Patterns of early childhood allergy prevention behaviours: results of the KUNO-Kids health study

M. Pawellek^{1, 2}; A. Köninger^{3, 2}; M. Melter^{1, 2}; M. Kabesch^{1, 2}; C. Apfelbacher^{4, 2}; S. Brandstetter^{1, 2}

¹University Children’s Hospital Regensburg (KUNO), Regensburg, Germany; ²Hospital St. Hedwig of the Order of St. John, Regensburg, Germany; ³Hospital St. Hedwig of the Order of St. John, University Medical Center Regensburg, Regensburg, Germany; ⁴Otto von Guericke University Magdeburg, Regensburg, Germany

Background

Early childhood allergy prevention (ECAP) practices include parental behaviours related to exposure to or avoidance of potential allergens in the child. The S3 guideline in Germany specifies not only the behaviours recommended for allergy prevention, but also discourages most measures related to avoidance of allergens. This study aimed to identify patterns of ECAP behaviours practiced in German families.

Method

1662 mothers participating in the KUNO-Kids health study in the area of Regensburg, Germany were surveyed at birth of child, and after 1, 6, and 12 months using interviews and self-report questionnaires on several ECAP behaviours including nutrition and the living environment. Latent class analysis was used to analyse patterns of ECAP behaviours. Models with different numbers of classes were compared using the Bayesian information criterion (BIC) as a criterion for model selection.

Results

A model with three classes showed the best fit (BIC=16967.8). Classes were comparable regarding fish consumption in pregnancy and the child’s diet, timing of introduction of solid foods and feeding farm milk. The most prominent characteristic of class one (52.29%) was exclusively breastfeeding for at least 4 months. The other two classes were characterised by greater probabilities of exclusive breastfeeding for less than 4 months or not at all. Most notably, class two (18.57%) comprised mothers who fed hypoallergenic infant milk, who avoided specific foods in the child’s diet and who implemented measures against house dust mites. Class three (27.52%) was characterised by a higher probability of exposing the child to tobacco smoke.

Conclusion

This study investigated a range of parental ECAP behaviours, including both recommended and not recommended behaviours, using data from a large and well characterized birth cohort in Germany. We identified different patterns of ECAP behaviours practiced in families: a pattern of mostly recommended behaviours, a pattern of behaviours aiming at the avoidance of allergens and a pattern of mixed, partially unhealthy behaviours. ECAP counselling should take these patterns into account.