Risk factors in childhood eczema.

Abstract

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...

Asthma and infant diet.

“…Of the eight studies reporting positive benefits, five2-5 8 were based on samples of children chosen for a clear history of parental atopy, one study6 was based on a general population sample in which children of atopic parentage were thought to be over-represented, and only two' 7 were based on population samples. In contrast, of the six studies (including the present study) which have found no benefits, five9-11 13 have been based on population samples and one12 on a case control design. This correlation between methods of sample selection and reports of benefits for breast feeding strongly suggests that a correlation between breast feeding and reduced risks of atopic disease may exist only for children with a clear and perhaps severe family history of atopy.…”

“…The method of data collection has been described in previous papers." 13 The following measures were chosen for analysis:…”

Timing of Solid Food Introduction in Relation to Eczema, Asthma, Allergic Rhinitis, and Food and Inhalant Sensitization at the Age of 6 Years: Results From the Prospective Birth Cohort Study LISA

“…A recent review 4 identified only a few studies with conflicting results on the relationship between early introduction of solids and the development of allergic disease. [5][6][7][8][9][10] We recently published results of the Influences of Lifestyle-Related Factors on the Immune System and the Development of Allergies in Childhood (LISA) study, a large, prospective, population-based birth cohort study on asthma and allergic disease. 11 In this cohort, there was no clear evidence of a protective effect of a delayed introduction of solids (past 4 or 6 months) on the development of eczema or sensitization at 2 years of age; however, asthma and allergic rhinitis were not investigated because these conditions play a minor role and diagnosis is difficult at this age.…”

The epidemiology and experience of atopic eczema during childhood: a discussion paper on the implications of current knowledge for health care, public health policy and research

“…For example, the Danish study by Shultz-Larsen et al involving atopic twins found that among monozygotic twins there was 85% concordance compared with 21% for dizygotic twins. Fergusson et al 26 interviewed the mothers of a birth cohort of 1265 infants delivered in maternity units in an urban region in New Zealand, supplemented by diaries kept by the mothers and by attendance records for the community nurse. This study found that the perinatal risk of atopic eczema was almost double for those children with a parental history of eczema compared with those with no parental history.…”