PURPOSE OF THE STUDY.
The authors had previously reported that supplementing infants at risk for allergic disease with probiotics did not prevent eczema or allergen sensitization in the first year of life. The present study evaluated the allergic outcomes of these same subjects at 5 years of age.
In this Singaporean study, qualifying term infants had a first-degree relative who not only had a diagnosis of asthma, allergic rhinitis, or eczema but also a positive result on skin prick testing to Dermatophagoides pteronyssinus and/or Blomia tropicalis. A total of 124 infants were given cow’s milk formula with probiotics and 121 infants were given cow’s milk formula without probiotics from the first day of life until 6 months of age. By 5 years, 87% had completed the study (112 who were on probiotics and 108 who did not receive probiotics).
Subjects received at least 60 mL (9.26 g) per day of commercially available cow’s milk–based infant formula in this double-blind, placebo-controlled randomized study. Probiotic supplementation was with Bifidobacterium longum (BL999) and Lactobacillus rhamnosus (LPR). During regular follow-up visits over the next 5 years, children were assessed for asthma, allergic rhinitis, eczema, and food allergy.
At the age of 5 years, presence of eczema and eczema severity according to the SCORAD (Scoring Atopic Dermatitis) index were not significantly different between the probiotic group and the placebo group (16.9 vs 15.3; P = .295). There was also no significant difference between the 2 groups for asthma development, food allergy, and dust mite sensitization. Of note, those subjects who consumed probiotics on their own accord after the initial 6-month treatment period were statistically associated with a reduced incidence of asthma and allergic rhinitis at 5 years of age. There was no difference in growth rate (for height and weight) between the 2 study populations.
Early-life supplementation with probiotics did not change allergic outcomes at 5 years of age.
Studies in Scandinavia, Australia, and Germany have had similar negative findings. Nevertheless, the authors noted that those infants who continued probiotic supplementation once a week from the age of 2 years for at least 1 year did have a reduced incidence of asthma and allergic rhinitis, no matter which study group they were part of. It seems we are not yet able to reach any final conclusions regarding probiotic supplementation and its influence on atopy.
- Copyright © 2014 by the American Academy of Pediatrics