The Introduction of Allergenic Foods and the Development of Reported Wheezing and Eczema in...

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.

Copyright restrictions may apply

http://archpedi.ama-assn.org/


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.



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.



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.



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.



Results


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


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.



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.



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 ([email protected]).

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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