Eczema link for bigger newborns

Newborns with a high fat mass and whose mums are prone to allergic reactions have an increased risk of developing eczema in the first year of life, researchers have found.

 

According to Margaret Kiely, professor of human nutrition at University College Cork (UCC), the finding could help devise strategies to prevent babies developing the distressing condition which causes the skin to become itchy, swollen, red and cracked, and for which there is currently no cure.

The research, published in the Journal of Allergy and Clinical Immunology, shows for the first time that infants in the top 20% for fat mass at birth have a 3-fold higher risk of eczema, also known as atopic dermatitis (AD), than infants who have lower body fat. Prof Kiely stressed the finding had nothing to do with obesity in babies.

One of Prof Kiely’s researchers at UCC, Dr Sinéad O’Donovan, made the association between a high level of infant body fatness and the risk of AD in the first 12 months, particularly among infants of parents with self-reported allergic disease.

The link followed analysis of the nutritional determinants of AD in the first year of life in infants who participated in the Cork Baseline Birth Cohort, Ireland’s first and only longitudinal maternal-infant cohort.

Prof Kiely said their study was the first to include data on infant body composition in relation to AD in infancy.

The study followed 1,537 infants from 15 weeks gestation through to 12 months. Just over one fifth (21%) of infants were diagnosed with AD in the first year of life and 8% had atopic dermatitis at both six and 12 months of age. The main risk factors that persisted throughout the first year were maternal self-reported history of allergic disease and infant fat mass at birth.

Prof Kiely said the novel finding “may aid in the early identification of those at risk of AD” which represented “the best opportunity for prevention”. She said the type of eczema they looked at was not “a wee rash that comes and goes”.

“This type of eczema is the kind babies typically start to experience at four to six months. For some it just disappears, but we were interested in those for whom it develops and persists for the first year. It’s the most common and distressing inflammatory disease in infants and causes a huge amount of stress, including sleep loss for babies and parents,” Dr Kiely said.

She said there were currently no preventative strategies as part of a standard of care and that ideally they would like babies assessed for AD in a systematic way in the first few days of life.

As AD is a significant risk for paediatric food allergy, Prof Kiely said by building up a more complete picture of babies predisposed to AD, they hoped it could eventually go some way to preventing the development of food allergy.

Prof Kiely said the results of the research, funded by the European Commission, were on foot of multidisciplinary collaboration.

AD is the most common inflammatory disease of childhood affecting around one in five children in the developed world. Many people with AD develop hay fever or asthma later in life.

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