The Introduction of Allergenic Foods and the

Development of Reported Wheezing and Eczema in

Childhood: The Generation R Study

Tromp IIM, Kiefte-de Jong JC, Lebon A, et al. The introduction

of allergenic foods and the development of reported wheezing

and eczema in childhood: the Generation R Study. Arch Pediatr

Adolesc Med. Published online June 6, 2011.

doi:10.1001/archpediatrics.2011.93.

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Introduction

• Recommendations for the timing of complementary feeding vary, mostly

recommending introduction beyond the age of 4 to 6 months.

• Whether delayed introduction of allergenic foods could decrease the risk of

atopic diseases is controversial.

• The aim of this study was to examine whether the timing of introduction of

select allergenic foods is associated with eczema and wheezing in children

up to 4 years of age.

– Cow’s milk, hen’s egg, peanuts, tree nuts, soy, and gluten.

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Methods

• Study Design: Population-based prospective cohort study from fetal life until young adulthood.

• Participants: A total of 6905 preschool children born between April 2002

and January 2006.

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Methods

• Data Analysis: Multivariate logistic regression analyses.

– Dependent variables: eczema and wheezing (ages 2, 3, and 4 years).

– Independent variables: introductions of allergenic foods before or after 6

months of age.

– Adjustment for potential confounders.

• Limitations:

– Diagnosis based on parent-reported questionnaires.

– Residual confounding.

– This study was not able to examine the effect of allergenic food

introduction before 4 months of age.

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Results

• Introduction of cow’s milk, hen’s egg, peanuts, tree nuts, soy, and gluten

before the age of 6 months was not significantly associated with eczema or

wheezing up to 4 years of age.

• The results did not alter after stratification according to the child’s history of

cow’s milk allergy and parental history of atopy.

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Results

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Association Between the Introduction of Allergenic Foods and Wheezing at Ages 2, 3, and 4 Years in 6905 Preschool Children

Participating in the Generation R Study

Results

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Association Between the Introduction of Allergenic Foods and Eczema at Ages 2, 3, and 4 Years in 6905 Preschool Children Participating in

the Generation R Study

Comment

• This study does not support the recommendation for delayed introduction of

allergenic foods beyond age 6 months for the prevention of eczema and

wheezing.

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Comment

• Further studies in this cohort should focus on asthma and eczema at later

ages to elucidate whether late introduction of food allergens delays the

onset of atopic disease.

• Delayed introduction of allergenic foods beyond 6 months of age does not

prevent the development of atopic diseases eczema and wheezing.

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Contact Information

• If you have questions, please contact the corresponding author:

– Henriëtte A. Moll, MD, PhD, Department of Pediatrics, Erasmus Medical Center, PO Box 2060, 3000 CB Rotterdam, the Netherlands (h.a.moll@erasmusmc.nl).

Funding/Support

• This phase of the Generation R Study was supported by the Erasmus

Medical Center, the Erasmus University Rotterdam, the Netherlands,

Organization for Health Research and Development (Zon Mw), and Europe

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