Published Online: December 2012
For more than a decade there have been promising reports of well-conducted trials suggesting that probiotics reduce the risk of eczema in infants and children. Nonetheless, the optimal mode of probiotic intervention has not yet been identified. It is not presently clear which population is most likely to benefit from the intervention, nor do we know when or for how long probiotics should be administered. Furthermore, administering viable bacteria to newborn infants raises obvious safety concerns.
In an article recently published in The Journal of Allergy & Clinical Immunology (JACI), Rautava et al. investigated whether maternal probiotic supplementation during pregnancy and breastfeeding is safe and effective in reducing the risk of eczema in high-risk infants. In a study conducted in Finland, the investigators randomized 241 skin prick test positive mothers with allergic disease to receive a combination of Lactobacillus rhamnosus LPR and Bifidobacterium longum BL999, a combination of L. paracasei ST11 and B. longum BL999, or placebo beginning 2 months before delivery and during the first 2 months of breastfeeding. The infants were followed until the age of 24 months.
The authors found that the risk of developing eczema during the first 2 years of life was significantly reduced in infants whose mothers received either probiotic combination as compared to infants whose mothers received placebo. In contrast, probiotics seemed to have no impact on the risk of atopic sensitization as assessed by skin prick tests in the infants. The interventions were well-tolerated since neither the mothers nor the infants in the study experienced adverse effects related to maternal use of probiotics.
The authors’ findings suggest that specific probiotics administered to pregnant and breastfeeding mothers are effective in reducing eczema risk in infants at high hereditary risk. Infants likely to benefit from such intervention may be objectively identified by skin prick test positive allergic mothers. Maternal probiotic intervention is safe, relatively inexpensive, and feasible during pregnancy and exclusive breastfeeding.
The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.