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Perinatal Prevention of Eczema in Neonates

Issue: 07/2016 | Vol. 4 | No. 1

Approximately 15-20% of children in the US are affected by atopic dermatitis,[1] yet current conventional treatment can only achieve symptom control rather than cure.  
More and more recent research has shown that disruptions in the development of neonatal microbiota and immunity have been linked with the development of allergies and eczema.[2]
Infant GI microflora develops quickly after birth and is closely associated with the development of the immune system. The first exposure takes place via the mother, who becomes the primary source of bacterial species found in the developing gut microbiota of the infant.
Infant nutrition (breast feeding or formula feeding) provides further support for an infant's microbiota growth, which continues to develop and drive the maturation of the immune system until 3 years of age.
Specific Strain of Probiotic Reduces the Risk of Eczema in Neonates by 46%- A 6-Year RCT[3],[4],[5]
In a double-blind, randomized controlled trial (RCT) carried out in Auckland, New Zealand, 474 pregnant mothers and their later born-children were involved and followed up for 6 years. Based on their family history, the subjects with higher risk of developing atopy were selected.
Daily supplementation of 6 billion cfu of L. rhamnosus HN001, 9 billion cfu of B. lactis HN019, and placebo started from 35 weeks gestation until birth, continuing to 6 months after birth in mothers if breastfeeding, and from birth till 2 years in all infants. Study outcomes were assessed at 2 and 4 years. The assessment includes eczema severity (SCORAD), Skin Prick Test (SPT), serum-specific IgE (ssIgE), and a standard questionnaire used for asthma, wheeze, and rhinoconjunctivitis.
The results demonstrated a significant reduction in the cumulative prevalence of eczema in the group supplemented with L. rhamnosus HN001, while the HN019 Group did not reduce any atopic parameters significantly.
The prevalence of eczema decreased by 49% (p=0.01)in the HN001 Group at 2 years of age, and more importantly the effect of L. rhamnosus HN001 persisted until six years of age when the cumulative prevalence was found to be 44% lower (p=0.01). At 4 years of age the relative risk of rhinoconjunctivits (rhinitis and red eyes) was found to be 62% less (p=0.01). In addition, supplementation with L. rhamnosus HN001 reduced the cumulative prevalence of positive skin prick test (SPT) by 31% (p=0.04) at 6-year follow up.
Immune-Modulatory Mechanisms of Probiotics
In general, there have been two mechanisms proposed for probiotic's effects on atopy:
  1. Probiotics may enhance gut barrier function.[6]
  2. Atopic conditions have been associated with Th2 dominant responses, thus it has been suggested that probiotic bacteria may protect against allergy through their modulatory actions to restore the balance of Th1 and Th2 cytokines.[7] 
Other than the Th1/Th2 shift, probiotics may also influence various mechanisms, such as T regulatory (Treg) cells involved in maintaining immunological tolerance, tolerogenic dendritic cells involved in Treg differentiation in the gut, and anti-inflammatory cytokines including IL-10 and TGF-Beta.[8]
Via Placenta & Breast Milk - The Better Routes
Clinical data suggests that probiotics may be more efficacious if infant exposure is via the placenta or breast milk rather than when given directly to the infant, potentially due to the fact that modified cytokine profile of maternal blood has a bigger impact on infant's immature immune system. [9],[10]
Early life protection of infant's microbiota is both necessary and time-sensitive; therefore, our medical advisory board has worked together to develop a comprehensive Prenatal & Breastfeeding nutrition support for the health of both Mom and Baby.
Perinatal Multi+ is a comprehensive multi with L. rhamnosus HN001 for pre- & post-natal support.
  • Provides essential vitamins & minerals for women before, during, and after pregnancy.
  • Formulated with Active Forms of B-Vitamins (ie. 5-MTHF [800 mcg/day], methylcobalamin, P5P, R5P).
  • Contains daily supply of 6 billion cfu of L. rhamnosus HN001- shown in a 6-year RCT to reduce the risk of baby developing eczema by 44-49%.
  • All minerals included are amino acid chelates to ensure optimal absorption and avoid toxicity
  • Contains ONLY Natural mixed carotenoids & free form lutein instead of vitamin A and beta carotene isolate.


  1. Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab (2015). 66(1):8-16.
  2.  Madan JC, Farzan SF, Hibberd PL, Karagas MR. Normal neonatal microbiome variation in relation to environmental factors, infection and allergy. Curr Opin Pediatr (2012). 24(6): 753-9.
  3. Wickens K, Black PN, Stanley TV, Mitchell E, Fitzharris P, Tannock GW, Purdie G, Crane J, Probiotic Study Group. A differential effect of 2 probiotics in the prevention of eczema and atopy: a double-blind, randomized, placebo-controlled trial. J Allergy Clin Immunol (2008). 122(4):788-94.
  4. Wickens K, Black P, Stanley TV, Mitchell E, Barthow C, Fitzharris P, Purdie G, Crane J. A protective effect of Lactobacillus rhamnosus HN001 against eczema in the first 2 years of life persists to age 4 years. Clin Exp Allergy (2012). 42: 1071-79.
  5. Wickens K, Stanley TV, Mitchell EA, Barthow C, Fitzharris P, Purdie G, Siebers R, Black PN, Crane J. Early supplementation with Lactobacillus rhamnosus HN001 reduces eczema prevalence to 6 years: does it also reduce atopic sensitization? Clin Exp Allergy (2013). 43:1048-57.
  6. Nermes M, Kantele JM, Atosuo TJ, Salminen S, Isolauri E. Interaction of orally administered Lactobacillus rhamnsosus GG with skin and gut microbiota and humoral immunity in infants with atopic dermatitis. Clin Exp Allergy (2010). 41:370-7.
  7. Schaub B, Liu J, Hoppler S et al. Maternal farm exposure modulates neonatal immune mechanisms through regulatory T cells. J Allergy Clin Immunol 2009; 123:774-82.
  8. McLoughlin RM. Mills KHG Influence of gastrointestinal commensal bacteria on the immune responses that mediate allergy and asthma. J Allergy Clin Immunol 2011; 27:1097-107.
  9. Prescott S, Wickens K, Westcott L et al. Supplementation with Lactobacillus rhamnosus or Bifidobacterium lactis probiotics in pregnancy increases cord blood interferon-y and breast milk transforming growth factor-B and immunoglobulin A detection. Clin Exp Allergy 2008; 38:1606-14.
  10. Huurre A, Laitinen K, Rautava S et al. Impact of maternal atopy and probiotic supplementation during pregnancy on infant sensitization: a double-blind placebo-controlled study. Clin Exp Allergy 2008; 38:1342-8.

† This article is for educational purpose only.

The entire contents are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this presentation.

All statements in this article have not been evaluated by the Food and Drug Administration and are not intended to be used to diagnose, treat, or prevent any diseases.

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