• atopic predisposition;
  • atopic symptoms;
  • high-risk infants;
  • prevention

A total of 105 “high-risk” infants born in 1988 were studied prospectively from birth to 18 months of age. The infants were recommended breastfeeding and/or hypoallergenic formula (Nutramigen or Profylac) combined with avoidance of solid foods during the first 6 months of life. All mothers had unrestricted diet. Avoidance of daily exposure to tobacco smoke, furred pets and dust-collecting materials in the bedroom were advised. This prevention group was compared with a control group consisting of 54 identically defined “high-risk” infants born in 1985 in the same area. All infants had either severe single atopic predisposition combined with cord blood IgE ≥ 0.5 KU/1 or biparental atopic predisposition. The control group had unrestricted diet and was not advised about environmental factors. Apart from the prevention programme and year of birth the prevention group and the control group were comparable. The parents were highly motivated and compliance was good. The rate of participation was 97%, and 85% followed the dietary measures strictly. The cumulative prevalence of atopic symptoms was significantly lower at 18 months in the prevention group (32%), as compared with the control group (74%) (p<0.01), due to reduced prevalence of recurrent wheezing (13%, versus 37%; p<0.01), atopic dermatitis (14% versus 31%; p<0.01), vomiting/diarrhoea (5% versus 20%; p<0.01) and infantile colic (9% versus 24 %; p<0.01). The cumulative prevalence of food allergy was significantly lower in the prevention group (6% versus 17%; p<0.05). In both high-risk groups daily exposure to tobacco smoke increased the risk of recurrent wheezing significantly (p<0.01). The main difference between the prevention group and the control group was the diet. Thus, feeding with breastmilk and/or hypoallergenic formula combined with avoidance of solid foods until the age of 6 months appeared to reduce the cumulative prevalence of atopic symptoms during the first 18 months of life.