It is also linked to the recently published WAO guidelines ( 3 ) which are partially conflicting with the previous conclusion because it suggests that ‘ using probiotics in women who breastfeed infants at high risk of developing allergy , because considering all critical outcomes , there is a net benefit result ing primarily from prevention of eczema ( conditional recommendation , very low quality evidence ) ’ .
Probiotics in prevention of IgE-associated eczema: a double-blind, randomized, placebo-controlled trial.
BACKGROUND An altered microbial exposure may underlie the increase of allergic diseases in affluent societies .  Probiotics may alleviate and even prevent eczema in infants . OBJECTIVE To prevent eczema and sensitization in infants with a family history of allergic disease by oral supplementation with the probiotic Lactobacillus reuteri . METHODS Double-blind , r and omized , placebo-controlled trial , which comprised 232 families with allergic disease , of whom 188 completed the study . The mothers received L reuteri ATCC 55730 ( 1 x 10(8 ) colony forming units ) daily from gestational week 36 until delivery . Their babies then continued with the same product from birth until 12 months of age and were followed up for another year . Primary outcome was allergic disease , with or without positive skin prick test or circulating IgE to food allergens . RESULTS The cumulative incidence of eczema was similar , 36 % in the treated versus 34 % in the placebo group . The L reuteri group had less IgE-associated eczema during the second year , 8 % versus 20 % ( P = .02 ) , however . Skin prick test reactivity was also less common in the treated than in the placebo group , significantly so for infants with mothers with allergies , 14 % versus 31 % ( P = .02 ) . Wheeze and other potentially allergic diseases were not affected . CONCLUSION Although a preventive effect of probiotics on infant eczema was not confirmed , the treated infants had less IgE-associated eczema at 2 years of age and therefore possibly run a reduced risk to develop later respiratory allergic disease . CLINICAL IMPLICATION Probiotics may reduce the incidence of IgE-associated eczema in infancy
It is also linked to the recently published WAO guidelines ( 3 ) which are partially conflicting with the previous conclusion because it suggests that ‘ using probiotics in women who breastfeed infants at high risk of developing allergy , because considering all critical outcomes , there is a net benefit result ing primarily from prevention of eczema ( conditional recommendation , very low quality evidence ) ’ .