Probiotics no help for eczema or asthma in children
Probiotic supplementation during the first 6 months of life does not reduce the incidence of eczema or asthma later in childhood, according to the randomized controlled TIPS* study.
At 2 years of age, 68 children had eczema. At 5 years, 27 had asthma.
It was thought that probiotic supplementation during infancy could affect immune system development and reduce the risk of allergic diseases, particularly eczema and asthma, later in childhood.
“[However], our results do not support the use of early-life LGG [Lactobacillus rhamnosus GG] probiotic supplementation for the prevention of asthma or eczema in children at high risk,” said the researchers.
The trial involved 184 newborns who were randomized to a daily dose of 10 billion colony-forming units of LGG and 225 mg of inulin (n=92) or 325 mg of inulin alone (n=92) for 6 months and followed for up to 6 years. All newborns had at least one parent with asthma. Breastfeeding was encouraged throughout the study course. The primary endpoint of the study was the incidence of eczema at 2 years; and secondary endpoint was the incidence of asthma at 5 years. [Pediatrics 2017;140:e20163000]
By 6 months, the incidence of eczema was 6.6 percent in the LGG arm and 15.6 percent in the control arm. At 2 years, there was an increased incidence of eczema in both the study arms (28.7 percent in the LGG arm and 30.9 percent in the control arm).
Of note, the first incidence of asthma was observed at 2 years. At 5 years, the incidence of asthma increased to 9.7 and 17.4 percent in the LGG and control arms, respectively.
Among the 27 children diagnosed with asthma, 18 had an earlier diagnosis of eczema. Children who previously had eczema had a higher risk of asthma, noted the researchers.
“Although the results of this study can only be extrapolated to those children born to at least 1 parent with asthma, it is assumed that any effects for lower-risk infants (eg, infants born to parents without asthma) are probably lower,” they added.
The results were contrary to findings of a previous study which showed that 6-month supplementation with LGG in high-risk infants nearly halved the risk of developing eczema compared with placebo (23 percent vs 46 percent). [Lancet 2001;357:1076-1079]
“There have been mixed results regarding the effectiveness of early infant LGG supplementation in decreasing the likelihood of eczema,” said the researchers. What the current study adds is that supplementation with LGG probiotic strain appeared to have no impact on eczema or asthma in infants born to one parent with asthma and with high breastfeeding rates.
*TIPS: Trial of Infant Probiotic Supplementation