ATOPİK DERMATİTLİ ÇOCUKLARDA SÜT ÇOCUKLUĞU DÖNEMİNDE BESLENMENİN DEĞERLENDİRİLMESİ

Yıl 2023, Cilt: 17 Sayı: 3 - Turkish Journal of Family Medicine and Primary Care, 459 - 465, 20.09.2023

Aslı Güçlü , Ümit Aydoğan , Yusuf Çetin Doğaner , Ahmet Bolat

https://doi.org/10.21763/tjfmpc.1280596

Öz

Giriş: Atopik dermatit (AD); kronik, kaşıntılı, tekrarlayıcı ataklarla giden inflamatuar bir cilt hastalığıdır. AD, astım ve alerjik rinokonjonktivit gibi alerjiye bağlı hastalıkların bebeklik döneminde değişen immün sistem gelişimiyle ilgili olduğu düşünülmektedir. Yenidoğan döneminden itibaren beslenme immun sistem gelişimini etkileyerek, bireyin sağlığını uzun vadede etkilemektedir.1 Bu çalışmamızda, AD tanısı alan çocuklarda hayatın ilk 6 aylık sürecinde anne sütü ve/veya formül mama ile beslenme oranlarının değerlendirmesi amaçlandı.
Yöntem: Çalışma, Gülhane Eğitim ve Araştırma Hastanesi Çocuk Sağlığı ve Hastalıkları Polikliniği’ne müracaat eden ve AD tanısı konulan çocukların ebeveynleri ile yapılmıştır. Çalışmaya toplam 75 ebeveyn dahil edilmiştir. Ebeveynlere yazılı onamları alınarak, araştırmacılar tarafından hazırlanılan, katılımcıların ve çocukların sosyodemografik özellikleri, özgeçmişi, ilk 6 ay beslenme şekli, annenin laktasyon dönemindeki beslenme şekli gibi bilgileri içeren anket formu uygulanmıştır. Veriler SPSS programı ile uygun testlerle analiz edilmiştir.
Bulgular: Ebeveynleri çalışmaya dahil edilen AD tanılı çocukların ilk 6 ayda %73,3’ü sadece anne sütü ile, %24’ü anne sütü ve formül mama ile geri kalan %2,7 çocuk ise sadece formül mama ile beslendiği saptanmıştır. AD tanı yaşı ile AD tanılı çocukların sosyodemografik özellikleri, soy geçmişi, ilk 6 ay beslenme şekilleri, emzirme döneminde annenin beslenme şekli ve tıbbi özgeçmişleri arasındaki fark incelendiğinde istatistiksel olarak anlamlı fark olmadığı gözlenmiştir (p>0,05).
Sonuç: AD tanısı alan hastaların hayatın ilk 6 aylık döneminde beslenme şekillerinin incelendiği çalışmamızda hastaların en fazla sadece anne sütü ile beslendiği tespit edilmiştir. AD tanı yaşı ile hayatın ilk 6 ayında beslenme şekli ve annenin laktasyon döneminde beslenme biçimi arasında anlamlı fark bulunmamıştır.

