Published Online: October 2, 2015
Food allergy is common, especially in early childhood, and eczema, another allergic condition, often co-exists in children with food allergy. Food allergy has previously been associated with lower height and weight in cross-sectional studies in children. However, no previous studies have investigated the combined effect of food allergy and eczema on growth in early childhood. In addition, the effect of resolved and persistent food allergy and eczema on height and weight throughout early childhood has not been reported.
Beck et al report in The Journal of Allergy and Clinical Immunology: In Practice the analysis of growth parameters in children with persistent and resolved food allergy and eczema at ages 1 and 4 years. The Healthnuts study, a population based cohort of over 5,000 children from Melbourne, Australia, recruited infants at age 1 and followed them up at 4 years of age. All infants underwent skin prick testing at 1 year of age to peanut, egg, and sesame, and those sensitized went on to oral food challenges. Food challenges repeated at age 4 determined resolution or persistence of food allergy. Eczema status, as well as height and weight were collected at both ages.
Children with both food allergy and eczema at age 1 had lower weight and height at age 1 compared to those with neither condition. However, for children with only food allergy or only eczema there was no difference in growth parameters. By age 4, children who had grown out of their food allergy had caught up and had no differences in height or weight. Those who had persistent food allergy at age 4 were still shorter and lighter, irrespective of their eczema status.
This study indicates that children with both food allergy and eczema in infancy should be closely followed up. This is the case for children with any food allergy, not just those with allergies to nutritionally important foods. These children and their families should receive good dietary guidance and eczema management to ensure optimum growth.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.