de Jong M H, Scharp-Van Der Linden V T M, Aalberse R, Heymans H S A, Brunekreef B
Institute for Risk Assessment Sciences, Environmental and Occupational Health Group, University of Utrecht, Netherlands.
Arch Dis Child. 2002 May;86(5):365-9. doi: 10.1136/adc.86.5.365.
To determine the effect of brief early exposure to cows' milk on the expression of atopy during the first five years of life.
Follow up analysis of a double blind, placebo controlled, randomised feeding intervention trial (BOKAAL study). Subjects were 1108 children from 1533 initially randomised breast fed neonates in the Netherlands. Atopic disease and prevalence of allergic symptoms at age 1, 2, and 5, and specific IgE at age 1 and 5 were determined.
Atopic disease in the first year was found in 10.0% (cows' milk) versus 9.3% (placebo) of the children, with a relative risk (RR) of 1.07. No differences were found in the second year either. At age 5, atopic disease was found in 26.3% (cows' milk) versus 25.0% (placebo), RR 1.05. There was no difference in the prevalence of allergic symptoms. Specific IgE to cows' milk (RAST positive 2+ or more) was 5.8% (cows' milk) versus 4.1% (placebo) at age 1 (RR 1.43), and 5.3% versus 3.0% at age 5 (RR 1.77). There was no difference in sensitisation to other common allergens between the two groups.
Early, brief exposure to cows' milk in breast fed children is not associated with atopic disease or allergic symptoms up to age 5.
确定生命最初五年中短期早期接触牛奶对特应性疾病表达的影响。
对一项双盲、安慰剂对照、随机喂养干预试验（BOKAAL研究）进行随访分析。研究对象为来自荷兰1533名最初随机分组的母乳喂养新生儿中的1108名儿童。测定了1岁、2岁和5岁时的特应性疾病及过敏症状患病率，以及1岁和5岁时的特异性IgE。
第一年，10.0%（牛奶组）的儿童患有特应性疾病，而安慰剂组为9.3%，相对风险（RR）为1.07。第二年也未发现差异。5岁时，26.3%（牛奶组）的儿童患有特应性疾病，而安慰剂组为25.0%，RR为1.05。过敏症状患病率无差异。1岁时，对牛奶的特异性IgE（RAST阳性2+及以上）在牛奶组为5.8%，在安慰剂组为4.1%（RR 1.43）；5岁时，牛奶组为5.3%，安慰剂组为3.0%（RR 1.77）。两组对其他常见过敏原的致敏情况无差异。
母乳喂养儿童早期短期接触牛奶与5岁前的特应性疾病或过敏症状无关。
