Weaning to hypoallergenic formula improves gut barrier function in breast-fed infants with atopic eczema.
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.
Arvola
Taina
T
Paediatric Research Centre, University of Tampere and Department of Paediatrics, Tampere University Hospital, Finland. taina.arvola@uta.fi
Moilanen
Eeva
E
Vuento
Risto
R
Isolauri
Erika
E
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
D000515:alpha 1-Antitrypsin; D008353:Mannitol; D007792:Lactulose