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The atopic child

The Atopic Child

The incidence of childhood atopic disease in developed countries has increased dramatically over the past several decades. In Australia at present one in four children is affected. The exact reason(s) for this is still not completely understood. It may be linked to our environment, the food we are eating, changes in our lifestyle, genetics or a combination of these factors. [1]

What are Atopic Diseases?

Atopic diseases in children consist of atopic dermatitis (eczema), asthma and rhinoconjunctivitis (allergic rhinitis). The Medical Journal of Australia states that “a child with atopy produces specific IgE antibodies after exposure to common environmental allergens and is said to be sensitised to that allergen. The presence of specific IgE antibodies is measured by means of a skin prick test or radioallergosorbent testing (RAST). Eczema, asthma and rhinoconjunctivitis are clinical syndromes each defined by a collection of symptoms and signs and are commonly referred to as the atopic diseases. While most children with these conditions are atopic, some are not, and, conversely, some children with atopy may not manifest atopic disease.”

Genetic Predisposition & Hygiene Hypothesis

Studies have shown that a child of atopic parents (or one parent and a sibling) has a 40% chance of being affected by an atopic disease. Dr. Kelly Stone, MD, PhD at the Children’s Hospital Division of Immunology in Boston (USA) wrote a paper on Atopic Disease of Children (2003), in which she discusses the link between the environmental aspects of atopic disease and the significant increase in its incidence...

“Although a genetic predisposition to atopic disease is important in disease pathogenesis, the genetic background in developed countries has not changed over the past several decades. What has changed and likely explains the increase in atopic diseases are environmental factors, including environmental exposures (allergens, pollution, and so on) and infection patterns.”

She also states that “the most commonly cited explanation for the increase in atopic disease in developed countries is the hygiene hypothesis... a more hygienic environment and fewer childhood infections in developed countries may be responsible for the increases in atopic disease seen over the past several decades.” The International Study of Asthma and Allergies in Childhood (ISAAC) supports Dr. Stone’s theories. Their study not only showed a marked difference between the frequencies of atopic disease in different countries but also regionally within these countries. As expected, the highest prevalence was found in the more westernised, industrialised countries. [1] [2]

Allergens in food have also been linked with atopic disease, especially eczema. The most problematic foods include cow’s milk, egg, nut, sesame seed, soy, wheat and seafood proteins. Traces of these food allergens have also been detected in human breast milk following maternal ingestion. [1] [3]


Unfortunately, at present the treatment of atopic disease is mainly symptomatic, most medications being used are either anti-inflammatory and/or designed to block the effects of substances released during the allergic or atopic response. For those children who are lucky enough to identify allergen triggers, strict avoidance should enable a more effective treatment plan. [1]

Numerous studies have evaluated the benefits of supplementing omega 3 fatty acids during pregnancy, lactation, infancy and childhood for the prevention and/or treatment of atopic disease, especially for asthma. Omega 3 plays a prominent role in reducing inflammation in the body and has shown to help boost the immune system. Fish oil and cod liver oil are two of the best quality sources of omega 3. [4]

Probiotics (beneficial bacteria in the gut) also play a significant role in supporting the immune system. They help to modulate T helper 1 and 2 immune responses and they alleviate changes related to (allergic) inflammation. [5]

When supplementing with fish oil, cod liver oil and probiotics the use of high quality products is essential. Fish oils can contain mercury naturally occurring in the fish. At Kingsway we stock our own fish oil capsules (EPA/DHA – 180/120mg). The oil is from fresh salmon caught in the wild from non-mercury containing waters. Another brand we stock is Nordic Naturals, which have an extensive range of very high quality fish and cod liver oils (in capsule and liquid form).

We also stock a wide range of probiotics. Bifidobacterium infantis is naturally present in high amounts in infants however the strain of probiotics used to treat atopic disease may vary from case to case. It is important to remember not to use probiotics that contain milk, as many atopic children are casein sensitive.



  1. Gold M.S., Kemp A.S. Atopic disease in childhood. Med J Aust. 2005; 182 (6):298-304.
  2. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczemz: ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC). Steering Committee. Lancet. 1998; 351: 1225-1232.
  3. Caffarelli, Cavagni G, Paganelli R, et al. Passage of food antigens into circulation of breast-fed infants with atopic dermatitis. Ann Allergy. 1988; 61: 361-365.
  4. Calder PC, Diaper ND, Kremmyda LS, Miles EA, Noakes PS, Vlachava M. Atopy risk in infants and children in relation to early exposure to fish, oily fish, or long-chain omega-3 fatty acids. Clin Rev Allergy Immunol. 2011;41(1):36-66.
  5. Betsi GI, Falagas ME Kouranos VD, Vliagoftis H. Probiotics for the treatment of allergic rhinitis and asthma: systematic review of randomized controlled trials. Ann Allergy Asthma Immunol. 2008;101(6):570-9.


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