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Baby Medical Q&A, Issue #093 Cats, Dogs, Asthma and Eczema
July 01, 2014
Hi

Welcome to another edition of Baby Medical Q&A News.

Cats, Dogs, Asthma and Eczema

This month's ezine is fairly specific. However, this is a question I am asked frequently.

We have asthma in the family? We have a new baby. Is it ok to get a cat?
or
My toddler has developed eczema, should we get rid of our cat?

You can switch the asthma for eczema in the questions as well, or substitute allergy. This theme is not uncommon.

To read more about allergy and the different types, click here.

So, in response to questions on this theme, here is my advice given current evidence:

Firstly, when there is a family tendency to asthma, this does mean your baby/child is at risk of developing asthma. It's true that some children with asthma will get wheezy when exposed to cats and to a lesser extent dogs. Does that mean cats (and/or dogs) are out for anyone with a history of asthma - No.

So how do you know if your baby is going to get asthma because there's a family tendency - you don't. How do you know if your child is going to react to cats (or dogs) if he or she has asthma - you don't.

The research evidence around cat exposure (and dog and other animal exposure) is conflicting:

  1. The Urban Environment and Childhood Asthma study found that high exposure to allergens from cats in the first year of life was associated with lower rates of wheezing at age 3 yrs. Overall, they showed that increased exposure to allergens (including dog, cat, mice, cockroaches etc) over the first 3 years was associated with increased wheeze. The finding that exposure in the first year and particularly the first few months was the opposite and actually was protective of wheeze is likely to be due to the the switching of the immune system from allergic to tolerant - something commonly referred to as the Hygiene Hypothesis.

    If you're wondering about dogs, in this study there was no protective effect, but equally no increased risk of asthma with having a dog.



  2. On the other hand, another study, the ISAAC (International Study of Asthma and Allergies in Childhood), found that exposure to cats in the first year of life was associated with increased asthma and eczema at age 6 - 7 years, especially in less affluent countries. There was a similar but less marked effect with dogs.


  3. Another of the ISAAC studies found that exposure to farm animals in the first year of life was not associated with increased asthma and eczema at 6 - 7 years in affluent countries although it was in non-affluent countries.


  4. And a study in New Zealand found that exposure to farm animals in utero (so before birth) was protective for asthma and eczema.


What does it all mean?

The evidence is not conclusive yet but it seems that if you want to have a cat or dog, then having it during pregnancy is best. Once you have a pet, you just have to wait and see if your child reacts. I would suggest that your child's bed and bedroom are pet free in all cases.

If you already have a cat or dog and your child is diagnosed with asthma or eczema, keep their bed and bedroom pet-free. If there is no increase in symptoms after your child plays with the cat or dog, there is probably no problem and no need to get rid of your pet. If on the other hand, there is a clear association between symptoms and playing with the pet, then a new home for the pet is required.

I hope this is helpful.

References

Susan V. Lynch et al. Effects of early-life exposure to allergens and bacteria

on recurrent wheeze and atopy in urban children. Journal of Allergy and Clinical Immunology

Available online 4 June 2014

Brunekreef B et al for ISAAC Phase Three Study Group.. Exposure to cats and dogs, and symptoms of asthma, rhinoconjunctivitis, and eczema. Epidemiology. 2012 Sep;23(5):742-50.

Brunekreef B et al for ISAAC Phase Three Study Group. Early life exposure to farm animals and symptoms of asthma, rhinoconjunctivitis and eczema: an ISAAC Phase Three Study. Int J Epidemiol. 2012 Jun;41(3):753-61. doi: 10.1093/ije/dyr216. Epub 2012 Jan 27.

J. Douweset al. Farm exposure in utero may protect against

asthma, hay fever and eczema. Eur Respir J 2008; 32: 603-611


Please feel free to share this ezine with family and friends.

Till next time,

Dr Maud

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