Koemelk, vaste voeding en het optreden van atopie

In infants at risk of atopic disease, if breast-feeding is not possible, current guidelines recommend the use of hypoallergenic formula instead of normal formula for at least 6 months and that solid food be withheld for at least 6 months. Scientific evidence shows that these recommendations are not based on firm evidence and may lead to unintended harm. Therefore, these guidelines should be reconsidered. A Cochrane review showed that the risk of any atopic disease is 21% less when using hypoallergenic formula. This advantage disappeared when good quality trials only were considered. The small reduction in infantile eczema is unlikely to be of sufficient relevance in primary care. Another systematic review showed that late introduction of solids had no clear advantage over early introduction. A recent large cohort study showed that, contrary to current beliefs, late introduction of solids was associated with atopic disease. Moreover, early introduction was not followed by sensitization.