Bebeklik döneminde formül mama ile beslenme alerjik rinit riskini arttırır mı?

Yıl 2019, Cilt: 16 Sayı: 1, 130 - 133, 22.03.2019

Alper Şen Yavuz Güler

Öz

Amaç:Bebeklik döneminde
formül mama ile beslenmenin çocukluk çağında alerjik rinite yakalanma riskini
arttırıp arttırmadığı retrospektif olarak araştırıldı.

Materyal ve metod:Çalışmaya 01
Haziran 2018- 01 Eylül 2018 tarihleri arasında ikinci basamak bir hastanenin
Kulak Burun Boğaz (KBB) polikliniklerine başvuran olan 876 hasta (355 (%40,5)
erkek, 521 (59,5) kız, ortalama yaş: 10,1±5,7 ) dahil edildi. Hastalar alerjik
rinit için skor (skor for allergic rhinitis; SFAR) anketi ile değerlendirildi.
Fizik muayenenin alerjik rinit ile uyumlu olması ve SFAR ≥7 olması alerjik
rinit lehine değerlendirildi. Bunun yanı sıra hastalara anne sütü ve yaşamın
ilk iki yılında formül mama ile beslenme öyküleri soruldu. Hiç anne sütü ile
beslenmemiş hastalar çalışma dışı bırakıldı. Yaşamın ilk iki yılında herhangi
bir süre formül mama ile beslenme öyküsü olanlar formül mama (+), olmayanlar
formül mama (-) olarak sınıflandırıldı.

Bulgular:Çalışmamıza dahil
edilen 876 hastanın 150 tanesine (%11,4) alerjik rinit tanısı konuldu. Alerjik
rinit tanısı konulan hastaların %70 (n=105) i kız, %30 (n=45) u erkek cinsiyete
sahip idi. Alerjik rinit kız cinsiyette anlamlı bir şekilde daha fazla idi
(p=0,004). Yaşamın ilk iki yılında herhangi bir formül mama kullanım oranı
%37,6 (n=329) idi. Ayrıca alerjik rinitli hastalarda formül mama ile beslenme
oranı % 56 (n=84) iken, alerjik rinit olmayanlarda (-) hastalarda formül mama
ile beslenme oranı %33,7 (n=245) idi. Alerjik rinit hastalarında formül mama
ile beslenme oranı anlamlı bir şekilde daha fazla görüldü (p<0,001).

Sonuç:Yaşamın
ilk iki yılında herhangi bir formül mama ile beslenmek alerjik rinit riskini
arttıran bir faktör olarak görülmektedir.

Anahtar Kelimeler

Alerjik rinit, SFAR, formül mama ile beslenme

Does formula-feeding in infancy increase the risk of allergic rhinitis?

Öz

Background: It has been investigated whether feeding with formula in infancy increases the risk of allergic rhinitis in childhood.

Methods: The study included a total of 876 patients 40.5% (n = 355) males, 59.5% (n =521) females with mean age 10,1±5,7 years, who applied to a secondary hospital Ear Nose and Throat (ENT) Clinic between June 01, 2018 and September 01, 2018. Patients were evaluated with ‘The Score for Allergic Rhinitis’ (SFAR) questionnaire. Consistency of physical examination with allergic rhinitis and the SFAR ≥7 were assessed in favor of allergic rhinitis. Besides this, patients were asked about their medical history if they had breast feeding and formula feeding in the first two years of life. Those who had a nursing history with formula in the first two years of life were grouped as Formula (+), and those without such a history were grouped as Formula (-).

Results: Number of patient with allergic rhinitis were 150 (17.1%) in 876 patient who has been included in the study. Allergic rhinitis was significantly higher in female gender (p=0.004). The use rate of any formula-fed during infancy was 37.6% (n=329). While 56% (n=84) of allergic rhinitic patients had formula-fed history, 33,7% (n=245) of non-allergic rhinitic patients had formula-fed history. Allergic rhinitis was detected significantly higher in the ones who had formula-fed during their infancy period (p<0.001).

Conclusion: Formula-feeding during infancy was seen as an increasing risk factor of allergic rhinitis.

