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Baby wipes linked to food allergies: study


The use of baby wipes and soaps may promote childhood food allergies by disrupting the natural protective barrier of the skin, US researchers say.

A study, published in the Journal of Allergy and Clinical Immunology, suggests a mix of environmental and genetic factors work together to trigger a food allergy.

These factors include the use of infant cleansing wipes that leave soap on the skin, skin exposure to household dust and food, and genetics that alter skin absorbency.

“This is a recipe for developing food allergy,” said the lead author of the study, Joan Cook-Mills, a professor of allergy-immunology at Northwestern University Feinberg School of Medicine.

Parents of infants should limit the use of baby wipes and remember to wash their hands regularly, particularly after handling food, advised Prof Cook-Mills.

“They may not be eating food allergens as a newborn, but they are getting them on their skin. Say a sibling with peanut butter on her face kisses the baby. Or a parent is preparing food with peanuts and then handles the baby,” said Prof Cook-Mills.

Food allergies – particularly allergies to peanuts and tree nuts – is a growing problem with no known cause.

In Australia, food allergy occurs in around one-in-20 children.

Allergic disease epidemiologist, Dr Adrian Lowe at the University of Melbourne says there is a growing body of evidence that shows the skin has an important role to play in the development of food allergy.

Dr Lowe says it makes sense that baby wipes may be part of the equation. Through disrupting the top skin layer – which is made of lipids (fats) – allergens have a better opportunity to enter the body, he explained.

“By cleaning our babies with soaps in the bathwater or wipes we may actually be helping that allergen ingress through the skin which helps induce the sensitisation and allergy,” he said.

However he noted more studies on humans are required.

It’s estimated up to 35 per cent of children with food allergies also have atopic dermatitis.

Researchers at the University of Melbourne and the Murdoch Children’s Research Institute are currently investigating whether the use of a special cream on a babies skin can prevent food allergy.

“So we’re conducting a randomised control trial where we are getting parents to apply a particular cream from very early in life through to six months of age. We’re trying to prevent the children from developing eczema and hopefully this will also prevent them from developing food allergy as well,” Dr Lowe said.

You can access the full study here.

The link between acid suppressants and allergy


The evidence is mounting that the dramatic increase in kids’ allergies over the past couple of decades could have something to do with medication-induced disturbances in the intestinal microbiome.

The latest evidence for this hypothesis comes from a large, retrospective US study published this week in JAMA, involving nearly 800,000 children under six months old. The researchers cross-checked the use of H2RA and PPI acid suppressants, as well as antibiotics, with the subsequent diagnosis of allergic diseases in this cohort.

Infants in the cohort who were prescribed acid suppressants were more than twice as likely to develop food allergies in later childhood, with peanut and cow’s milk allergies being the most common. They were also 70-80% more likely to develop an allergy to a medication, and 45-50% more likely to be hospitalised for anaphylaxis. Rates were also higher for allergic rhinitis and asthma.

Infants prescribed antibiotics also had higher allergy rates: they had double the risk of asthma, a 75% greater risk for allergic rhinitis and a 41% higher risk for anaphylaxis.

“Acid-suppressive medications and antibiotics should be used during infancy only in situations of clear clinical benefit,” the researchers conclude.

They caution that as the study was observational, a causal link cannot be demonstrated. But while it is possible acid-suppressants or antibiotics were given for misdiagnosed allergic diseases, the authors say this is very unlikely to explain all the findings.

They say what is more likely is that acid-suppressants or antibiotics enhance the development of allergies by altering the makeup of the microbiome. They point to increasing evidence that healthy flora in the gut modulate immune responses and augment regulatory T-cell populations, possibly by the production of short-chain fatty acids. Getting the right microbial balance in early life seems especially important, with mouse studies showing antibiotic-induced dysbiosis causing allergies in neonatal mice but not in adult mice.

The study showed a stronger risk of food allergies with acid-suppressing drugs than with antibiotics, which might be because the former increases sensitisation to ingested antigens by decreasing protein breakdown in the stomach, the authors say. In addition, H2RAs may have a direct effect on the immune system, as histamine is increasingly recognised as having a role in modulating immune system function.

In current paediatric practice, acid suppressants are generally considered safe and are commonly prescribed for infants who have a regurgitation problem or are fussy. Studies like the current one may prompt a rethink in prescribing patterns, particularly given that gastric regurgitation in infants is not a disease but a developmentally normal process.

Recent research has found little clinical benefit in the use of H2RAs and PPIs in infants, and paediatricians are increasingly advising against overprescription of these drugs. They should be prescribed “only in situations of clear benefit”, the study authors warn.

You can access the full study here.