Concerns and expectations of parents with atopic infants

The incidence of atopic diseases has rapidly increased in developed countri es. The put-pose of this study was to describe the problems that parents ex perience when atopic disease occurs in their children at an early age and w hat parents expect and get from health care professionals in the management of these problems. The parents of 81 high-risk atopic infants completed a questionnaire during the infant's first attendance at the Tampere Universit y Hospital, Finland, The patients were treated by an intervention team comp rising a pediatric nurse and two pediatricians consulting with dietician an d a dermatologist to detect the infant's specific food allergies and to int roduce and advise on appropriate diets at weaning. After a 9-month interven tion period, the parents' perception of the intervention was evaluated by a second questionnaire. The skin prick test was positive to cow's milk in 30 %, to egg in 26%, and to cereals in 19% of infants during breast-feeding. D ouble-blind placebo-controlled cow's milk challenge was positive in 56% of infants. Upon introduction of a tolerated weaning diet, subjective symptoms and the extent and intensity of atopic eczema diminished as evidenced by l owered SCORAD scores, from 19.3 to 8.2 (F = 57.6, p < 0.0001; SCORAD - scor ing index combining extent, severity and subjective symptoms of atopic ecze ma). Ninety per cent of parents found the care of an atopic infant more dem anding than that of a healthy child. This was because of the persistence of symptoms, such as atopic eczema and pruritus, and restlessness during slee p. For the management of these problems the parents advocated diagnostic ev aluation and elimination of specific foods from the diet of the lactating m other. They expected from the intervention accurate diagnosis of food aller gies, practical advice on elimination diets, alleviation of symptoms, and f ollow-up of growth and nutrition, and they considered the care provided by the intervention team to suffice in these aims. The present data support a comprehensive team approach to the care of atopic infants and their parents .