Pediatric Allergy and Immunology Volume 13 Issue 4 Page 234 - August 2002
Effect of exclusive breast-feeding
and early solid food avoidance on the incidence of atopic dermatitis in
high-risk infants at 1 year of age
Angela Schoetzau1,
Birgit Filipiak-Pittroff1,
Käthe Franke1,
Sibylle Koletzko2,
Andrea von Berg3,
Armin Gruebl4,
Carl Peter Bauer4,
Dietrich Berdel3,
Dietrich Reinhardt2
and H.-Erich Wichmann1,5,
for the GINI Study Group5
The aim of this study was to assess
the preventive effect of exclusive breast-feeding and early solid food
avoidance on atopic dermatitis (AD) in infancy. This study is part of a
dietary clinical trial in a prospective cohort of healthy term newborns at
risk of atopy. It was recommended to breast-feed for at least 4 months and
to avoid solid food in the same time-period. Eight hundred and sixty-five
infants exclusively breast-fed, and 256 infants partially or exclusively
formula-fed, were followed-up until the end of the first year following
birth. AD and sensitization to milk and egg were considered as study
end-points. The 1-year incidence of AD was compared between the two study
groups. Adjusted odds ratios (OR) with 95% confidence intervals (CI) were
calculated by multiple logistic regression. The incidence of AD was
calculated in relation to age at introduction of solid food and amount of
food given. In the breast-fed group, the adjusted OR for AD was 0.47 (95% CI
0.30-0.74). The strongest risk factor was the occurrence of AD in the
subject's core family. The risk of infants with AD to be sensitized to milk
was four times higher, and to egg eight times higher, than in infants
without AD. Age at first introduction of solid food and diversity of solid
food showed no effect on AD incidence. We conclude that in infants at atopic
risk, exclusive breast-feeding for at least 4 months is effective in
preventing AD in the first year of life.
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