Probiotics prevent IgE-associated allergy until age 5 years in cesarean-delivered children but not in the total cohort. A Longitudinal Analysis on the Association Between Antibiotic Use, Intestinal Microflora, and Wheezing During the First Year of Life Randomized placebo-controlled trial of lactobacillus on asthmatic children with allergic rhinitis. World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Probiotics Effects of early prebiotic and probiotic supplementation on development of gut microbiota and fussing and crying in preterm infants: a randomized, double-blind, placebo-controlled trial. No effect of probiotics on respiratory allergies: a seven-year follow-up of a randomized controlled trial in infancy. Use of antibiotics during pregnancy increases the risk of asthma in early childhood. Airway inflammation in probiotic-treated children at 5 years. Perinatal probiotic supplementation in the prevention of allergy related disease: 6 year follow up of a randomised controlled trial Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: a randomized, double-blind, placebo-controlled trial. Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant. Pro- and Prebiotic Supplementation Induces a Transient Reduction in Hemoglobin Concentration in Infants Effect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) in the primary prevention of eczema: a double-blind, randomized, placebo-controlled trial. World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Prebiotics Effects of bifidobacterial supplementation to pregnant women and infants in the prevention of allergy development in infants and on fecal microbiota. Early Probiotic Supplementation for Eczema and Asthma Prevention: A Randomized Controlled Trial Administration of a Multi-Strain Probiotic Product to Women in the Perinatal Period Differentially Affects the Breast Milk Cytokine Profile and May Have Beneficial Effects on Neonatal Gastrointestinal Functional Symptoms. A Randomized Clinical Trial
BACKGROUND Less microbial exposure in early childhood is associated with more allergic disease later . Allergic children have a different fecal microflora , with less lactobacilli and bifidobacteria . Beneficial effects regarding the development of allergy have been suggested to come through probiotic supplementation . OBJECTIVE We sought to study the effect of probiotic and prebiotic supplementation in preventing allergies . METHODS In a double-blinded , placebo-controlled study we r and omized 1223 mothers with infants at high risk for allergy to receive a probiotic mixture ( 2 lactobacilli , bifidobacteria , and propionibacteria ) or placebo during the last month of pregnancy and their infants to receive it from birth until age 6 months . Infants also received a prebiotic galacto-oligosaccharide or placebo . At 5 years , we evaluated the cumulative incidence of allergic diseases ( eczema , food allergy , allergic rhinitis , and asthma ) and IgE sensitization . RESULTS Of the 1018 intent-to-treat infants , 891 ( 88 % ) attended the 5-year visit .  Frequencies of allergic and IgE-associated allergic disease and sensitization in the probiotic and placebo groups were similar : 52.6 % versus 54.9 % and 29.5 % versus 26.6 % , respectively , and 41.3 % in both . No significant difference appeared in frequencies of eczema ( 39.3 % vs 43.3 % ) , atopic eczema ( 24.0 % vs 25.1 % ) , allergic rhinitis ( 20.7 % vs 19.1 % ) , or asthma ( 13.0 % vs 14.1 % ) between groups . However , less IgE-associated allergic disease occurred in cesarean-delivered children receiving probiotics ( 24.3 % vs 40.5 % ; odds ratio , 0.47 ; 95 % CI , 0.23 % to 0.96 % ; P = .035 ) . CONCLUSIONS No allergy-preventive effect that extended to age 5 years was achieved with perinatal supplementation of probiotic bacteria to high-risk mothers and children . It conferred protection only to cesarean-delivered children Objective . To examine the association between the intestinal flora at the age of three weeks and wheezing during the first year of life  in a prospect i ve birth cohort study . Methods . The Asthma and Allergy study is a prospect i ve birth cohort study . A total of 154 children were recruited through maternity clinics . Selection criteria were vaginal delivery at term and uncomplicated perinatal period . Question naires were collected with data on the parents , including demography , smoking , and asthma . Data of the child on demographic factors , respiratory symptoms , and risk factors for asthma were collected at the ages of 3 weeks and 6 and 12 months . A