Anahtar Kelimeler

Atopik dermatit, süt çocukluğu, beslenme, anne sütü

Evaluatıon Of Nutrıtıon Durıng Influence In Chıldren Wıth Atopıc Dermatıtıs

Öz

Objective: Atopic dermatitis (AD); It is an inflammatory skin disease with chronic, itchy, recurrent attacks. Allergy-related diseases such as AD, asthma and allergic rhinoconjunctivitis are thought to be related to the changing immune system development in infancy. From the neonatal period, nutrition affects the development of the immune system and affects the health of the individual in the long term. In this study, it was aimed to evaluate the rates of feeding with breast milk and/or formula in the first 6 months of life in children diagnosed with AD.
Materials and Methods: The study was carried out with the parents of children who applied to Gulhane Training and Research Hospital Pediatric Health and Diseases Polyclinic and were diagnosed with AD. A total of 75 parents were included in the study. A questionnaire containing information such as the sociodemographic characteristics of the participants and the children, their backgrounds, diet for the first 6 months, and the mother's diet during the lactation period, which was prepared by the researchers after obtaining the written consent of the parents, was applied. The data were analyzed with the SPSS program with appropriate tests.
Results: In the first 6 months, 73.3% of the children with AD whose parents were included in the study were fed only with breast milk, 24% with breast milk and formula, and the remaining 2.7% with only formula. When the relationship between the age at diagnosis of AD and the sociodemographic characteristics of the children with AD, family history, feeding patterns in the first 6 months, diet of the mother during breastfeeding and medical history was examined, it was observed that there was no statistically significant relationship (p>0.05).
Conclusion: In our study, in which the nutrition patterns of patients diagnosed with AD were examined in the first 6 months of life, it was determined that the patients were mostly fed only with breast milk. There was no significant difference between the age at diagnosis of AD and the diet in the first 6 months of life and the mother's diet during the lactation period.

