Atopy, eczema and breast milk fatty acids in a high-risk cohort of children followed from birth to 5 yr.
BACKGROUND
The incidence of atopic diseases such as eczema is increasing in westernized societies. The suggestion that there is a "protective" association between the unique fatty acid composition of breast milk, particularly the omega-3 (n-3) and omega-6 (n-6) essential polyunsaturated fatty acid content, and the development of atopic disease in children was investigated in a cohort study of 263 infants born into families with a history of allergy (one or both parents had asthma, hayfever, eczema). The objectives of this study were to determine the lipid profile [specifically in relation to long-chain polyunsaturated fatty acid (LC-PUFA) composition] in maternal breast milk samples collected at 6 wk and at 6 months following birth, and to investigate the potential role of these fatty acids in modulating the phenotype of children at high genetic risk of developing atopic disease.


METHODS
Breast milk samples were available from 91 atopic mothers at their child's ages of 6 wk and 6 months. These samples were analysed for the fatty acid spectrum. Analysis of variance was used to detect differences between groups of outcomes (no atopy or eczema, non-atopic eczema, atopy, atopic eczema) at ages 6 months and 5 yr, and a multiple comparisons procedure was conducted to isolate the parameters producing the different results (F-test, LSD test). For the exposure variables, n-3 and n-6 fatty acids are expressed as weight percentage and as a ratio (at both time-points).


RESULTS
The fatty acid profiles of maternal breast milk at 6 wk and 6 months were similar. An increased ratio of n-6: n-3 fatty acids in both 6 wk and 6 month milk samples was associated with non-atopic eczema (p < 0.005) but not atopy alone or atopic eczema.


CONCLUSIONS
We found milk fatty acids were a significant modulator of non-atopic eczema but not atopy or atopic eczema in infants at 6 months. In mothers with a history of asthma, hayfever or eczema, their 6-month-old infants were more likely to develop non-atopic eczema if their milk had a higher ratio of n-6: n-3 LC-PUFA.
Oddy
Wendy H
WH
Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, PO Box 855, West Perth, Perth, WA, Australia. wendyo@ichr.uwa.edu.au
Pal
Sebely
S
Kusel
Merci M H
MM
Vine
Donna
D
de Klerk
Nicholas H
NH
Hartmann
Peter
P
Holt
Patrick G
PG
Sly
Peter D
PD
Burton
Paul R
PR
Stanley
Fiona J
FJ
Landau
Louis I
LI
D002675:Child, Preschool; D015331:Cohort Studies; D004485:Eczema / Q000209:etiology* / Q000378:metabolism; D005227:Fatty Acids / Q000032:analysis* / Q000502:physiology; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000209:etiology* / Q000378:metabolism; D007223:Infant; D008895:Milk, Human / Q000737:chemistry*; D011247:Pregnancy; D018566:Pregnancy, High-Risk
D005227:Fatty Acids