Anahtar Kelimeler

Allergic rhinitis, The score for allergic rhinitis, Formula-feeding, Microbiota

Kaynakça

• 1- De Marco R, Cappa V, Accordini S, Rava M, Antonicelli L, Bortolami O et al. Trends in the prevalence of asthma and allergic rhinitis in Italy between 1991 and 2010. European Respiratory Journal 2012; 39: 883-892.
• 2- Schoenwetter WF, Dupclay L Jr, Appajosyula S, Botteman MF, Pashos CL. Economic impact and quality of-life burden of allergic rhinitis. Curr Med Res Opin 2004; 20: 305-17.
• 3- Lodge CJ, Tan DJ, Lau MX, Dai X, Tham R, Lowe AJ et al. Breastfeeding and asthma and allergies: a systematic review and meta-analysis. Acta Paediatr 2015;104: 38-53.
• 4- Hosea Blewett HJ, Cicalo MC, Holland CD, Field CJ. The immunological components of human milk. Adv Food Nutr Res 2008;54: 45–80.
• 5- Horta BL, Bahl R, Martines JC, Victora CG. Evidence on the longterm effects of breastfeeding systematic reviews and meta-analyses. Publication of the World Health Organization.
• 6- Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü (2014),‘2013 Türkiye Nüfus ve Sağlık Araştırması’. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, T.C. Kalkınma Bakanlığı ve TUBİTAK, Ankara, Türkiye.
• 7- Irmak N. The importance of breastmilk and the factors that effect exclusive breastfeeding. The Journal of Turkish Family Physician 206;7(2): 27-31.
• 8- De Seta L, Siani P, Cirillo G, Di Gruttola M, Cimaduomo L, Coletta S. The prevention of allergic diseases with a hypoallergenic formula: a follow-up at 24 months. The preliminary results. Pediatr Med Chir 1994; 16 (3): 251-4.
• 9- Ariata M, Mikawa H, Shirataka M, Takahashi K, Havasawa H, Tomita M. Epidemiological research on incidence of atopic disease in infants and children in relation to their nutrition in infancy. Arerugi 1997; 46 (4): 354-69.
• 10- Annesi-Maesano I, Didier A, Klossek M, Chanal I, Moreau D, Bousquet J. The scor for allergic rhinitis (SFAR): a simple and valid assessment method in population studies. Allergy 2002; 57: 107-14.
• 11- Cingi C, Songu M, Ural A, Annesi-Maesano I, Erdogmus N, Bal C, et al. The Score For Allergic Rhinitis study in Turkey. Am J Rhinol Allergy 2011;25:333-7.
• 12- De Seta L, Siani P, Cirillo G, Di Gruttola M, Cimaduomo L, Coletta S. The prevention of allergic diseases with a hypoallergenic formula: a follow-up at 24 months. The preliminary results. Pediatr Med Chir 1994; 16 (3): 251-4.
• 13- Yang SH, Hong CY, Yu CL. Decreased serum IgE level, decreased IFN-γ and IL-5 but increased IL-10 production, and suppressed cyclooxygenase 2 mRNA expression in patients with perennial allergic rhinitis after treatment with a new mixed formula of Chinese herbs. International Immunopharmacology Volume 1, Issue 6, June 2001, Pages 1173-1182.
• 14- Wright AL, Holberg CJ, Halonen M, Martinez FD, Morgan W, Taussig LM. Epidemiology of Physician-Diagnosed Allergic Rhinitis in Childhood. Pediatrics December 1994, VOLUME 94 / ISSUE 6.
• 15- Dominguez-Bello MG, Costello EK, Contreras M, Magris M, Hidalgo G, Fierer N et al. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proc Natl Acad Sci U.S.A. 2010; 107: 11971-11975.
• 16- Fallani M, Young D, Scott J, Norin E, Amarri S, Adam R, et al. Intestinal microbiota of 6-week-old infants across Europe: geographic influence beyond delivery mode, breast-feeding, and antibiotics. J Pediatr Gastroenterol Nutr 2010;51:77–84.
• 17- Wall R, Ross RP, Ryan CA, Hussey S, Murphy B, Fitzgerald GF, et al. Role of gut microbiota in early infant development. Clin Med Pediatr 2009; 3: 45-54.
• 18- Penders J, Thijs C, Vink C, Stelma FF, Snijders B, Kummeling I et al. Factors influencing the composition of the intestinal microbiota in early infancy. Pediatrics 2006; 118: 511-521.
• 19- Sang AL, Lim JY, Kim BS, Cho SJ, Kim NY, Kim OB et al. Comparison of the gut microbiota profile in breast-fed and formula-fed Korean infants using pyrosequencing. Nutrition Research and Practice. 2015; 9(3): 242-248.
• 20- Strachan DP. Hay fever, hygiene, and household size. BMJ. 1989;299:1259–1260.