fecal sample was collected at 3 weeks of age . Results . The frequency of wheezing averaged on 11.8 % , 18.4 % , and 23.5 % at the three time points . In univariate analyses , increasing total concentration of anerobic bacteria were associated with increased odds of wheezing . Furthermore , several trends were observed between wheezing and Bifidobacterium and Clostridium . A final model showed a significant association between wheezing during the first year of life and antibiotic use , total concentration of anerobic bacteria , while increasing concentrations of Clostridium were protective of wheezing . Conclusion . This study demonstrated an association between antibiotics , anerobic bacteria , and  wheezing during the first year of life . The effect of antibiotics was probably due to reverse causation . Since Clostridium was protective of wheezing , other anerobic bacteria are probably responsible for the increased risk of wheezing , which remains to be demonstrated Previous studies have suggested that probiotic administration may have therapeutic and /or preventive effects on atopic dermatitis in infants ; however , its role in allergic airway diseases remains controversial . To determine whether daily supplementation with specific Lactobacillus gasseri A5 for 8 weeks can improve the clinical symptoms and immunoregulatory changes in school children suffering from asthma and allergic rhinitis ( AR ) . We conducted a r and omized , double-blind , placebo-controlled study on school children ( age , 6 - 12 years ) with asthma and AR . The eligible study subjects received either L. gasseri A5 ( n = 49 ) or a placebo ( n = 56 ) daily for 2 months . Pulmonary function tests were performed , and the clinical severity of asthma and AR was evaluated by the attending physicians in the study period . Diary cards with records of the day- and nighttime peak expiratory flow rates ( PEFR ) , symptoms of asthma , and AR scores of the patients were used for measuring the outcome of the treatment . Immunological parameters such as the total IgE and cytokine production by the peripheral blood mononuclear cells ( P BMC s ) were determined before and after the probiotic treatments . Our results showed the pulmonary function and PEFR increased significantly , and the clinical symptom scores for asthma and AR decreased in the probiotic-treated patients as compared to the controls . Further , there was a significant reduction in the TNF-α , IFN-γ , IL-12 , and IL-13 production by the P BMC s following the probiotic treatment . In conclusion , probiotic supplementation may have clinical benefits for school children suffering from allergic airway diseases such as asthma and AR Background Prevalence of  allergic diseases in infants , whose parents and siblings do not have allergy , is approximately 10 % and reaches 20–30 % in those with an allergic first-degree relative . Intestinal microbiota may modulate immunologic and inflammatory systemic responses and , thus , influence development of sensitization and allergy . Probiotics have been reported to modulate immune responses and their supplementation has been proposed as a preventive intervention . Objective The World Allergy Organization ( WAO ) convened a guideline panel to develop evidence -based recommendations about the use of probiotics in the prevention of allergy . Methods We identified the most relevant clinical questions and performed a systematic review of r and omized controlled trials of probiotics for the prevention of allergy . We followed the Grading of Recommendations Assessment , Development and Evaluation ( GRADE ) approach to develop recommendations . We search ed for and review ed the evidence about health effects , patient values and preferences , and re source use ( up to November 2014 ) . We followed the GRADE evidence -to-decision framework to develop recommendations . Results Currently available evidence does not indicate that probiotic supplementation  reduces the risk of developing allergy in children . However , considering all critical outcomes in this context , the WAO guideline panel determined that there is a likely net benefit from using probiotics result ing primarily from prevention of eczema . The WAO guideline panel suggests : a ) using probiotics in pregnant women at high risk for having an allergic child ; b ) using probiotics in women who breastfeed infants at high risk of developing allergy ; and c ) using probiotics in infants at high risk of developing allergy . All recommendations are conditional and supported by very