Impact of early feeding on childhood eczema: development after nutritional intervention compared with the natural course – the GINIplus study up to the age of 6 years

Berg, Andrea von; Krämer, Ursula; Link, Elke; Bollrath, Christina; Heinrich, Joachim; Brockow, Inken; Koletzko, Sibylle; Grübl, A.; Filipiak-Pittroff, Birgit; Wichmann, Heinz‐Erich; Bauer, Carl‐Peter; Reinhardt, D.; Berdel, Dietrich

doi:10.1111/j.1365-2222.2009.03444.x

Cited by 126 publications

(106 citation statements)

References 32 publications

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“…The design of the study, details of recruitment, randomization, blinding and allocation of the formulas, outcome definitions, and results from the one‐, three‐, six‐, and ten‐year follow‐ups have been published previously 21, 25, 26, 27, 28. In brief, between September 1995 and July 1998, a total of 2252 healthy term newborns at high risk of allergy were recruited in two regions in Germany (Wesel, Munich) and randomly allocated at birth to one of four blinded study formulas using a computer‐generated list.…”

Section: Methodsmentioning

confidence: 99%

“…Data on the long‐term effectiveness of these interventions are important because asthma and especially AR risk increase during adolescence. The German Infant Nutritional Intervention (GINI) study allows a longitudinal evaluation of the long‐term impact of hydrolyzed formulas on allergic outcomes in 2252 children with a positive family history for allergic diseases, which were randomized at birth to three different hydrolyzed formulas or standard cow′s milk formula 25, 26, 27, 28.…”

mentioning

confidence: 99%

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Allergic manifestation 15 years after early intervention with hydrolyzed formulas – theGINIStudy

Berg

Filipiak-Pittroff

Schulz

et al. 2015

Allergy

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BackgroundData on the long‐term impact of hydrolyzed formulas on allergies are scarce.ObjectiveTo assess the association between early intervention with hydrolyzed formulas in high‐risk children and allergic outcomes in adolescence.Methods GINI trial participants (n = 2252) received one of four formulas in the first four months of life as breastmilk substitute if necessary: partial or extensive whey hydrolyzate (pHF‐W, eHF‐W), extensive casein hydrolyzate (eHF‐C) or standard cow′s milk formula (CMF) as reference. Associations between these formulas and the cumulative incidence and prevalence of parent‐reported physician‐diagnosed asthma, allergic rhinitis (AR) and eczema, as well as spirometric indices and sensitization, were examined using generalized linear models.ResultsBetween 11 and 15 years, the prevalence of asthma was reduced in the eHF‐C group compared to CMF (odds ratio (OR) 0.49, 95% confidence interval (CI) 0.26–0.89), which is consistent with the spirometric results. The cumulative incidence of AR was lower in eHF‐C (risk ratio (RR) 0.77, 95% CI 0.59–0.99]) and the AR prevalence in pHF‐W (OR 0.67, 95% CI 0.47–0.95) and eHF‐C (OR 0.59, 95% CI 0.41–0.84). The cumulative incidence of eczema was reduced in pHF‐W (RR 0.75, 95% CI 0.59–0.96) and eHF‐C (RR 0.60, 95% CI 0.46–0.77), as was the eczema prevalence between 11 and 15 years in eHF‐C (OR 0.42, 95% CI 0.23–0.79). No significant effects were found in the eHF‐W group on any manifestation,nor was there an effect on sensitization with any formula.ConclusionIn high‐risk children, early intervention using different hydrolyzed formulas has variable preventative effects on asthma, allergic rhinitis and eczema up to adolescence.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Allergic manifestation 15 years after early intervention with hydrolyzed formulas – theGINIStudy

Berg

Filipiak-Pittroff

Schulz

et al. 2015

Allergy

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“…1 times higher risk for eczema than children without a familial predisposition. In other words, the data demonstrate that early intervention with hydrolysed infant formulas can substantially compensate up until the age of 6 years for an enhanced risk of childhood eczema due to familial predisposition to allergy (31) . Meta-analysis of clinical trial and intervention studies was conducted and included a total of eighteen articles on hydrolysed infant formula and the risk of atopic dermatitis.…”

