Probiotics in Infancy Ineffective in Preventing Eczema and Asthma Later in Life

Close-up of eczema, showing an eczematous skin rash on the leg
Close-up of eczema, showing an eczematous skin rash on the leg
Supplementing high-risk infants with probiotics does not help prevent future eczema or asthma development, new research suggests.

Although earlier studies suggest exposure to probiotics in infancy may affect future immune system development, a new study published in Pediatrics finds that supplementing high-risk infants with probiotics does not help prevent future eczema or asthma development.

In a randomized, double-blind, controlled trial, researchers examined whether supplementation of Lactobacillus rhamnosus GG (LGG) during the first 6 months of life affects cumulative incidence of eczema, as well as asthma and rhinitis. In the intervention group, 92 infants received 10 billion colony-forming units of LGG and 225 mg inulin, whereas 92 infants in the control group were given 325 mg inulin alone.

Eligible newborns needed to have at least 1 biological parent with a history of asthma. The primary outcome measure was the incidence of eczema within 2 years of birth. Secondary outcomes included incidences of asthma and allergic rhinitis within 5 years of birth. Researchers used survival analysis methods to approximate disease incidence in the presence or absence of LGG and to estimate the efficacy of LGG in delaying or preventing these diseases.

Findings showed that the estimated cumulative incidence of eczema at 2 years of age was 30.9% (95% CI, 21.4%-40.4%) in the control group and 28.7% (95% CI, 19.4%-38.0%) in the intervention group (HR 0.95; 95% CI, 0.59-1.53, P =.83).

The cumulative incidence of asthma at 5 years of age was estimated to be 17.4% (95% CI, 7.6%-27.1%) in the control group and 9.7% (95% CI, 2.7%-16.6%) in the intervention group. However, the HR was not statistically significant (0.88; 95% CI, 0.41-1.87, P =.25).

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“[I]n infants with 1 parent with asthma, probiotic supplementation during the first 6 months of life did not affect the incidence of eczema or asthma at 2 years of age,
 the investigators noted.

Reference

Cabana MD, McKean M, Caughey AB, et al. Early probiotic supplementation for exzema and asthma prevention: a randomized controlled trial [published online August 7, 2017]. Pediatrics. doi: 10.1542/peds.2016-3000.