low quality evidence . Conclusions WAO recommendations about probiotic supplementation for prevention of allergy are intended to support parents , clinicians and other health care professionals in their decisions whether to use probiotics in pregnancy and during breastfeeding , and whether to give them to infants OBJECTIVE To evaluate the impact of early prebiotic and probiotic intervention on  preterm infants ' well-being , crying , growth , and microbiological programming . STUDY DESIGN Ninety-four preterm infants ( gestational age 32 - 36 weeks and birth weight > 1500 g ) r and omized to receive prebiotics ( mixture of galacto-oligosaccharide and polydextrose 1:1 ) , probiotics ( Lactobacillus rhamnosus GG ) , or placebo during the first 2 months of life were followed up for 1 year . Infants were categorized based on the extent of crying and irritability during the first 2 months of life , and their gut microbiota was investigated by fluorescence in situ hybridization ( n = 66 ) and quantitative polymerase chain reaction ( n = 63 ) . RESULTS A total of 27 of 94 infants ( 29 % ) infants were classified as excessive criers , significantly less frequently in the prebiotic and the probiotic groups than in the placebo group ( 19 % vs 19 % vs 47 % , respectively ; P = .02 ) . The placebo group had a higher percentage of Clostridium histolyticum group bacteria in their stools than did the probiotic group ( 13.9 % vs 8.9 % , respectively ; P = .05 ) . There were no adverse events related to either supplementation . CONCLUSIONS Early prebiotic and probiotic supplementation may alleviate symptoms associated with crying and fussing in preterm infants . This original finding may offer new therapeutic and preventive measures for this common disturbance in early life BACKGROUND Supplementation with the probiotic Lactobacillus reuteri reduced the incidence of IgE-associated allergic disease in infancy . This treatment might therefore also reduce the risk of asthma and allergic rhinoconjunctivitis in school age . OBJECTIVE To evaluate whether perinatal and infant supplementation with L. reuteri reduced the prevalence of respiratory allergic disease in school age and to explore whether this supplementation was associated with any long-term side effects . METHODS A r and omized , placebo-controlled trial with oral supplementation with L. reuteri ATCC 55730 ( 1 × 10(8 ) CFU ) during the last month of gestation and through the first year of life comprising 232 families with allergic disease , of whom 184 completed a 7-yr follow-up . The primary outcomes at 7 yr of age were allergic disease and skin prick test reactivity ( Clinical Trials.gov ID NCT01285830 ) . RESULTS The prevalence of asthma ( 15 % in the probiotic vs. 16 % in placebo group ) , allergic rhinoconjunctivitis ( 27 % vs. 20 % ) , eczema ( 21 % vs. 19 % ) and skin prick test reactivity ( 29 % vs. 26 % ) was similar in the probiotic and placebo group . Growth indices and gastrointestinal symptoms were similar in the two groups . No severe adverse events were reported . CONCLUSION The effect of L. reuteri on sensitization and IgE-associated eczema in infancy did not lead to a lower prevalence of respiratory allergic disease in school age . Thus , the effect of L. reuteri on the immune system seems to be transient . Administration of L. reuteri during the last weeks of gestation and in infancy was not associated with any long-term side effects OBJECTIVES To investigate the hypothesis that mother 's use of antibiotics in pregnancy could influence  asthma and eczema  in early life . STUDY DESIGN Subjects were included from the Copenhagen Prospect i ve Study on Asthma in Childhood cohort of children born of mothers with asthma ( N = 411 ) . Severe asthma exacerbations and eczema were diagnosed by research unit physicians . Replication was sought in children from the Danish National Birth Cohort ( N = 30 675 ) . Asthma outcomes were hospitalization and use of inhaled corticosteroids .  