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Impact of maternal atopy and probiotic supplementation during pregnancy on infant sensitization
Author(s) -
Van Der Aa L. B.,
Sprikkelman A. B.,
Van Aalderen W. M. C.
Publication year - 2008
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/j.1365-2222.2008.03089.x
Subject(s) - medicine , respiratory medicine , pediatrics , atopy , asthma , surgery
With great interest, we have read the article by Huurre et al. [1] reporting on the impact of maternal atopy and probiotic supplementation during pregnancy on infant sensitization. We would like to comment on some of the results of this trial. First, the authors found an increased risk of sensitization in infants with allergic mothers breastfeeding over 6 months or exclusively breastfeeding over 2.5 months. Therefore, they conclude that breastfeeding in atopic mothers is a risk factor for sensitization in infants. However, these results may be biased, because of reversed causation [2]. The authors give no information regarding the prevalence of allergic disease, specifically atopic dermatitis, in the participating infants. It seems likely that the presence of allergic symptoms caused mothers to continue breastfeeding for a longer period of time, which could explain the observed relation between breastfeeding and increased sensitization. Second, considerable attention is given to the observation that TGF-b2 was higher in the probiotic than in the placebo group. However, this difference did not reach significance (CI, 0.96–2.34; P = 0.073). Moreover, this moderate effect was seen only in the colostrum sample and had totally disappeared after 1 month, despite that the probiotic supplementation was still continued at that time. Therefore, it is questionable if probiotic supplementation actually changed the breast milk cytokine pattern. Finally, we regret that no faecal samples of the mothers were analysed to confirm actual colonization with the given probiotic strains. This would have given important information on compliance.