91 Can Postnatal Supplementation with Probiotics Reduce the Risk for Allergic Disease in Infancy?

Abstract

Background and aims: The increasing allergy prevalence may depend on a reduced microbial exposure early in life. Probiotics may prevent eczema in infants. Prenatal maternal supplementation might be crucial for this effect. The mixture of probiotic strains used in the present study reduced eczema when previously supplemented both pre- and postnatally. The aim of this study was to evaluate the effect of only postnatal probiotic supplementation on allergic manifestations during the first two years of life and to explore the impact of environmental factors on allergy development.Methods: In the double-blind placebo-controlled PRODIA study, infants with HLA risk genotype for type 1 diabetes were supplemented from two until six months of age with placebo or the probiotic strains Lactobacillus rhamnosus GG, Lactobacillus rhamnosus LC705, Bifidobacterium breve Bbi99 and Propionibacterium freudenreichii ssp. Shermani JS. 177 of the families completed questionnaires addressing allergy development until two years of age.Results: The cumulative incidence of eczema was not significantly different in the probiotic (21.7%) and the placebo group (14.1%). Children receiving probiotics, as compared with placebo, had a lower cumulative incidence of wheeze, 34.1% versus 49.4% (p=0.04). Children attending day-care had a lower cumulative incidence of eczema (p=0.03). Recurrent wheeze was associated with treatment with antibiotics (p=0.005) and care in the neonatal ward (p=0.02).Conclusion: Postnatal probiotic supplementation did not affect the development of infant eczema in children with genetic risk for diabetes, but showed association with a lower incidence of wheeze. Allergy development was associated with environmental factors potentially modulating microbial load.