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the effect of brief early exposure to cows' milk on atopy in the first
2 years of life.
DESIGN—Double blind, placebo controlled, randomised feeding intervention trial (Bokaal study).
SETTING—Dutch midwifery practices.
PARTICIPANTS—1533 breast fed neonates.
INTERVENTION—Exposure to cows' milk protein (n = 758) or a protein free placebo (n = 775) during the first 3 days of life.
MAIN OUTCOME MEASURES—Clinical atopic disease and any positive radioallergosorbent (RAST) tests at 1 year of age.
RESULTS—Atopic disease in the first year was found in 10.0% (cows' milk) v 9.3% (placebo) of the children, with a relative risk of 1.07; in the second year, atopic disease was found in 9.6% v 10.2%, respectively, with a relative risk of 0.94. Per protocol analysis showed similar results. Any RAST positive test was found in 9.4% (cows' milk) v 7.9% (placebo) of children, with a relative risk of 1.19. Stratified analysis for high family risk of allergy showed a doubled incidence of atopic disease but no effect from the intervention.
CONCLUSION—Early and brief exposure to cows' milk in breast fed children does not increase the risk of atopic disease in the first 2years.