title: Weaning to hypoallergenic formula improves gut barrier function in breast-fed infants with atopic eczema.
abstract: OBJECTIVE
  Infants may be sensitized to dietary antigens even during exclusive breast-feeding. Because food antigen traces in breast milk may have harmful effects on gut barrier function in infants with atopy, the authors sought to evaluate whether or not it is beneficial to shift such infants from breast milk to a hypoallergenic formula.
  
  
  METHODS
  Fifty-six infants (mean age, 5.0 months) manifesting atopic eczema during exclusive breast-feeding were studied at weaning to a tolerated hypoallergenic formula. The urinary recovery ratios of orally administered lactulose and mannitol, fecal alpha-1 antitrypsin and urinary methylhistamine, and eosinophil protein X concentrations were assessed during breast-feeding and after weaning.
  
  
  RESULTS
  The median (interquartile range, IQR) concentration of fecal alpha-1 antitrypsin was 2.3 mg/g (range, 1.2-3.3 mg/g) during breast-feeding and 0 (0.0-1.9 mg/g) after weaning to a tolerated hypoallergenic formula, z = -4.23, P < 0.0001. The urinary recovery ratio of lactulose and mannitol decreased from 0.029 (range, 0.021-0.042) to 0.023 (range, 0.016-0.031), respectively, z = -3.45, P = 0.0006. Concomitantly, the atopic eczema improved, and the concentration of urinary eosinophil protein X decreased significantly.
  
  
  CONCLUSIONS
  In breast-fed infants with atopy, gut barrier function is improved after cessation of breast-feeding and starting of hypoallergenic formula feeding.
authors.affiliation: Paediatric Research Centre, University of Tampere and Department of Paediatrics, Tampere University Hospital, Finland. taina.arvola@uta.fi
authors.forename: Taina
authors.initials: T
authors.lastname: Arvola
authors.forename: Eeva
authors.initials: E
authors.lastname: Moilanen
authors.forename: Risto
authors.initials: R
authors.lastname: Vuento
authors.forename: Erika
authors.initials: E
authors.lastname: Isolauri
mesh_terms: D000818:Animals; D001942:Breast Feeding / Q000009:adverse effects*; D002417:Cattle; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D005243:Feces / Q000737:chemistry; D005260:Female; D005512:Food Hypersensitivity / Q000209:etiology / Q000276:immunology; D006801:Humans; D007223:Infant; D007225:Infant Food; D041943:Infant Formula / Q000008:administration & dosage*; D007227:Infant Nutritional Physiological Phenomena; D007792:Lactulose / Q000652:urine; D008297:Male; D008353:Mannitol / Q000652:urine; D008892:Milk / Q000276:immunology; D008895:Milk, Human / Q000276:immunology*; D012307:Risk Factors; D014886:Weaning; D000515:alpha 1-Antitrypsin / Q000032:analysis
chemical_list: D000515:alpha 1-Antitrypsin; D008353:Mannitol; D007792:Lactulose