Eczema was defined by an algorithm developed from cases of clinical ly verified eczema . All children were followed to age 5 years in a cohort study design . RESULTS The Copenhagen Prospect i ve Study on Asthma in Childhood data showed increased risk of asthma exacerbation ( hazard ratio 1.98 [ 95 % CI 1.08 - 3.63 ] ) if mothers had used antibiotics during third trimester . The Danish National Birth Cohort confirmed increased risk of asthma hospitalization ( hazard ratio 1.17 [ 1.00 - 1.36 ] ) , and inhaled corticosteroids ( 1.18 [ 1.10 - 1.27 ] ) in the children if mothers used antibiotics any time during pregnancy . In the subgroup of mothers using antibiotics for nonrespiratory infection , the children also had increased risk of asthma . CONCLUSION We found increased risk of asthma associated with maternal antibiotic use in a clinical study of a birth cohort with increased risk of asthma and replicated this finding in an unselected national birth cohort , and in a subgroup using antibiotics for nonrespiratory infections . This supports a role for bacterial ecology in pre- or perinatal life for the development of asthma Early treatment of new-born high-risk children with certain probiotic strains has reduced the risk of atopic eczema . Whether probiotics reduce risk for airway inflammation in long term is not known . We aim ed at study ing the effect of probiotic treatment during the six first months of life on airway inflammation at age 5 yr . In a r and omized double-blind allergy prevention trial between 2000 and 2007 in Helsinki , Finl and , we gave a probiotic combination , plus pre-biotics , or placebo , to 1018 children during 6 months from birth . At age 5 , we measured exhaled nitric oxide ( FE(NO ) ) in a r and omized sub- population of 160 children . Allergic diseases and IgE-sensitization  were assessed in all infants .  FE(NO ) did not differ between probiotic and placebo groups , median ( interquartile range , IQR ) 5.45 ( 4.3 - 7.3 ) vs. 5.70 ( 3.9 - 6.8 ) ppb , p = 0.22 . FE(NO ) was elevated among those suffering from asthma during the first 5 yr than in healthy non-sensitized children ( p = 0.009 ) . FE(NO ) correlated positively with serum total and allergen-specific IgE concentrations . Early intervention with probiotics and pre-biotics does not affect airway inflammation later in childhood Background Perinatal probiotics supplementation has been shown to be effective in the primary prevention of  atopic dermatitis ( AD ) in early childhood , although the long term effects of probiotics on AD and other allergic diseases is less certain . We have previously reported a significant reduction in the cumulative incidence of AD at 2 years after maternal probiotic supplementation . In this study we present the effects of perinatal probiotics given to women from a general population on allergy related diseases in their offspring at 6 years . Methods Four hundred and fifteen pregnant women were r and omised to receive  probiotic or placebo milk  in a double-blinded trial from 36 week gestation until 3 months postpartum . Probiotic milk contained Lactobacillus rhamnosos GG , L. acidophilus La-5 and Bifidobacterium animalis subsp . lactis Bb-12 . At 6 years , children were re-assessed for AD , atopic sensitisation , asthma and allergic rhinoconjunctivitis ( ARC ) . Results At 6 years , 81 and 82 children were assessed for AD in the probiotic and placebo groups , respectively . In a multiple imputation analysis , there was as trend towards a lower cumulative incidence of AD in the probiotic group compared to the placebo group ( OR 0.64 , 95 % CI 0.39 - 1.07 , p = 0.086 ; NNT = 10 ) . This finding was statistically significantly in the complete case analysis ( OR 0.48 , 95 % CI 0.25 - 0.92 , p = 0.027 , NNT = 6 ) . The prevalence of asthma and atopic sensitisation , and the cumulative incidence of ARC were not significantly affected by the probiotic regime at 6 years of age . Conclusions Maternal probiotic ingestion alone may be sufficient for long term reduction in the cumulative incidence of AD , but not other allergy related diseases . Trial registration Clinical Trials.gov identifier : BACKGROUND The increase in allergic diseases is attributed to a relative lack of microbial stimulation of the infantile gut immune system . Probiotics , live health-promoting microbes , might offer such stimulation . OBJECTIVE We studied the effect of a mixture of 4 probiotic bacterial strains along with prebiotic galacto-oligosaccharides in preventing allergic diseases . METHODS We r and omized 1223 pregnant women carrying high-risk children to use a probiotic preparation or a placebo for 2 to 4 weeks before delivery . Their infants received the same probiotics plus galacto-oligosaccharides ( n = 461 ) or a placebo ( n = 464 ) for 6 months . At 2 years , we evaluated the cumulative incidence of allergic diseases ( food allergy , eczema , asthma , and allergic rhinitis ) and IgE sensitization ( positive skin prick test response or serum antigen-specific IgE level > 0.7 kU/L ) . Fecal bacteria were analyzed during treatment and at age 2 years . RESULTS