Breast-feeding of allergic infants

• Published in: The Journal of pediatrics Vol. 134; no. 1; pp. 27 - 32
• Main Authors: Isolauri, Erika, Tahvanainen, Annette, Peltola, Terttu, Arvola, Taina
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 1999; Elsevier; Mosby-Year Book, Inc
• Subjects: Allergic diseases; Biological and medical sciences; Breast Feeding - adverse effects; Breast Feeding - psychology; Child Development; Dermatitis, Atopic - classification; Dermatitis, Atopic - etiology; Diet; Female; Humans; Immunopathology; Infant; Infant, Newborn; Medical sciences; Milk, Human - chemistry; Mothers - psychology; Nutritional Status; Severity of Illness Index; Skin allergic diseases. Stinging insect allergies; Surveys and Questionnaires; Weaning; ln; Human; Immunopathology; Allergy; Evaluation; Skin disease; Eczema; Sensitization; Breast feeding; Child; Atopy
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(99)70368-9

Objective: Infants may have allergic disease even during exclusive breast-feeding. The aim of this study was to evaluate whether allergic infants should continue breast-feeding.
Study design: We studied 100 infants who had atopic eczema during exclusive breast-feeding. The extent and severity of the eczema, allergic sensitization, and the patients’ growth and nutrition were assessed during and after cessation of breast-feeding.
Results: The mean body length SD score decreased at the onset of allergic disease, and an association was seen between the duration of symptoms and poor growth (r = –.23,
P = .04). Some improvement could be achieved by strict elimination diet by the mothers. The atopic eczema improved significantly after breast-feeding was stopped: SCORAD score 20 (range 15 to 27) during and 7 (range 4 to 11) after breast-feeding; t = 5.38,
P < .0001, and the relative length of patients increased, in parallel with improved nutritional parameters.
Conclusions: Breast-feeding should be promoted for primary prevention of allergy, but breast-fed infants with allergy should be treated by allergen avoidance, and in some cases breast-feeding should also be stopped. This particularly applies to infants with atopic eczema who also have impaired growth. (J Pediatr 1999;134:27-32)