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Solid food introduction in relation to eczema: results from a four-year prospective birth cohort study.

Filipiak B, Zutavern A, Koletzko S, von Berg A, Brockow I, Grübl A, Berdel D, Reinhardt D, Bauer CP, Wichmann HE, Heinrich J,

GSF-National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany.

OBJECTIVE: To assess the association between the introduction of solid foods in the first 12 months and the occurrence of eczema during the first 4 years of life in a prospective study of newborns. STUDY DESIGN: Data were taken from annually administered questionnaires from a large birth cohort (recruited 1995-1998) comprised of an intervention and a nonintervention group. Outcomes were doctor-diagnosed and symptomatic eczema. Multiple generalized estimation equation models were performed for the 2 study groups. RESULTS: From the 5991 recruited infants, 4753 (79%) were followed up. The 2 study groups were different in their family risk of allergies and feeding practices. No association was found between the time of introduction of solids or the diversity of solids and eczema. In the nonintervention group, a decreased risk was observed for avoidance of soybean/nuts, but an increased risk was seen in doctor-diagnosed eczema for the avoidance of egg in the first year. CONCLUSION: The evidence from this study supports neither a delayed introduction of solids beyond the fourth month nor a delayed introduction of the most potentially allergenic solids beyond the sixth month of life for the prevention of eczema. However, effects under more extreme conditions cannot be ruled out.

Published 24 September 2007 in J Pediatr, 151(4): 352-8.
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