ABSTRACT. Objective. It has been hypothesized that early infections protect against the development of atopic disease, but there have been few long-term follow-up studies. We estimated the associations between early respiratory infections and doctor-diagnosed asthma, allergic rhinitis, and skin-prick sensitization in children at 10 years of age in the Oslo Birth Cohort, established in 1992-1993. We also considered birth order and attendance at a child care center as proxy measures of increased exposure to infections early in life.Methods. A total of 2540 children were followed from birth to the age of 10 years. Experiences of respiratory infections were recorded in follow-up surveys at 6 and 12 months. At age 10, questions were asked about current symptoms of asthma and allergic rhinitis and about having ever received a doctor diagnosis for these diseases. A subsample (n ؍ 1740) of the cohort was tested for skinprick test reactivity.Results. Current asthma was related to lower respiratory tract infection (adjusted odds ratio [OR]: 2.1; 95% confidence interval: 1.3-3.0) and croup (adjusted OR: 2.3; 95% confidence interval: 1.3-4.2) in the first year. ORs for allergic rhinitis and skin-prick sensitization were smaller but mainly positive. Birth order and child care attendance at age 1 year were not significantly associated with any of the studied outcomes.Conclusions. Early respiratory infections did not protect against the development of asthma, allergic rhinitis, or sensitization to common allergens during the first 10 years of life but increased the risk for asthma symptoms at age 10 in this population. H aving older siblings has been found to be inversely associated with asthma and other atopy-related disorders. [1][2][3][4][5][6] Some studies have also shown that these disorders are inversely associated with child care attendance outside the home, 6-10 whereas other studies have not been able to confirm these findings. 11-13 A common interpretation of these results has been that older siblings and child care attendance are indirect measures of earlylife infections and that early-life infections have a preventive effect on the development of atopic disorders. A number of studies have also assessed the relation between atopic disorders and direct measures of early-life infections, 11,13-23 but fewer have been able to do this prospectively. [13][14][15][18][19][20][21][22] Studies that have used direct measures of infections have shown less consistent results than the studies that have used indirect measures, and the inverse relation has often been restricted to subgroups of diseased individuals, mainly those with atopic predisposition. Furthermore, childhood asthma has been found to be more common in children who experienced at least 1 specific type of early respiratory infection, namely respiratory syncytial virus infection. [24][25][26][27] The inverse relation between early-life infections and the development of atopic disorders is supported by a plausible biological mechanism, according to which early-lif...