Science

Samuli Rautava, MD, PhD; Essi Kainonen, MD; Seppo Salminen, PhD; and Erika Isolauri, MD, PhD

Background:
Probiotics have shown promising potential in reducing the risk of eczema in infants. Optimal probiotic intervention regimen remains to be determined.
Objective:
We investigated whether maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of developing eczema in high-risk infants.
Methods:
This was a parallel, double-blind placebo-controlled trial of 241 mother-infant pairs. Mothers with allergic disease and atopic sensitization were randomly assigned to receive (1) Lactobacillus rhamnosus LPR and Bifidobacterium longum BL999 (LPR1BL999), (2) L paracasei ST11 and B longum BL999 (ST111BL999), or (3) placebo, beginning 2 months before delivery and during the first 2 months of breast-feeding. The infants were followed until the age of 24 months. Skin prick tests were performed at the ages of 6, 12, and 24 months.
Results:
Altogether 205 infants completed the follow-up and were included in the analyses. The risk of developing eczema during the first 24 months of life was significantly reduced in infants of mothers receiving LPR1BL999 (odds ratio [OR], 0.17; 95% CI, 0.08-0.35; P less than .001) and ST111BL999 (OR, 0.16; 95% CI, 0.08-0.35; P less than .001). The respective ORs for chronically persistent eczema were 0.30 (95% CI, 0.12-0.80; P 5 .016) and 0.17 (95% CI, 0.05-0.56; P 5 .003). Probiotics had no effect on the risk of atopic sensitization in the infants. No adverse effects were related to the use of probiotics.
Conclusion:
Prevention regimen with specific probiotics administered to the pregnant and breast-feeding mother, that is, prenatally and postnatally, is safe and effective in reducing the risk of eczema in infants with allergic mothers positive for skin prick test.