Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Skin Care and Synbiotics for Prevention of AD in Newborns
Emollients and synbiotics, alone or in combination, do not prevent the occurrence of atopic dermatitis (AD) or food allergy (FA) in children ≤1 year of age, a new study found. Infants of mothers recruited prenatally received either an emollient, symbiotic, both, or neither. The intervention was carried out from birth ≤6 months of age. The age of occurrence of AD and FA were reported in multiple questionnaires at 1, 6, and 9 months and at 1 year of age. Researchers found:
- 459 infants qualified for the outcome assessment at 1 year of age.
- Neither the emollient nor the symbiotic demonstrated and effect on reducing the development of AD and FA at 1 year of age.
Dissanayake E, et al. Skin care and synbiotics for prevention of atopic dermatitis or food allergy in newborn infants: A 2 x 2 factorial, randomized, non-treatment controlled trial. [Published online ahead of print August 8, 2019]. Int Arch Allergy Immunol. doi: 10.1159/000501636.
Recent studies have suggested there may be some benefit in early use of emollients to prevent AD in high-risk infants (e.g. those with parental atopy). This study looked at emollient and/or synbiotic use compared to untreated controls in consecutive infants, not necessarily at high risk for AD. At 1 year of age there was no difference in any of the 4 groups in development of AD or food allergies. The major criticism here is that while food allergy usually develops before the age of 2, AD may not appear until several years later. Infants at high risk of AD may still benefit from aggressive emollient use and a mild skin care regimen while those at lower risk may not need this approach. — Joseph Fowler, Jr., MD, Clinical Professor of Dermatology, University of Louisville, KY