Your browser has 'Cookies' disabled, alert boxes will continue to appear without this feature.

Probiotics in pregnancy for infant atopic eczema


The gut of a healthy fetus is sterile. After delivery, the mother’s gut flora colonises the infant’s gut


Intervention

Oral probiotics (containing only Lactobacillus species) taken by women during pregnancy and/or women and infants during the postpartum period.

Indication

Infants at higher risk of atopic eczema, with the aim of preventing or reducing its incidence. 

Higher risk is determined by a family history of allergic disease. There is a strong hereditary component to infant atopic eczema: if both parents have a history of eczema, the offspring risk is 60–80%. 

Probiotics may reduce the relative incidence of atopic eczema by almost 80%. In trials, the favourable effect was similar across different periods of probiotic use (ie after delivery only or also during pregnancy), the receiver(s) of the probiotics (ie mother, child or both) and the duration of probiotic use. 

Probiotics have several actions in the gut, including actively competing with pathogens for nutrition, making gut contents acidic, secreting local antimicrobial agents and enhancing specific and non-specific immune responses. The composition of gut flora may reduce allergies by driving maturation of the immune system.

Precautions

Evidence suggests that probiotics are safe for the vast majority of people. Although there is little risk of sepsis, these agents should potentially be avoided in patients who are immunocompromised, severely debilitated, critically ill or postoperative.

Adverse effects

Probiotics are safe in both pregnant women and infants, and are not associated with serious adverse effects. 

Some people experience bloating and diarrhoea.

Availability

Many different formulations of probiotics (capsules, powders, sachets) are available from supermarkets, pharmacies and health food stores. Products containing probiotics that are classed as foodstuffs (eg yoghurt) are not subjected to the same rigorous processes for labelling and listing as are applied to medicines.

Probiotics containing Lactobacillus species are widely available.

Description

In medical trials, probiotic supplementation was generally started in the mother at 34­–36 weeks of gestation and continued in the postpartum period until the baby was 3–6 months of age (or until weaned). Some of the infants in the trials were given probiotics mixed in breast milk or formula, either concurrently or independently of the mother taking probiotics. 

Lactobacillus species (particularly Lactobacillus  rhamnosus GG) are typically used, most commonly at a strength of 2 x 1010 CFUs (colony-forming units) daily. However, there does seem to be a moderate effect seen across all probiotics tested. 

Probiotics may be taken alone or with food/fluid to manufacturer’s directions.  

Grading

NHMRC Level I evidence.

References

Doege K, Grajecki D, Zyriax BC, Detinkina E, Zu Eulenburg C, Buhling KJ. Impact of maternal supplementation with probiotics during pregnancy on atopic eczema in childhood – a meta-analysis. Br J Nutr 2012;107:1–6.

Pelluchi C, Chatenoud L, Turati F, et al. Probiotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: A meta-analysis. Epidemiology 2012;23(3):402–14.

Allen SJ, Jordan S, Storey M, et al. Probiotics in the prevention of eczema: A randomised controlled trial. Arch Dis Child 2014;99(11):1014–19.

First published: December 2016

Advertisement loading...

Advertisement


Interact with HANDI

About HANDI

Interventions

Children

Nutrition

Cardiovascular

Mental health

Musculoskeletal

Other

The Royal Australian College of General Practitioners Ltd

Contact Us

General Inquiries

General Enquiries

Opening hours 8:00 am-8:00 pm AEST

1800 4RACGP

1800 472 247 | +61 (3) 8699 0300 (international)

Payments

Payments

Pay invoices online

RACGP automated payment service: 1800 198 586

Follow us on

Follow RACGP on Twitter Follow RACGP on Facebook Follow RACGP on LinkedIn


Healthy Profession. Healthy Australia Logo

The Royal Australian College of General Practitioners Ltd (RACGP) ABN 34 000 223 807
RACGP House, 100 Wellington Parade, East Melbourne, Victoria 3002 Australia

Terms and conditions | Privacy statement
Sponsor conditions | Delegate conditions