Nutrition for prevention of atopic dermatitis in infants

• C.H. Lifschitz

Abstract

In recent years the incidence of atopic diseases such as asthma, atopic dermatitis (AD), allergic rhinitis and food allergy have increased significantly. AD is a chronic skin disease characterized by pruritic, inflamed skin. It has been estimated that prevalence of AD in school age children in western countries ranges from 10 to 20% and in the United States. In addition to the skin problem, AD has been associated with a series of complications, including clinical, behavioral, and financial distress , including treatment and discharge period. On the other hand, prevalence of allergy has increased and although the reasons for this are multifactorial, it has been seen that protein content in infant formula is one of the factors that contribute to its development. Exclusive breastfeeding has been shown to be protective of problem.

However, when for whatever reason an infant cannot be breastfed, partially hydrolyzed predominantly whey protein formula in a lower concentration than in regular infant formula, has been shown to be effective in prevention of the manifestations of AD, and highly cost-effective in the prevention of atopic dermatitis compared to standard formula, proven in randomized, controlled studies. Among other factor that could affect the manifestation of AD is development of the fecal flora of the newborn infant is thought to be related to several factors such as the mode of delivery (vaginal vs. cesarean section (CS), place of delivery (home versus hospital). The fecal flora of babies delivered by CS is quite different than that of vaginally delivered babies. Increasingly, epidemiologic and clinical data support the hypothesis that perturbations in the gastrointestinal microbiota disrupt the normal microbiota-mediated mechanisms of immunological tolerance in the intestinal mucosa, leading to an increase in the incidence of allergies, in particular, allergic airway disease and other ailments, including type I diabetes and overweight. Probiotics are beneficial bacteria to the host and multiple studies have demonstrated the benefits of many of them. In addition, administration of probiotics in feeding may be a way to overcome the problems caused by an abnormal development of the fecal flora. Among one of the most studied probiotics is Bifidobacterium lactis, known as BB12.

Others include Lactobacillus GG, Lactobacillus reuteri. The effects of probiotics are species specific. It is not possible to extrapolate results from studies done with one particular strain of a probiotic to prevent or treat one condition, to another bacterial or yeast strain or to treat other conditions.

Keywords:allergy, prevention, atopic dermatitis, probiotics, partially hydrolyzed whey protein, cesarean section