Eczema or atopic dermatitis (AD) dramatically impacts children’s health and the quality of life of the family as a whole. Although the exact cause of eczema is somewhat unclear, we do know there are multiple factors at work including genes, environment, immune function, skin sensitivities, and the developing gut microbiome.1 According to the Centers for Disease Control and Prevention (CDC) and the World Allergy Organization, the frequency of both food (~5%) and respiratory (~17%) childhood allergies in the United States has increased in recent years.2,3 But none so much as eczema, which is currently estimated to affect up to 30% of American children (or approximately 10 million), one-third of whom experience significant symptoms and prolonged disease.4,5

Eczema: Early-Life Risk Factors

Mode of delivery: Cesarean-section (C-section) birth rates have tripled since 1990 and show no sign of slowing down. Studies have shown that children delivered by C-section harbor less Bifidobacteria and Bacteroidesspecies in their gut and more potentially problematic Clostridia, E coli, and S aureus species compared to children delivered vaginally. These children are also more likely to develop immune disorders including asthma and allergies.6,7

Breastfeeding: Extended breastfeeding is very helpful in mitigating the microbial impact of C-section births. Although 84% of U.S. mothers begin breastfeeding, nearly 20% supplement with formula by day two after birth, and only 58% of U.S. babies are breastfeeding at six months of age.8

Antibiotic exposure: Antibiotic use has become common in modern obstetric/neonatal practice. But there is increased evidence that links early-life antibiotic exposure with inflammatory bowel disease, diabetes, obesity, and immune-modulated disease.9

Infant Immune and Microbiome Development: Mother Matters

During pregnancy, a mother’s body goes through remarkable changes to support her baby’s development. Her immune system adapts, and her gut microbiome shifts in ways that help prepare the infant for life outside the womb.10,11

Mothers also pass along important antibodies and growth factors that help guide the baby’s early immune development. While some early microbial exposure may begin late in pregnancy, the biggest influence on a baby’s gut microbiome happens at birth and beyond.16

Babies born vaginally are typically exposed early on to beneficial bacteria such as Bacteroides and Bifidobacterium, which play an important role in immune development and microbial balance. Babies born by C-section tend to have a different early microbial exposure, with a greater presence of skin-associated bacteria such as Staphylococcus species.17 While these initial differences are well documented, the infant microbiome continues to develop over time and is influenced by many factors, including feeding, environment, and early nutrition.

Research suggests that lower levels of Bifidobacterium and Bacteroides in early life are associated with a higher likelihood of allergic conditions such as eczema. At the same time, many factors help shape and support a healthy infant microbiome. Breastfeeding can play a supportive role, as human milk contains components that nourish beneficial bacteria. As babies grow—particularly from around three months of age onward—diet becomes an increasingly important influence on gut microbial development.6 While shorter breastfeeding duration has been associated with a higher incidence of eczema and asthma, early nutrition is just one of many interacting factors that contribute to immune development over time.6 Supporting the baby’s gut microbiome with a high-quality probiotic designed for this stage of life can also be a powerful way to support microbiome development. · Omni-Biotic Panda was formulated to help newborns develop a balanced microbiome, promoting healthy digestion, a strong immune system, and reducing the risk of conditions like colic or allergies

Related Reading

• Can You Take Probiotics While Pregnant?

Support for the Developing Microbiome

Children with eczema often have a gut microbiome that looks different from that of healthy children.18 This has led researchers to take a closer look at how gut bacteria interact with the immune system. Much of this interaction happens in the gut, where beneficial microbes help communicate with immune cells and influence how the body responds to potential triggers.

Researchers believe that one key role of gut bacteria is helping regulate immune responses. Well-studied beneficial bacteria such as Bifidobacterium and Lactobacillus are often found at lower levels in children with eczema,19,20 Because of this, scientists have explored whether probiotic supplementation may help support immune balance and play a role in the prevention or management of eczema.

That said, study results have been mixed. Differences in probiotic strains, dosages, study design, and how products are made can all affect outcomes. This explains why not all probiotics work the same way and why results can vary from one product to another.

Omni-Biotic PandA: A Prenatal and Infant Probiotic

Selecting a Probiotic Formulation for Best Outcomes

Strain Significance: Over the years, research has taught us that our gut microbes play a strong role in immune system development and function. In eczema cases, specifically, children are found to have impaired gut barrier integrity (a.k.a. leaky gut) and less than optimal production of nourishing short chain fatty acids. Both of which can be supported by a high-quality probiotic.

But these functional capabilities are highly strain-specific. It is therefore critical to identify the right probiotic blend, containing strains that perform the right jobs and in the right combination, to address a specific condition.