Anahtar Kelimeler

Atopic dermatitis, infancy, nutrition, breast milk

Kaynakça

• 1. Kultursay, N. Development of intestinal flora in infancyanditseffects on immunesystem/Bebeklikte barsak florasigelisimi ve immun sisteme etkileri. Journal of PediatricInfection. 2009: 75-79.
• 2. Aksu K, Arga M, Asilsoy S, Avcıl, S, Çetinkaya F, Civelek, E. Atopik Dermatit Tanı ve Tedavisine Yaklaşım: Ulusal Rehber. AsthmaAllergyImmunol. 2018; 16(2): 9-10.
• 3. Gür E. Anne sütü ile beslenme. Türk Pediatr Arşivi. 2007; 42(11):11-15.
• 4. Wang, Li‐Chieh, et al. Lowercaprylateandacetatelevels in thebreastmilk is associatedwithatopicdermatitis in infancy. PediatricAllergyandImmunology, 2022, 33.2: e13744.
• 5. Jepsen, A, et al. High breastmilk IL‐1β level is associatedwithreduced risk of childhoodeczema. Clinical&ExperimentalAllergy, 2016, 46.10: 1344-1354
• 6. Lim, D, et al. Theeffects of breast-milk feding on severe atopicdermatitis in Korean infant anadtoddler. Journal of AllergyandClinicalİmmunology, 2007, 119. 1: s282
• 7. Nakamura, Yosikazu, et al. Relationshipbetweenbreastmilkfeedingandatopicdermatitis in children. Journal of epidemiology, 2000, 10.2: 74-78.
• 8. Gdalevich M, Mimouni D, David M, Mimouni M. Breast-feeding and the onset of atopic dermatitis in childhood: A systematic review and meta-analysis of prospective studies. J Am Acad Dermatol. 2001; 45(4):520–527.
• 9. Novy R, Setiabudiawan B, Kartasasmita CB. The association between duration of breastfeeding and atopy in children with or without family history of atopic disease Riana. Paediatr Indones. 2007; 47(4):179-184.
• 10. Laitinen K, Hoppu U, Hämäläinen M, Linderborg K, Moilanen E, Isolauri E. Breast milk fatty acids may link innate and adaptive immune regulation: Analysis of soluble CD14, prostaglandin E2, and fatty acids. Pediatr Res. 2006; 59(5):723–727.
• 11. Logan CA, Weiss JM, Koenig W, Stahl B, Carr PR, Brenner H, et al. Soluble CD14 concentration in human breast milk and its potential role in child atopic dermatitis: Results of the Ulm Birth Cohort Studies. Clin Exp Allergy. 2019; 49(2):199–206.
• 12. Yang YW, Tsai CL, Lu CY. Exclusive breastfeeding and incident atopic dermatitis in childhood: A systematic review and meta-analysis of prospective cohort studies. Br J Dermatol. 2009; 161(2):373–383.
• 13. Miyake Y, Yura A, Iki M. Breastfeeding and the prevalence of symptoms of allergic disorders in Japanese adolescents. Clin Exp Allergy. 2003; 33(3):312–316.
• 14. Roduit C, Frei R, Depner M, Karvonen AM, Renz H, Braun-Fahrländer C, et al. Phenotypes of atopic dermatitis depending on the timing of onset and progression in childhood. JAMA Pediatr. 2017; 171(7):655–662.
• 15. Morales Suárez-Varela MM, Llopis González A, Martínez Selva MI. Socioeconomic risk factors in the prevalence of asthma and other atopic diseases in children 6 to 7 years old in Valencia, Spain. Eur J Epidemiol. 1999; 15(1):35-40.
• 16. Rha Y-H, Lee KS, Choi S-H. Relationship between socioeconomic and sociodemographic risk factors and atopic dermatitis in Korean adolescents. J Allergy Clin Immunol. 2013; 131(2):96.
• 17. Brunner PM. Early immunologic changes during the onset of atopic dermatitis. Ann Allergy, Asthma Immunol. 2019; 123(2):152–157.
• 18. Jedrychowski W, Perera F, Maugeri U, Mrozek-Budzyn D, Miller RL, Flak E, et al. Effects of prenatal and perinatal exposure to fine air pollutants and maternal fish consumption on the occurrence of infantile eczema. Int Arch Allergy Immunol. 2011; 155:275-281.
• 19. Schäfer T, Heinrich J, Wjst M, Krause C, Adam H, Ring J, et al. Indoor risk factors for atopic eczema in school children from East Germany. Environ Res. 1999; 81(2):151–158.
• 20. Kantor R, Kim A, Thyssen J, Silverberg, et al. Association of atopic dermatitis with tobacco smoke exposure: a systematic review and meta-analysis. Dermatol Online J. 2016; 22(9):1119-1125.
• 21. Bonamonte D, Filoni A, Vestita M, Romita P, Foti C, Angelini G. The Role of the Environmental Risk Factors in the Pathogenesis and Clinical Outcome of Atopic Dermatitis. BioMed Research International. 2019; 2450605
• 22. Schäfer T, Stieger B, Polzius R, Krauspe A. Associations between cat keeping, allergen exposure, allergic sensitization and atopic diseases: results from the Children of Lübeck Allergy and Environment Study (KLAUS). Pediatr Allergy Immunol. 2009; 20(4):353-357.
• 23. Ojwang V, Nwaru BI, Takkinen HM, Kaila M, Niemelä O, Haapala AM,et al. Early exposure to cats, dogs and farm animals and the risk of childhood asthma and allergy. Pediatr Allergy Immunol. 2020; 31(3):265-272.
• 24. Venter C, Palumbo MP, Glueck DH, Sauder KA, O’Mahony L, Fleischer DM, et al. The maternal diet index in pregnancy is associated with offspring allergic diseases: the Healthy Start study. Allergy Eur J Allergy Clin Immunol. 2022; 77(1):162–172.
• 25. Ng YT, Chew FT. A systematic review and meta-analysis of risk factors associated with atopic dermatitis in Asia. World Allergy Organ J. 2020; 13(11):100477.
• 26. Kramer MS, Kakuma R. Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child. Evidence-Based Child Heal. 2014; 9(2):447-483.
• 27. Khan A, Adalsteinsson J, Whitaker-Worth DL. Atopic dermatitis and nutrition. Clin Dermatol. 2022; 40(2):135-144.
• 28. Netting MJ, Middleton PF, Makrides M. Does maternal diet during pregnancy and lactation affect outcomes in offspring? A systematic review of food-based approaches. Nutrition. 2014; 30(11–12):1225–1241.
• 29. Uenishi T, Sugiura H, Tanaka T, Uehara M. Aggravation of atopic dermatitis in breast‐fed infants by tree nut‐related foods and fermented foods in breast milk. J Dermatol. 2011; 38(2):140-145.