Section: Hydrolysed Formulamentioning

confidence: 99%

“…In conclusion, exclusive breast-feeding should be encouraged as the standard for infant nutrition in the first months of life (29,30) . However, when infants are not exclusively breastfed, partially hydrolysed formula may be considered an effective measure to potentially reduce the risk of developing atopic dermatitis (3,6,30,31) .…”

Section: Hydrolysed Formulamentioning

confidence: 99%

“…When infants are not exclusively breastfed, partially hydrolysed formula (infant formula where cow's milk proteins were modified by hydrolysation processes) may be considered an effective measure to potentially reduce the risk of developing atopic dermatitis (3,6,(29)(30)(31) . Specifically, it was observed that feeding with partially-hydrolysed wheyprotein formula instead of intact protein cow's milk formula reduces the risk of atopic dermatitis in infants, particularly in infants with a family history of allergy (3,6,13,14,29) .…”

Section: Hydrolysed Formulamentioning

confidence: 99%

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Infant nutrition and allergy

Mišak

2011

Proc. Nutr. Soc.

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Over the past several decades, the incidence of atopic diseases such as asthma, atopic dermatitis and food allergies has increased dramatically. Although atopic diseases have a clear genetic basis, environmental factors, including early infant nutrition, may have an important influence on their development. Therefore, attempts have been made to reduce the risk of the development of allergy using dietary modifications, mainly focused on longer breast-feeding and delayed introduction or elimination of foods identified as potentially most allergenic. Recently, there is also an increasing interest in the active prevention of atopy using specific dietary components. Many studies have shown that breast-feeding may have the protective effect against future atopic dermatitis and early childhood wheezing. Concerning complementary feeding, there is evidence that the introduction of complementary foods before 4 months of age may increase the risk for atopic dermatitis. However, there is no current convincing evidence that delaying introduction of solids after 6 months of age has a significant protective effect on the development of atopic disease regardless of whether infants are fed cow's milk protein formula or human subject's milk, and this includes delaying the introduction of foods that are considered to be highly allergic, such as fish, eggs and foods containing peanut protein. In conclusion, as early nutrition may have profound implications for long-term health and atopy later in life, it presents an opportunity to prevent or delay the onset of atopic diseases.

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Infant formulas containing hydrolysed protein for prevention of allergic disease and food allergy

Osborn

Sinn

Jones

2017

Cochrane Database of Systematic Reviews

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We found no evidence to support short-term or prolonged feeding with a hydrolysed formula compared with exclusive breast feeding for prevention of allergy. Very low-quality evidence indicates that short-term use of an EHF compared with a CMF may prevent infant CMA.In infants at high risk of allergy not exclusively breast fed, very low-quality evidence suggests that prolonged hydrolysed formula feeding compared with CMF feeding reduces infant allergy and infant CMA. Studies have found no difference in childhood allergy and no difference in specific allergy, including infant and childhood asthma, eczema and rhinitis and infant food allergy.Very low-quality evidence shows that prolonged use of a partially hydrolysed formula compared with a CMF for partial or exclusive feeding was associated with a reduction in infant allergy incidence and CMA incidence, and that prolonged use of an EHF versus a PHF reduces infant food allergy.

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Impact of early feeding on childhood eczema: development after nutritional intervention compared with the natural course – the GINIplus study up to the age of 6 years

Abstract: Although direct comparability is somewhat restricted, the data demonstrate that early intervention with hydrolysed infant formulas can substantially compensate up until the age of 6 years for an enhanced risk of childhood eczema due to familial predisposition to allergy.

Cited by 126 publications

References 32 publications

Allergic manifestation 15 years after early intervention with hydrolyzed formulas – theGINIStudy

Allergic manifestation 15 years after early intervention with hydrolyzed formulas – theGINIStudy

Infant nutrition and allergy

Infant formulas containing hydrolysed protein for prevention of allergic disease and food allergy

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