title: Introduction of complementary foods in infancy and atopic sensitization at the age of 5 years: timing and food diversity in a Finnish birth cohort.
abstract: OBJECTIVE
  To study the associations between timing and diversity of introduction of complementary foods during infancy and atopic sensitization in 5-year-old children.
  
  
  METHODS
  In the Finnish DIPP (type 1 diabetes prediction and prevention) birth cohort (n = 3781), data on the timing of infant feeding were collected up to the age of 2 years and serum IgE antibodies toward four food and four inhalant allergens measured at the age of 5 years. Logistic regression was used for the analyses.
  
  
  RESULTS
  Median duration of exclusive and total breastfeeding was 1.4 (interquartile range: 0.2-3.5) and 7.0 (4.0-11.0) months, respectively. When all the foods were studied together and adjusted for confounders, short duration of breastfeeding decreased the risk of sensitization to birch allergen; introduction of oats <5.1 months and barley <5.5 months decreased the risk of sensitization to wheat and egg allergens, and oats additionally associated with milk, timothy grass, and birch allergens. Introduction of rye <7.0 months decreased the risk of sensitization to birch allergen. Introduction of fish <6 months and egg ≤11 months decreased the risk of sensitization to all the specific allergens studied. The introduction of <3 food items at 3 months was associated with sensitization to wheat, timothy grass, and birch allergens; the introduction of 1-2 food items at 4 months and ≤4 food items at 6 months was associated with all endpoints, but house dust mite. These results were particularly evident among high-risk children when the results were stratified by atopic history, indicating the potential for reverse causality.
  
  
  CONCLUSIONS
  The introduction of complementary foods was consecutively done, and with respect to the timing of each food, early introduction of complementary foods may protect against atopic sensitization in childhood, particularly among high-risk children. Less food diversity as already at 3 months of age may increase the risk of atopic sensitization.
authors.affiliation: School of Health Sciences, University of Tampere, Tampere, Finland. bright.nwaru@uta.fi
authors.forename: B I
authors.initials: BI
authors.lastname: Nwaru
authors.forename: H-M
authors.initials: HM
authors.lastname: Takkinen
authors.forename: O
authors.initials: O
authors.lastname: Niemelä
authors.forename: M
authors.initials: M
authors.lastname: Kaila
authors.forename: M
authors.initials: M
authors.lastname: Erkkola
authors.forename: S
authors.initials: S
authors.lastname: Ahonen
authors.forename: H
authors.initials: H
authors.lastname: Tuomi
authors.forename: A-M
authors.initials: AM
authors.lastname: Haapala
authors.forename: M G
authors.initials: MG
authors.lastname: Kenward
authors.forename: J
authors.initials: J
authors.lastname: Pekkanen
authors.forename: R
authors.initials: R
authors.lastname: Lahesmaa
authors.forename: J
authors.initials: J
authors.lastname: Kere
authors.forename: O
authors.initials: O
authors.lastname: Simell
authors.forename: R
authors.initials: R
authors.lastname: Veijola
authors.forename: J
authors.initials: J
authors.lastname: Ilonen
authors.forename: H
authors.initials: H
authors.lastname: Hyöty
authors.forename: M
authors.initials: M
authors.lastname: Knip
authors.forename: S M
authors.initials: SM
authors.lastname: Virtanen
mesh_terms: D000367:Age Factors; D000485:Allergens / Q000276:immunology; D001942:Breast Feeding; D002675:Child, Preschool; D004032:Diet; D005260:Female; D005387:Finland; D005512:Food Hypersensitivity / Q000276:immunology; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000276:immunology*; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007223:Infant; D007225:Infant Food; D007231:Infant, Newborn; D008297:Male; D016017:Odds Ratio; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000485:Allergens; D007073:Immunoglobulin E