Atopic diseases, such as atopic dermatitis, are allergic reactions associated with the production of specific IgE (Immunoglobulin E) antibodies to common environmental allergens. Allergic diseases usually occur in the first decade of life and are directly linked to the maturation of the immune system.
During the first months of life, initial IgE responses to food proteins, particularly hen's egg and cow's milk may be observed even in exclusively breastfeed infants. In such individuals, it is proposed that exposure occurs through proteins in their mother's milk.
The risk of neonates having atopic symptoms during the first two decades of life strongly depends on the manifestation of the disease in their parents and siblings. Many other risk factors for allergy have been identified, such as exposure to tobacco smoke during pregnancy, infancy and childhood; urban living; and indoor humidity or mold growth.
The management of infantile atopic dermatitis should incorporate appropriate strategies to diagnose and manage underlying allergen, that often are a dermatitis cause.
Allergy to cow milk is a frequent cause of atopic dermatitis in infants. Food elimination has been shown to often resolve symptoms of baby atopic dermatitis but appropriate dietary restrictions should be properly programmed and monitored by a pediatrician or a dietitian in accordance with parents, because unnecessary restrictions can contribute to serious nutritional problems, especially in children. In cases where appropriate dietary elimination must accompany measures taken to reduce inflammation in the skin, treatment goals are twofold: the control of cutaneous symptoms and the promotion of baby's optimal growth.
In breast-fed infants with atopic dermatitis, weaning with hypoallergenic amino acid-based infant formula as Neocate has been shown to improve gut barrier function and eczema, delivering a rapid resolution of symptoms (between 3-14 days) and promoting an optimal growth, even in very sensitive infants (Arvola T., 2004, Chan YH, 2002).
Another study comparing the efficacy of an amino acid-based formula and an extensively hydrolysed protein formula in the management of infants with food allergy and eczema showed a significant improvement in eczema and, only when amino acid-based formula has been used, also an additional advantage of a catch-up growth (Isolauri, 1999).