Effect of Breastfeeding, Timing of Introduction of Complementary Foods, and other Confounders on the Development of Childhood Atopic Dermatitis


Background: Atopic dermatitis is a chronic skin disease. Its incidence around the world has increased dramatically over the past several decades. A multi-factorial etiology is postulated, with genetic, immunological and environmental factors all thought to be relevant to the pathogenesis. Objective: To assess the effect of breastfeeding, solid food introduction to the infant's diet, and other confounders on the development of atopic dermatitis.Methods: Two hundred and forty children between 2 to 6 years were enrolled in this case control study in Baghdad, comprised of 60 children with atopic dermatitis and 180 children free from atopic dermatitis of the same age, sex and ethnicity as a control. Data collection had been done by an interview using a questionnaire form designed by the investigators. Diagnosis of atopic dermatitis was made according to the Haninfin and Rajka’s diagnostic criteria.Results: This study showed a significant difference between case and control groups regarding the presence of family history of atopy among child's parents. The frequency of children with positive history of animal contact differs significantly between patients and control groups. No significant association was detected between atopic dermatitis and positive breastfeeding history. However, the relation between atopic dermatitis and breastfeeding is duration dependent, the percentage of infants with short exclusive breastfeeding was higher among control group (85.3%) as compared to (58.1%) in the case group. While, with prolong breastfeeding more than 6 months the reverse was found. Early supplement feeding increased the rate of atopic dermatitis, there was more infants with atopic dermatitis when solid food introduced at the age of 4 months, this was statistically significant (P=0.023). Conclusion: Exclusive breastfeeding for 6 months is effective in reducing atopic dermatitis. On the other hand, prolonging exclusive breastfeeding and postponing the introduction of solid foods for over 6 months is not helpful in prevention of atopic dermatitis