The case study is related to a two month old infant suffering from infantile Atopic Dermatitis who is breastfed. Infantile Atopic Dermatitis is most common type of dermatitis which occurs before six months of age and continues through the childhood. More than 3 percent of infants are affected by it. It normally subsides by the time child reaches the magic twelve years mark. It is a skin disorder which is caused by hypersensitivity to allergen related reactions on the skin, causing characteristic inflammation, itching and scaling of the skin. It is frequently associated with the triad of other atopic (allergic) disorders like asthma and hayfever.
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Breastfeeding does not contribute to the appearance of Atopic Dermatitis. Hence there is no need to stop breastfeeding. A study indicates that “exclusive breastfeeding does not influence the risk of Atopic Dermatitis during the first year of life, while presence of furred pets at home seems to be negatively associated with Atopic Dermatitis.” (Ludvigsson, para.1). A study further confirms that in case of infants who are at the risk of developing and Atopic Syndrome , there is possibility to prevent or delay these symptoms by exclusive breastfeeding for four months.
The important consideration here is the age at which breast milk is introduced rather than the duration of the breastfeeding. “Atopic dermatitis, the most common form of eczema, can be reduced through exclusive breastfeeding beyond 12 weeks in individuals with a family history of Atopy. But when breastfeeding beyond 12 weeks is combined with other foods, incidents of eczema rise irrespective of family history.”(Barr,para.12 ). The supplement of additional food, formula and milk suddenly affirms increase in the symptoms of Atopic Dermatitis. It would be advisable to delay formula and stay with breastfeeding and gradual introductions of soft foods for infants.
Mother should also practice caution in her intake of food which may produce adverse symptoms in the child like rashes or colic. Mother should avoid milk, eggs, wheat, fish and peanut.(Spagnola & Korb, para.34.). Infants from atopic families whose mother eliminated egg, milk and fish during lactation has less atopic dermatitis than those who had no dietary restrictions. (Metcalfe & Simon,pg.155,para1). Incase of baby food sometimes the trigger can be seen in foods like cereals, eggs, black olives and chocolate. Infant should receive solid food at four months. Caution should be observed with the reactions to various foods and their reaction to the child in terms of symptoms which reflect allergic response.
A significant linear relationship was found between number of solid foods introduced into the diet by four months of age and subsequent Atopic Dermatitis. (Metcalfe & Simon,pg.155,para1).Studies have further indicated that it is best to avoid exposing young infants to food allergens like peanuts, nuts, fish and shellfish for the first two to three years of life, in some cases where the risk of atopic reaction is high it helps to avoid cow’s milk for the first year and egg for the first two years. These factors would prevent to some degree occurrence of the Atopic Dermatitis.
If the infants symptoms worsens with certain exposure to environmental factors like pillows, blankets which indicate that there is allergic response to dust and dust mites then prompt measures should be taken to remove the environmental allergens like dust and dust mites to further reduce the triggering factors of the symptoms. One can also be encouraged to use air purifier with effective HEPA filter to control the level of floating allergens.
It would be necessary to get rid of any furry pets like cats and dogs as they have negative impact on the symptoms; it has been a proven fact.
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The role of fish oils with its anti –inflammatory has been long studied in the prevention of allergic diseases. The study suggests that there is potential reduction in subsequent infant allergy after supplementation of polyunsaturated fatty acids in the form of fish oils.(Dunstan,para.1).
Probiotics have been known through many studies to have the potential to protect children form Aptoic Dermatitis for up to four years when given to pregnant women and babies around the time of childbirth. Probiotic bacteria has been suggested to have the power to reduce symptoms of Atopic Dermatitis syndromes in food allergic infants. (Viljanen.para.1). It should be taken by the mother during pregnancy as well as during breastfeeding and can also be given to the infant in regulated quantities to control the adverse effects of dermatitis induced by food allergies. This has really been effective in the case of occurrence of Atopic Dermatitis. This is found in lactobacillus bacteria, which is commonly found in food for fermentation. It is abundantly found in yogurt. Food supplements which are nutritionally enriched with these bacteria are called probiotics.
Probiotics have favorable effects on the gut and effects on developing immune system. (Mercola,para.6).
Once determined as high risk for Atopic diseases which consist of the triad of Atopic Dermatitis, asthma and hayfever all triggered by food allergens and environmental allergens the only remedy is to manage the symptoms and reduce the occurrence by sensible use of combination of fish oil, probiotics and immune boosting supplements. The symptoms can be controlled and managed but cannot be completely prevented. The baby needs to be monitored carefully as to what triggers the allergic reaction and must be protected from such exposure in the form of food or environmental allergen floating in the surroundings.
Atopic Dermatitis. Web.
Ludvigsson, Mostrom, Duchen. Exclusive breastfeeding and the risk of atopic dermatitis in some 8300 infants. Pediatr Allergy Immunol. 2005. PubMed. Web.
Barr, Diana. Breastfeeding Best Formula for Feeding Infants. Daily Observer. 2009. Web.
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Spagnola, Caroline.C. & Korb. James.D. EMedicine. 2008. Web.
Metcalfe, Dean D. & Simon, Ronald A. Food Allergy: adverse reactions to food and food additives. Wiley. 2003.
Dunstan, Mori, Barden, Beilin, Taylor, Holt & Prescott. Fish oil supplementation in pregnancy modifies neonatal-specific immune responses and clinical outcomes in infants at high risk atopy: a randomized, controlled trial. J Allery Clin Immunol. 2003. Web.
Viljanen M, Savilahti E, Haahtela T, Juntunen-Backman K, Korpela R, Poussa T, Tuure T, Kuitunen M. Probiotics in the treatment of atopic eczema/dermatitis syndrome in infants: a double-blind placebo-controlled trial.Allergy. 2005. Web.
Kalliomäki, M.; Salminen, S.;.Arvilommi, H; Kero, P ; Koskinen, P.& Isolauri E. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial The Lancet, 2009. Volume 357, Issue 9262, Pages 1076-1079.
Mercola. Good Bacteria Prevents Eczema in Infants. 2003. Web.