If you have a child with eczema or atopic dermatitis (AD), you may have heard that probiotics may be helpful for the skin condition. In this article, I talk about probiotics for eczema in babies and whether they are helpful and what things to look for when providing your child with probiotics.
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First of all, what are probiotics?
They are good bacteria (and even yeast) that go to your gut and help improve digestive and immune function. Some people may also experience other health benefits such as improvement in allergy symptoms, cholesterol, irritable bowel syndrome, infectious diarrhea. In our case, we are concerned about whether it benefits eczema symptoms.
Common bacteria that are used as probiotics include:
- Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, Escherichia, and Bacillus
There is also something called prebiotic, which are fuel to help probiotics to keep going. They are usually complex carbohydrates such as inulin and other fructo-oligosaccharides.
The benefits of probiotics depend on the species and strain used. I will discuss in more detail about different strains later in this article. (1)
Is there evidence that probiotic help eczema in babies and children?
This is a very hot topic and there are many research studies published and ongoing! The World Allergy Organization (WAO) currently states they endorse limited support for the use of probiotics for women in their third trimester, breastfeeding mothers and infants. The keyword is limited because although there is good evidence, it is not the strongest evidence possible.
The following recommendation is for children who have a genetic predisposition for eczema (ie sibling or parent who have one of the three components of atopic triad – eczema, allergic rhinitis, asthma). (2)
Click here for more information about outgrowing eczema and atopic triad
Another important consideration is that there are multiple factors that influence whether probiotics are beneficial. For example, the bacterial strain is an important component. Timing also is an important factor including duration and dosage.
Bifidobacterium lactis and Lactobacillus rhamnosus GG were found to be effective in decreasing eczema severity in breastfed infants with eczema. This improvement happened after taking these probiotic strains in formula for 2 months. The average age of children were 4.6 months old. (3)
What foods are a source of probiotics?
Food can be a source of probiotics that are beneficial for your health. They can be present in dairy food and non-dairy food. Dairy food include fermented milks, cheese, ice cream, buttermilk, milk powder, yogurts, kimchi, kefir, sauerkraut, tempeh, Japanese miso, beer, sour dough bread, chocolate, olives, and pickles. (4) These are a good source of probiotics for eczema in babies.
Non-dairy food includes soy based products, nutrition bars, cereals, juices, legumes, cabbage, maize, pearl millet, and sorghum. (5)
What are probiotic supplements?
Aside from food, probiotics are available in various forms including powder, capsules, gel caps, tablets, pills.
Homayoni et al in 2016 looked at multiple studies of various strains in food and supplements to see how they compared as vehicles for delivering probiotics. Although they did not perform statistical analyses, they found that there were many beneficial effects from probiotics whether it was delivered via food or supplement. (6)
In general, people are always recommended to get their nutrition, vitamins, and minerals through food. It’s not always easy, especially with young children and infants who cannot consume whole food yet. Personally, I started using Probonix since my baby’s first month of life. This brand has all the probiotics that research shows are beneficial and high number of bacteria, approximately 45 billion CFU.
How to use probiotics for treating eczema
They are commonly found in fermented food such as kimchi, kefir, yogurt, sauerkraut, tempeh (and others mentioned above). If your kids are able to consume table food, this might be a good way to introduce probiotics to them.
Obviously, babies cannot consume these foods until they reach a certain age. Probiotics as liquid supplements may be more acceptable for babies as they come in liquid form that you drop into their mouth.
Which Probiotics Strains Should I Choose?
The two strains of bacteria that are found to be beneficial based on research include Lactobacillus rhamnosus and Bifidobacterium.
Below is a brief summary of which bacteria strains help eczema. Sources are provided to research abstracts on Pubmed.
Lactobacillus acidophilus LA-5, Bifidobacterium lactis Bb12, and L. rhamnosus (LGG) were consumed through milk products by Norwegian mothers. There is evidence showing that these strains reduced the babies’ risk of developing atopic dermatitis if the mothers consumed these probiotics during pregnancy. (7)
Bifidobacterium breve M-16V and Bifidobacterium longum BB536 were also found to possibly decrease the number of atopic dermatitis in infants. This study was done in the Japanese population. (8)
Lactobacillus (LS), Lactobacillus fermentum (LF), and a probiotic mixture reduced SCORAD (a grading scale for eczema severity) values in children with AD. On the other hand, LGG and Lactobacillus plantarum (LP) showed no effect in children with AD for this particular study. (9)
Lactobacillus acidophilus DDS-1 and Bifidobacterium lactis UABLA-12 helped improve eczema in children with moderate-to-severe AD. (10)
LPCJLP 133, Lactobacillus paracasei, and LF helped improve eczema (11)
How much probiotic should I give?
There is no standardized dosage to give for children and infants. In general, for adults, at least 1 billion CFU (colony forming units) are recommended.
Nermes et. al wrote a paper stating probiotics containing as low as 3.4 billion CFU once a day over 12 weeks of Lactobacillus rhamnosus GG (LGG) were beneficial for children.(12)
In general, it seems that at least 20 billion CFU daily for 12 weeks is when patients started to show an improvement in their eczema symptoms. (13)
The randomized control trials included in Huang’s meta-analysis are summed up as follows:
- Lactobacillus rhamnosus strain GG (LGG) appears to be most helpful for infants (who are IgE sensitized) starting at age 1 month old.
- Lactobacillus fermentum (LF) appears to be helpful starting at 6 months old
- Lactobacillus (LS2) appears to be helpful at 2 years old
- Lactobacillus (LP) or Bifidobacterium lactis (BL) appears to be helpful at 3 months old
- Lactobacillus paracasei(LP), Lactobacillus fermentum (LF) at 1 year old (13)
- Bifidobacterium breve M-16V and Bifidobacterium longum BB536 starting 4 weeks prenatal for mothers and up to 6 moths after birth to infants (14)
When should I start probiotics?
This is a very good question. Certain strains of Lactobacillus were helpful at 6 months such as LF. Others such as LS2, LP, LF appears to help starting 1 year old and up. (13)
A paper from Japan by Enomoto et al found that Bifidobacterium breve M-16V and Bifidobacterium longum BB536 were helpful to reduce the risk of developing eczema. Their protocol was 1 month of probiotics to mothers prior to delivery and then 6 months of probiotics to the infant. So for this strain, it appears to help at a younger age for children with eczema (14)
Basically, if you plan to start probiotics and your baby is less than 6 months old, consider bifidobacterium. Otherwise, the research seems to show lactobacillus will be more helpful.
The topic of probiotics and how they can help children with eczema is a hot topic today. There is much to discuss and I believe there will be more information that comes forth with further research in the future. Based on what I have found through my research to write this article, probiotics can be helpful for babies with eczema. I hope that this article helps answer your question about probiotics for eczema in babies.