Overview of atopic dermatitis (eczema)

Atopic dermatitis results from a complex interplay between environmental and genetic factors

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What is Whole Goat Milk Formula?

Whole goat milk formula refers to infant or follow-on formula in which whole goat milk is used as the only source of protein and ~50% of fat is from milk fat, rather than relying on isolated milk proteins (skim milk and whey) or vegetable oils.

Its defining features include the preservation of the natural 20:80 whey-casein protein ratio of goat milk and retention of a high proportion of milk fat (~50%).
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This means that the whole goat milk formula:

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• Has lower levels of key milk allergens, αS1-casein and β-lactoglobulin.
• Is more efficiently digested, lowering the allergic trigger potential
• A post hoc analysis of the TIGGA study showed a trend for one-third lower cumulative incidence of eczema over 12 months in infants fed whole goat milk formula.

Overview of atopic dermatitis assessment of children to 12 months of age

{small}Adapted from Ferry, et al. 2023^4^{/small}

For the outcomes related to eczema, the participants were assessed for atopic dermatitis by several methods:

• AD_PRIMARY is the primary outcome and the strictest measure. Trained staff use the UKWP diagnostic criteria during face-to-face visits with infants at three time points (4, 6, and 12 months) to assess atopic dermatitis. To diagnose eczema under the UKWP criteria, a child must exhibit itchy skin and at least three of the following symptoms: dry skin, eczema in skin creases, a family history of asthma or hay fever, and visible eczema. Diagnosis based on objective criteria from the UK Working Party (UKWP), capturing only some forms of AD and/or AD present at study visits.
• AD_UKWP includes two additional time points, eight and ten months, where trained staff lead the parents through the UKWP examination of their toddler during a phone call.
• AD_DOCTOR was any AD that was diagnosed by a doctor up to 12 months of age. This captures any occurrence at any time, as evaluated by a trained practitioner, representing normal clinical practice. AD diagnosed by a doctor captures infants developing AD at any time throughout the intervention period.
• AD_ANY combines all the data, representing the total number of infants identified as having AD by one of the measures. Note that an infant diagnosed by two or more methods they are only counted once.

Collaborative clinical study

• The GIraFFE Study is led by the Comprehensive Childhood Research Center, Ludwig-Maximilians-Universität, Munich.
• The Study involves 10 university groups across Poland and Spain, with experience in clinical trials and led by Principal Investigators with expertise in infant and childhood nutrition.
• This work is supported by Dairy Goat Co-operative (NZ) Limited and the New Zealand Ministry for Primary Industries as part of the Caprine Innovations NZ Sustainable Food & Fibre Futures Partnership Programme {small}(grant number PGP06- 16001){/small}.

Prevention is the most effective way to reduce the burden of eczema and the development of other allergic conditions.

• Exclusive breastfeeding for at least 4-6 months has a protective effect of breastfeeding in the general population of infants and provides even greater protection for infants with a family history, with ~40% reduction^6^.
• Hydrolysed formulas may reduce the risk of eczema in infants with a family history by up to 25%^7-8^.
  Supporting the skin barrier with the use of emollients soon after birth (e.g. those that include ceramides), and the use of water softeners can provide benefits for infants at high-risk of eczema^6^.

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