Preventing Eczema by Changing Your Microbes

There may not be an “x” in eczema, but extreme itching and inflammation spell out this painful disease most common in infants and children.

Quick review: Eczema is an allergic response to foreign substances, often food; it falls under the medical umbrella of atopic dermatitis, along with asthma. Prevalence of allergic responses is rising globally.

Enter the microbiome, which when healthy can maintain a strong gut wall to discourage pathogens and also shrink the immune response to allergies.

How to make gut microbes healthier?

Synbiotics combine the nutrient mix of prebiotics (non-digestible oligosaccharides found in breast milk and high-fiber foods) and probiotics (beneficial organisms). Ample evidence shows their skill in remodeling our microbes.

And where does research stand in managing this painful problem, made more so because of the age of the young victims?

Probiotics in eczema

As always, an ounce of prevention is worth a pound of cure. And as always, prevention is harder to prove but good results are emerging among the conflicted outcomes.

• A meta-analysis of 17 studies reporting data from nearly 5000 children revealed that infants treated with probiotics had a significantly lower risk ration for eczema compared to controls.
• Another review of 29 randomized trials gauged the effects of any probiotic administered to pregnant women, breast-feeding mothers, and/or infants: Results: Probiotics reduced the risk of eczema when used by women during the last trimester of pregnancy however the certainty in the evidence was judged to be low.

Experts agree that strain specificity, genetic influence and timing of administration appear to impact efficacy of probiotics in atopic dermatitis.

• For example, one recent study reported that in a double-blind, randomized, placebo-controlled birth cohort, a strain of Lactobacillus rhamnosus was beneficial for the prevention of eczema in children possessing high-risk genotypes.
• In addition, there was more good news reported in a 2014 study from Japan. Strains of bifidobacterium given prenatally to 130 mothers beginning 1 month prior to delivery and postnatally to their infants for 6 months, afforded a reduced risk of developing eczema during the first 18 months of life.

Thus probiotic supplementation may be beneficial in eczema though more work must be done to ascertain strain and dose specifics.

Prebiotics in eczema

Prebiotics (our indigestibles which feed the gut microbes) are vital to the equation and here too the outcomes of recent research are encouraging.

Meta-analysis of four studies found a significant reduction in eczema (1218 infants including controls) done at the University of Sydney. The authors concluded that it is unclear whether the use of prebiotics should be restricted to infants at high risk of allergy or may have an effect in low risk populations.

Synbiotics in eczema

A 2016 meta-analysis  of randomized clinical trials supported the use of synbiotics for the treatment of atopic dermatitis, particularly synbiotics with mixed strains of bacteria and for children aged 1 year or older.

Interesting aside

Consider this 180-degree pivot by the medical community: Decades of medical intelligence urged parents to steer clear of food allergens to prevent adverse reactions such as eczema. The newest wisdom suggests that babies should be exposed to allergens to prevent food allergies. Immune systems build up over time, learning friends and foes. Perhaps peanuts aren’t to be feared if they are familiar to immunoglobulins.

Takeaway

Deliver vaginally if possible, breastfeed your baby and introduce cultured foods when appropriate. A supplement while pregnant and breastfeeding may be helpful and feasting on prebiotics at meals is always a good practice.

Other reading:

Nutrition and Allergic Diseases

Eczema

Overview of Reviews The prevention of eczema in infants and children: an overview of Cochrane and non-Cochrane reviews.

Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant.

Probiotics and prebiotics in preventing food allergy and eczema.