Arch Dis Child 94:11-15 doi:10.1136/adc.2008.140418
  • Original article

Early introduction of fish decreases the risk of eczema in infants

Open Access
  1. B Alm1,
  2. N Åberg1,
  3. L Erdes3,
  4. P Möllborg2,
  5. R Pettersson4,
  6. S G Norvenius1,
  7. E Goksör1,
  8. G Wennergren1
  1. 1
    Department of Paediatrics, University of Gothenburg, Queen Silvia Children’s Hospital, Gothenburg, Sweden
  2. 2
    Central Infant Welfare Unit, Uddevalla Hospital, Uddevalla, Sweden
  3. 3
    Paediatric Outpatient Clinic, Skene Hospital, Skene, Sweden
  4. 4
    Department of Paediatrics, Skaraborg Hospital, Skövde, Sweden
  1. Bernt Alm, Department of Paediatrics, University of Gothenburg, Queen Silvia Children’s Hospital, SE-416 85 Gothenburg, Sweden; bernt.alm{at}
  • Accepted 27 July 2008
  • Published Online First 25 September 2008


Background: Atopic eczema in infants has increased in western societies. Environmental factors and the introduction of food may affect the risk of eczema.

Aims: To investigate the prevalence of eczema among infants in western Sweden, describe patterns of food introduction and assess risk factors for eczema at 1 year of age.

Methods: Data were obtained from a prospective, longitudinal cohort study of infants born in western Sweden in 2003; 8176 families were randomly selected and, 6 months after the infant’s birth, were invited to participate and received questionnaires. A second questionnaire was sent out when the infants were 12 months old. Both questionnaires were completed and medical birth register data were obtained for 4921 infants (60.2% of the selected population).

Results: At 1 year of age, 20.9% of the infants had previous or current eczema. Median age at onset was 4 months. In multivariable analysis, familial occurrence of eczema, especially in siblings (OR 1.87; 95% confidence interval (CI) 1.50 to 2.33) or the mother (OR 1.54; 95% CI 1.30 to 1.84), remained an independent risk factor. Introducing fish before 9 months of age (OR 0.76; 95% CI 0.62 to 0.94) and having a bird in the home (OR 0.35; 95% CI 0.17 to 0.75) were beneficial.

Conclusions: One in five infants suffer from eczema during the first year of life. Familial eczema increased the risk, while early fish introduction and bird keeping decreased it. Breast feeding and time of milk and egg introduction did not affect the risk.


  • Funding: The study was supported by the Sahlgrenska Academy at the University of Gothenburg, the Research Foundation of the Swedish Asthma and Allergy Association, the Swedish Foundation for Health Care Sciences and Allergy Research, and the Health & Medical Care Committee of the Region Västra Götaland.

  • Competing interests: None.

  • Ethics approval: This study was approved by the ethics committee at the University of Gothenburg.

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