Synergistic Performance: Beyond the individual strains, it is crucial to demonstrate that the entire probiotic blend performs as expected. Researcher Niers and team demonstrated this with Omni-Biotic® PandA probiotic.

In their study, the researchers showed that  when mothers took Omni-Biotic Panda during pregnancy and then gave Omni-Biotic Panda to their  infants, the children demonstrated a significantly lower risk of developing childhood eczema.26 An additional, follow-up study analyzing the children’s gut microbiome via a stool test showed that there was a distinctive difference in the levels of microbial metabolic products between the healthy group and those who later developed eczema.27 

In summary, select probiotic strains and formulations offer promise in the prevention and management of atopic dermatitis. However, not all strains or available probiotic formulations will perform at similar levels of impact. Understanding how a formulation was developed, what strains are used and why, and how the final formulation tested in a specific condition through published clinical trials defines the difference between a general probiotic and one built for performance.

1. Dharmage SC, Lowe AJ, Matheson MC, et al. Atopic dermatitis and the atopic march revisited. Allergy. 2014; 69:17-27.

2. Centers for Disease Control and Prevention. Trends in Allergic Conditions Among Children: United States, 1997–2011. Number 121, May 2013. Last reviewed November 6, 2015. CDC Web site. https://www.cdc.gov/nchs/products/databriefs/db121.htm. Accessed February 7, 2021.

3. Pawankar R, Holgate ST, Canonica RW, et al, eds. White Book on Allergy: Update 2013. World Allergy Organization. WAO Web site. https://www.worldallergy.org/UserFiles/file/WhiteBook2-2013-v8.pdf. Accessed February 7, 2021.

4. National Eczema Association. Eczema Stats. Available at: https://nationaleczema.org/research/eczema-facts/. Accessed February 7, 2021.

5. Kim BS. What is the global prevalence of atopic dermatitis (eczema)? June 3, 2020. Medscape Web site. https://www.medscape.com/answers/1049085-4692/what-is-the-global-prevalence-of-atopic-dermatitis-eczema. Accessed February 7, 2021.

6. Galazzo G, van Best N, Bervoets L, et al. Development of the Microbiota and Associations With Birth Mode, Diet, and Atopic Disorders in a Longitudinal Analysis of Stool Samples, Collected From Infancy Through Early Childhood. Gastroenterology. 2020;158(6):1584-1596.

7. Lee SY, Lee E, Park YM, Hong SJ. Microbiome in the Gut-Skin Axis in Atopic Dermatitis. Allergy Asthma Immunol Res. 2018;10(4):354-362.

8. Centers for Disease Control and Prevention. Breastfeeding Report Card: United States, 2020. Last reviewed September 17, 2020. CDC Web site. https://www.cdc.gov/breastfeeding/data/reportcard.htm. Accessed February 7, 2021.

9. Eck A, Rutten NBMM, Singendonk MMJ, et al. Neonatal microbiota development and the effect of early life antibiotics are determined by two distinct settler types. PLoS One. 2020;15(2):e0228133.

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17. Dominguez-Bello MG, Costello EK, Contreras M, et al. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proc Natl Acad Sci U S A. 2010;107(26):11971-11975.

18. Kalliomäki M, Salminen S, Arvilommi H, et al. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet. 2001;357(9262):1076-1079.

19. Zheng H, Liang H, Wang Y, et al. Altered Gut Microbiota Composition Associated with Eczema in Infants. PLoS One. 2016;11(11):e0166026.

20. Melli LCFL, Carmo-Rodrigues MSD, Araújo-Filho HB, et al. Gut microbiota of children with atopic dermatitis: Controlled study in the metropolitan region of São Paulo, Brazil. Allergol Immunopathol (Madr). 2020;48(2):107-115.

21. Huang R, Ning H, Shen M, et al. Probiotics for the Treatment of Atopic Dermatitis in Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Cell Infect Microbiol. 2017;7:392.

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23. Rosenfeldt V, Benfeldt E, Valerius NH, et al. Effect of probiotics on gastrointestinal symptoms and small intestinal permeability in children with atopic dermatitis. J Pediatr. 2004;145(5):612-616.

24. Yan F, Polk DB. Probiotics and immune health. Curr Opin Gastroenterol. 2011;27(6):496-501.

25. Kim NY, Ji GE. Effects of probiotics on the prevention of atopic dermatitis. Korean J Pediatr. 2012;55(6):193-201.

26. Niers L, Martin R, Rijkers G, et al. The effects of selected probiotic strains on the development of eczema (the PandA study). Allergy. 2009;64(9):1349-1358.

27. Kim HK, Rutten NB, Besseling-van der Vaart I, et al. Probiotic supplementation influences faecal short chain fatty acids in infants at high risk for eczema. Benef Microbes. 2015;6(6):783-790.