggested that the effect of early breast feeding on preventing subsequent atopic disease may only be seen in children from highly atopic families. This concept seems to be supported by previous investigators studying general population samples who have found no protection (Mueller et al, 1963;Brown et al, 1969;Halpern et al, 1973;Fergusson et al, 1981Fergusson et al, , 1983. However even in infants with a strong family history of atopic disease the role of cow's milk avoidance in preventing atopic disease in infancy has varied, with some studies showing a protective effect (Johnstone & Dutton, 1966;Kaufman & Frick, 1976;Matthew et al, 1977;Chandra, 1979) and others no benefit (Dannaeus et al, 1978;Kjellman & Johansson, 1979;Gordon et al, 1982).…”

“…Grulee & Sanford (1936) were the first investigators to suggest that breast feeding protected against the development of eczema while Glaser and Johnstone (1953) suggested a similar effect with soy-bean formula. Several prospective studies have subsequently attempted to examine the role of cow's milk avoidance in preventing the development of atopic disease in infancy (Mueller et al, 1963;Johnstone & Dutton, 1966;Brown et al, 1969;Halpern et al, 1973;Kaufman & Frick, 1976;Matthew et al, 1977;Dannaeus, Johansson & Foucard, 1978;Kjellman & Johansson, 1979;Chandra, 1979;Saarinen et al, 1979;Fergusson et a/., 1981;Hide & Guyer, 1981;Gordon et al, 1982;Fergusson, Horwood & Shannon, 1983). These studies have been difficult to compare because of differences in design, including the choice of infant population, control of feeding, follow-up interval and type of follow-up employed.…”

“…In only five studies was the one investigator responsible for the clinical diagnosis of atopic disease (Johnstone & Dutton, 1966;Matthew et al, 1977;Dannaeus et al, 1978Kjellman & Johansson, 1979Saarinen et al, 1979). Results of the studies have varied with some showing a protective effect of breast milk or soy formula (Johnstone & Dutton, 1966;Kaufman & Frick, 1976;Matthew et al, 1977;Chandra, 1979;Saarinen et al, 1979) others a borderline effect (Brown et al, 1969;Hide & Guyer, 1981) while the remaining studies were unable to demonstrate any protective effect (Mueller et al, 1963;Halpern et al, 1973;Dannaeus et al, 1978;Kjellman & Johansson, 1979;Fergusson et al, 1981;Gordon et al, 1982;Fergusson et al, 1983). Recently Fergusson et al (1981) suggested that early introduction of solids rather than cow's milk may be the trigger for atopic dermatitis.…”

Infant feeding and allergy.

“…Table 5 shows the incidence of certain conditions during the first year of life according to whether the infants were breast fed and for how long, irrespective of their randomised allocation in the trial. The numbers of infants in this table are greater than those in table 4 owing to the inclusion of some who were excluded from the trial because their randomised allocation was uncertain. Wheeze occurred about twice as frequently in those never breast fed (125/293) as in those ever breast fed (41/189), the difference being highly significant (p<0-001).…”

How Common Is Food Allergy?

“…This review acknowledges a large element of overlap but not identity. The text (9) of only one of the series listed makes a specific epidemiological statement: "New cases of allergy among children under 1 year of age occurred at a rate of 11.2 per 100 children per year" (9). It is disturbing that this yielded an estimate in the higher range of published estimates of incidence, from which the reader cannot but conclude that the criteria are fairly broadly applied.…”