Influence of maternal diet during lactation and use of formula feeds on development of atopic eczema in high risk infants

OBJECTIVE

To examine the effects of maternal diet during lactation and the use of formula feeds on the development of atopic eczema in infants at risk.

DESIGN

Mothers who planned to breast feed exclusively were randomly allocated to either a restricted diet (avoiding milk and other dairy products, eggs, fish, peanuts, and soybeans) or a diet without restrictions. Mothers who did not plan to breast feed were randomly allocated to using one of three formula feeds.

SETTING

Child health centre in Canada.

SUBJECTS

97 Mothers who chose to breast feed and 124 mothers who did not.

INTERVENTIONS

Restricted diet for 49 mothers who breast fed. Casein hydrolysate formula, soy milk formula, or cows' milk formula for infants not breast fed.

MAIN OUTCOME MEASURE

Development of eczema in babies.

RESULTS

Infants were followed up over 18 months and examined for eczema. Eczema was less common and milder in babies who were breast fed and whose mothers were on a restricted diet (11/49 (22%) v 21/48 (48%)). In infants fed casein hydrolysate, soy milk, or cows' milk 9/43 (21%), 26/41 (63%), and 28/40 (70%), respectively, developed atopic eczema.

CONCLUSIONS

In families with a history of atopic disease [corrected] mothers who breast feed should avoid common allergenic foods during lactation. If they choose not to breast feed a hydrolysate formula should be used.

Influence of maternal food antigen avoidance during pregnancy and lactation on incidence of atopic eczema in infants

One hundred and twenty-one women with history of a previous child with atopic disease were randomly allocated during the next pregnancy to antigen avoidance or control groups. Dietary advice consisted of almost complete exclusion of milk and dairy products, egg, fish, beef and peanut throughout pregnancy and lactation. A total of 109 completed the study. Maternal antigen avoidance was associated with reduced occurrence of atopic eczema and the skin involvement was less extensive and milder. The beneficial effect was observed mainly in the breast-fed group. Among the fifty-five who completed the trial of antigen avoidance, seventeen infants developed atopic eczema, five out of thirty-five who were breast-fed and twelve out of twenty who were formula-fed. Among the offspring of fifty-four control mothers given no dietary restriction, eczema was observed in twenty-four infants, eleven out of thirty-six breast-fed and thirteen of eighteen formula-fed. Avoidance of common dietary allergens during pregnancy and lactation enhanced the preventive beneficial effect of exclusive breast feeding on the incidence of atopic eczema among infants at high risk.

Predictive value of cord blood IgE in the development of atopic disease and role of breast-feeding in its prevention

The predictive value of cord blood IgE in the development of atopic disease was evaluated in a prospective study of two groups of infants. Total serum IgE level was greater than or equal to 0.7 U/ml in 44.3% of the infants with positive family history of atopy and in 16.0% among those with negative family history. The level of cord blood IgE correlated significantly with the subsequent development of atopic disease in both groups. Cord blood IgE higher than 0.7 U/ml was associated with a high risk of development of atopic eczema and wheezing, 52.8% and 58.8% respectively in the groups with or without family history of atopy; compared with 13.4% and 1.1% in the groups with IgE levels less than 0.7 U/ml. Among newborns fed exclusively on breast milk for a minimum of 3 months, the incidence of eczema and wheezing was significantly lower (12%) compared with findings in the formula-fed group (32%).

Nutritional regulation of host resistance and predictive value of immunologic tests in assessment of outcome

In this review, the authors describe the current information on nutrition modulation of immunity, enumerate the various immunologic tests that are potentially useful in nutritional assessment, examine the reliability of tests predicting disease and complications, and discuss how immunologic evaluation may help in the decision process regarding nutritional support.

Urinary vasopressin in male infertility

In 10 healthy but infertile men, semen analysis and urinary vasopressin levels were evaluated and correlated. A significant correlation was observed between sperm count and urinary vasopressin (r -0.86). Similar correlation was seen between sperm motility and urinary vasopressin (r -0.83). It thus appears that higher levels of vasopressin are associated with aspermia and oligozoospermia.

T cell chronic lymphocytic leukemia with lymphocytes of unusual immunologic phenotype and function

This report discusses a case of T cell chronic lymphocytic leukemia (T-CLL) in an elderly white man whose lymphocytes expressed a post-thymic phenotype except for the coexpression of T4 and T8 on 80% to 95% of the cells. Because of the uncommon phenotype, in vitro functional assays were performed that showed decreased mitogenic responses but normal helper activity for B cell immunoglobulin secretion and normal suppressor activity of lectin-induced mitogenesis. Morphologic evaluation by both light and electron microscopy and cytochemical staining were consistent with the "knobby" type T-CLL. Adenosine deaminase and terminal deoxynucleotidyl transferase (TdT) levels were low, but the acetylcholinesterase level was normal, which is consistent with the peripheral T cell phenotype. The patient underwent splenectomy, and the spleen cells showed very low levels of T3 and T4 by immunoperoxidase and undetectable levels by immunofluorescence. The morphology of the splenic infiltrate was not significantly different from that in the initial bone marrow. Human T cell leukemia virus (HTLV) antigen and antibody tests were negative. The cells in this leukemia apparently are derived from a transitional stage of maturation between the cortical and medullary thymocyte. A small subset of lymphocytes of identical phenotype to this leukemia has been identified in normal individuals.