Early introduction of fish decreases the risk of eczema in infants.

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.

SIDS risk factors and factors associated with prone sleeping in Sweden.

OBJECTIVE: To compare the current prevalence of risk factors for sudden infant death syndrome (SIDS) in Sweden with a decade earlier, and assess factors associated with prone sleeping. METHODS: The results of a cohort study (Infants of Western Sweden) and a population based case-control study (Nordic Epidemiological SIDS Study) were examined. Subjects were 5600 healthy 6 month old infants born in 2003 in the Western Sweden region and 430 healthy Swedish infants born between 1991 and 1995. RESULTS: Prone sleeping decreased from 31.8% to 5.6% and supine sleeping increased from 35.3% to 47.3%. Side or side/supine sleeping increased from 25.2% to 43.8%. Maternal smoking during pregnancy decreased from 23.5% to 9.5%. The risk for prone sleeping increased if the mother was unemployed (OR 2.4, 95% CI 1.5 to 4.0), if she was a heavy smoker in the third trimester (OR 44.1, 95% CI 1.6 to 1199.6), and if the child was irritable (OR 2.5, 95% CI 1.3 to 5.1), shared a bedroom with siblings (OR 2.6, 95% CI 1.0 to 6.6), or never used a dummy (OR 3.2, 95% CI 1.9 to 5.4). CONCLUSIONS: Parents have complied with advice to prevent SIDS given at infant welfare centres for the last 10 years. A change in the preferred sleeping position from side variants to exclusively supine, and reducing the number of pregnant women smoking may be beneficial. Use of a prone sleeping position was associated with maternal employment status, maternal smoking, temperament of the child, dummy use, and sharing a bedroom with siblings.

Health habits and risk behavior among youth in three communities with different public health approach.

BACKGROUND: There is a consensus today that comprehensive public health activities including many actors are needed for impact on health compromising behaviors. However, few studies are available to document long term effects regarding youth. We identified three rural, demographically comparable communities dominated by nuclear middle class families. One of these communities demonstrated comprehensive public health activities directed towards adolescents' needs and life-styles for a duration of at least 15 years, while the other two had an outspoken ideology of relying only on national health promotion. METHODS: Local health planners and pediatricians performed in-depth interviews with key people and checked relevant reports to trace the local public health history and to assess conventional and unconventional activities regarding health promotion for adolescents in the three communities. The outcome of at least 15 years of different policy regarding health promotion was studied in 1991 through self-reports of 915 subjects, 13-16 years old, with a questionnaire distributed through schools with questions on health, health habits and health compromising behaviors. The study itself turned out to be an important intervention. The two "inactive" communities changed their policy and methods. For this reason a second survey was done in 1993 with 593 subjects 13-16 years in the "active" and in one of the "inactive" communities. RESULTS: The adolescents in the "active" community with a long duration of energetic and comprehensive public health activities consistently demonstrated better mental health, health habits and less risk behavior in contrast to the state in the two "inactive" communities. Two years of active work in the "inactive" communities marginally improved health there. CONCLUSION: This study suggests that consistent and comprehensive public health activities might have reduced risk taking behavior and improved health and health habits during mid-adolescence.

Self-assessment of sexual maturity by mid-adolescents based on a global question.

The objective of this research was to investigate the use of a global question for evaluation of body development relative to age-mates in addition to graded statements on sexual maturity (SM) as part of self-reports on pubertal development. In total, 4516 adolescents answered written questions on pubertal development and the global question. They represented a normative Swedish sample. To validate these results, 100 mid-adolescents were asked to answer the statements regarding SM and the global question. This was compared with ratings made by two professional examiners for each young person. The outcome of the population study was evaluated against standard biological timetables and demonstrated adequate agreement. In the validation study, the inter-rater agreement between the professionals was excellent and so were professional ratings against those of the adolescents, with one exception: boys rating of their public hair. The global question alone gave the best agreement on pubertal progress. We can conclude that the global question is a valid tool for evaluation of pubertal development during mid-adolescence in population surveys.