Effect of Breast Feeding During the First 6 Months of Life on Development of Atopic Dermatitis in 1 year Old Infants

Document Type : Original Article

Authors

1 Associate Professor of Pediatrics.Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

2 Assistant Professor of Pediatrics.Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

3 Pediatrician.Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

4 Medical Doctor. Ahvaz City Health Center

5 Medical Doctor. Ahvaz City Health Center.

Abstract

Background and Objective: Atopic dermatitis is an inherited, chronic and relapsing skin disease. Although it is generally believed that breast-feeding has a protective effect on developing asthma and atopic dermatitis, nowadays, some researchers question this idea and suggest that breast feeding may be a risk factor for atopic dermatitis. The purpose of this study was to determine the effect of exclusive breast feeding in the first 6 month of life on development of atopic dermatitis in infants till one year of age.
Subjects and Methods: In this retrospective cohort study, parents of infants who visited four health centers in ahvaz, the capital of Khozestan province, Iran, for MMR vaccination at 12
 months of age were questioned about the kind of their infants feeding till 6 months age. Infants were divided to two groups, exclusive and non-exclusive breast- fed. The number of cases for each group was followed till 511 infants were reached. Frequency of atopic dermatitis in each group was investigated.
Results: Atopic dermatitis was noted in 22.3% of them. The prevalence of atopic dermatitis in non-exclusive breast fed infants was higher (P<0.001).  The frequency of atopic dermatitis in exclusively and non-exclusively breast-fed infants was 15.35 and 29.25 %  respectively. Odds ratio for exclusively breast fed infants was 19.36%, 95%CI (11.35%-19.58%) and for non-exclusively breast fed infants was 29.64%, 95%CI (25.26-34.07).
Conclusion: Exclusive breast feeding not only decrease the frequency of atopic dermatitis in infants, but also decrease the risk of development of atopic dermatitis in infants with positive family history for atopia. 

Keywords


1-Leung D, Eichenfield L, BoguniewiczM .Atopic dermatitis. In : Wolf K., Goldsmith L.,Katz S., Gillchrest B.A., Paller A.S., Leffell D., eds. Fitzpatrick's dermatology in general medicine. . New York: McGraw Hill; 2008. P.146-150.
2-Jones SM .The role of food allergy and other allergic disease in atopic dermatitis.Clin Rev Allergy Immunol 1999;17(3):293-321.
3-Sampson HA.Food sensitivity and the pathogenesis of atopic dermatitis. J R Soc Med 1997;90(Suppl 30):2-8
4-Proelss Y, Bieber TH. Atopic Dermatitis In: Kay A.B., Kaplan A., Bousquet J., Holt P.G. Allergy and Allergic Diseases. 2nd ed. West Sussex: Wiley-Blackwell; 2008. P.1813-25.
5-Heine RG, Hill DJ, Hosking CS. Primary prevention of atopic dermatitis in breast-fed infants: what is the evidence? J Pediatr 2004;144(5):564-7.        
6-Gdalevich M, Mimouni D, David M,Mimouni M. Breast-feeding and the onset of atopic dermatitis in childhood:a systematic review and meta-analysis of prospective studies.J Am AcadDermatol2001;45(4):520-7.
7-Pesonen M, Kallio MJ, Ranki A, Siimes MA. Prolonged exclusive breastfeeding is associated with increased atopic dermatitis: a prospective follow-up study of unselected healthy newborns from birth to age 20 years. ClinExp Allergy 2006;36(8):1011-8.
8-Sears MR, Greene JM, Willan AR, Taylor DR, Flannery EM, Cowan JO, et al.  Long-term relation between breastfeeding and development of  atopy and asthma in children and young adults: a longitudinal study.Lancet 2002;360(9337):901-7.
9-World Health Organization.Exclusive breastfeeding for six months best for babies everywhere. 2011.available at: www.who.int/.../news/.../2011/breasfeeding_20110115/en/index.htm.
10-Williams HC, Burney PG, Hay RJ, Archer CB, Shipley MJ, Hunter JJ, et al.  The U.K. Working Party's Diagnostic Criteria for Atopic Dermatitis. I. Derivation of a minimum set of discriminators for atopic dermatitis. Br J Dermatol 1994;131(3):383-96.
11- Larsen FS, Hanifin JM. Epidemiology of Atopic Dermatitis.Immunol Allergy Clinics NA 2002;22:1-25.
12-Kalyoncu AF, Stalenheim G. Survey on the allergic status in a turkish population in sweden. AllergolImmunopathol 1993;21(1):11-4.
13-Schultz Larsen F, Diepgen T, Svensson A. The occurance of atopic  dermatitis in north Europe: an international questionnaine study. J Am AcadDermatol 1996;34(5pt1):760-4.
14-Shahri P, Namadmalan M, Rafiee A, Haghighizadeh MH. A Case – Control study of Prevalence of Consanguineous Marriage Among Parents of Handicapped and Healthy Children in Ahvaz. SCi Med J 2010;9(5):473-82.
15-Friedmann PS, Ardern-Jones MR, Holden CA. Atopic Dermatitis In: Burns T, Breathnach S, Cox N , Criffiths C. Rook's Textbook Of Dermatology. 8th ed.  Chichester: Wiley- Blackwell; 2010. P. 24-3.
16-Schultz Larsen FV, Holm NV. Atopic dermatitis in a population based twin series. concordance rates and heritability estimation . Acta Derm Venereol Suppl (Stockh) 1985;114:159-63.
17-Lee YA, Wahn U, Kehrt R, Tarani L, Businco L, Gustafsson D, et al.  A major susceptibility locus for atopic dermatitis maps to chromosome 3q21. Nat Genet 2000;26(4):470-3.
18-Cookson WO, Ubhi B, Lawrence R, Abecasis GR, Walley AJ, Cox HE, et al. Genetic linkage of childhood atopic dermatitis to psoriasis susceptibility loci. Nat Genet 2001;27(4):372-3.
19-Bradley M, Söderhäll C, Luthman H, Wahlgren CF, Kockum I, Nordenskjöld M. Susceptibility loci for atopic dermatitis on chromosomes 3,13,15,17 and 18 in a Swedish population. Hum Mol Genet 2002;11(13):1539-48.
20-Haagerup A, Bjerke T, Schiøtz PO, Dahl R, Binderup HG, Tan Q, et al. Atopic dermatitis--a total genome-scan for susceptibility genes. ActaDermVeneral 2004;84(5):346-52.
21-Ghaderi R, Makhmalbaf Z. Effect of breast-feeding on the development of atopic dermatitis. Iran J Allergy Asthma Immunol 2005;4(3):129-32.
22-Casas R, Böttcher MF, Duchén K, Björkstén B. Detection Of IgA antibodies  to cat, bet-lactoglobulin, and ovalbumin allergens in human milk. J Allergy clinImmunol 2000;105(6pt1):1236-40.
23-Duchén K, Casas R, Fagerås-Böttcher M, Yu G, Björkstén B. Human milk polyunsaturated long-chain fatty acids and secretary immunoglobulin a antibodies and  early childhood allergy. Pediatr  Allergy Immunol 2000;11(1):29-39.