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

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 (LPR+BL999), (2) L paracasei ST11 and B longum BL999 (ST11+BL999), 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 LPR+BL999 (odds ratio [OR], 0.17; 95% CI, 0.08-0.35; P < .001) and ST11+BL999 (OR, 0.16; 95% CI, 0.08-0.35; P < .001). The respective ORs for chronically persistent eczema were 0.30 (95% CI, 0.12-0.80; P = .016) and 0.17 (95% CI, 0.05-0.56; P = .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. (J Allergy Clin Immunol 2012;130:1355-60.)