Cows milk exposure and atopic dermatitis after six months of age

Abstract Background About 60% of individuals with atopic dermatitis (AD) develop their first manifestation during infancy. Cow’s milk (CM) exposure is considered to be a risk factor for AD. Objective To evaluate for an association between cow’s milk exposure and atopic dermatitis in infants > 6 months of age. Methods This cross-sectional study consisted of subjects from a previous study and new subjects recruited in order to meet the minimum required number of subjects. Our study population comprised 120 infants, born between 1 February and 30 November, 2012 in Sanglah Hospital, Denpasar. Subjects were divided into CM and non-CM groups and analyzed for their risk of AD. Subjects were included to CM group if they were fed with cow’s milk/formula and included to non-CM group if they were breastfeed exclusively in the first six months of life. Other possible risk factors were assessed by multivariate analysis. Results One hundred twenty subjects were enrolled and analyzed (59 in the CM and 61 in the non-CM groups). The prevalence of AD was 30%. Multiple logistic regression analysis revealed a significant association between CM exposure and AD, with odds ratio (OR) 2.37 (95%CI 1.036 to 5.420; P=0.04). In addition, maternal diet including eggs and/or cow’s milk during the breastfeeding period was significantly associated with AD in infants (OR 3.18; 95%CI 1.073 to 9.427; P=0.04). Conclusion Cow’s milk exposure is significantly associated with atopic dermatitis in infants > six months of age. [Paediatr Indones. 2016;56:325-9. doi: 10.14238/pi56.6.2016.325-9]. Keywords: cow’s milk exposure; atopic dermatitis; infant This study was presented at the 6th Annual Scientific Meeting of Child Health (Pertemuan Ilmiah Tahunan Ilmu Kesehatan Anak VI/PIT IKA VI), Solo, October 5-9, 2013. From the Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Indonesia. Reprint requests to: Kadek Surya Jayanti, Department of Child Health, Udayana University Medical School/Sanglah Hospital, Jalan Pulau Nias, Denpasar 80114, Indonesia. Tel. +62-361-244038; Fax. +62-361-244038; E-mail: surya_owen84@yahoo.com Atopic dermatitis is a chronic inflammatory skin disease that commonly occurs in infants. As the most common atopic disease in infants, 60% of affected individuals develop manifestations during their first year of life.1 Atopic dermatitis is one of a cluster of diseases termed the “allergic march.” Food allergies and AD are typically seen first, followed by asthma and allergic rhinitis in children.2,3 Many studies have shown a correlation between atopic dermatitis and feeding practices in infants.4,5 Exclusive breastfeeding, has long been considered to protect against allergies, including AD. The feeding practice of giving formula early in infancy is cause for concern.6 Widyanti et al. reported that the prevalences of AD in the first three months of life were 17% in the cow’s milk (CM) group and 8% in the breastfeeding group. Though the relationship between infant feeding practices and the development of AD in infants remains controversial, the World Health