Probiotic treatment compared with placebo showed no effect on the cumulative incidence of allergic diseases but tended to reduce IgE-associated ( atopic ) diseases ( odds ratio [ OR ] , 0.71 ; 95 % CI , 0.50 - 1.00 ; P = .052 ) . Probiotic treatment reduced eczema ( OR , 0.74 ; 95 % CI , 0.55 - 0.98 ; P = .035 ) and atopic eczema ( OR , 0.66 ; 95 % CI , 0.46 - 0.95 ; P = .025 ) . Lactobacilli and bifidobacteria more frequently ( P < .001 ) colonized the guts of supplemented infants . CONCLUSION Probiotic treatment showed no effect on the incidence of all allergic diseases by age 2 years but significantly prevented eczema and especially atopic eczema . The results suggest an inverse association between atopic diseases and colonization of the gut by probiotics . CLINICAL IMPLICATION S The prevention of atopic eczema in high-risk infants is possible by modulating the infant 's gut microbiota with probiotics and prebiotics BACKGROUND Probiotics have shown promising potential in reducing the risk of eczema in infants . Optimal probiotic intervention regimen remains to be determined . OBJECTIVE We investigated whether maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of developing eczema in high-risk infants . METHODS This was a parallel , double-blind placebo-controlled trial of 241 mother-infant pairs . Mothers with allergic disease and atopic sensitization were r and omly assigned to receive ( 1 ) Lactobacillus rhamnosus LPR and Bifidobacterium longum BL999 ( LPR+BL999 ) , ( 2 ) L paracasei ST11 and B longum BL999 ( ST11+BL999 ) , or ( 3 ) placebo , beginning 2 months before delivery and during the first 2 months of breast-feeding . The infants were followed until the age of 24 months . Skin prick tests were performed at the ages of 6 , 12 , and 24 months . RESULTS Altogether 205 infants completed the follow-up and were included in the analyses . The risk of developing eczema during the first 24 months of life was significantly reduced in infants of mothers receiving LPR+BL999 ( odds ratio [ OR ] , 0.17 ; 95 % CI , 0.08 - 0.35 ; P < .001 ) and ST11+BL999 ( OR , 0.16 ; 95 % CI , 0.08 - 0.35 ; P < .001 ) . The respective ORs for chronically persistent eczema were 0.30 ( 95 % CI , 0.12 - 0.80 ; P = .016 ) and 0.17 ( 95 % CI , 0.05 - 0.56 ; P = .003 ) . Probiotics had no effect on the risk of atopic sensitization in the infants . No adverse effects were related to the use of probiotics . CONCLUSION Prevention regimen with specific probiotics administered to the pregnant and breast-feeding mother , that is , prenatally and postnatally , is safe and effective in reducing the risk of eczema in infants with allergic mothers positive for skin prick test Objectives : Regarding safety , we investigated the effect of prenatal probiotic and 6 months of pro- and prebiotic supplementation of infants on their hematologic values at 6 months and 2 years and factors affecting these values . Patients and Methods : In a prospect i ve r and omized controlled probiotic intervention trial in infants at high risk for allergy , we obtained blood sample s consecutively from 98 infants at 6 months and from 658 children at 2 years to measure hematologic values . We collected fecal sample s at 3 and 6 months to measure immunologic development by calprotectin , α-1-antitrypsin , tumor necrosis factor-α , and immunoglobulin A. Results : At 6 months , infants in the probiotic group had significantly lower hemoglobin ( Hb ) values than did the placebo group , mean ( SD ) : 119.8 g/L ( 6.3 ) versus 123.3 g/L ( 8.4 ) , P = 0.025 . Adjustment for factors that might affect Hb values ( breast-feeding duration , solid-food introduction , and sex ) , revealed no need for adjustment . A significant negative correlation emerged between Hb values at 6 months and fecal calprotectin at age 3 months r = −0.301 , P = 0.009 , which was affected neither by breast-feeding , sex , nor study group . At 2 years , hematologic values in both groups became similar . Conclusions : Probiotics cause a gut mucosal inflammation with decreased Hb values during intervention , corrected after halting the supplementation Controversy exists regarding the preventive effect of probiotics on the development of  eczema or atopic dermatitis .  We investigated whether supplementation of probiotics prevents the development of  eczema in infants at high risk . In a r and omized , double-blind , placebo-controlled trial , 112 pregnant women with a family history of allergic diseases received a once-daily supplement , either a mixture of Bifidobacterium bifidum BGN4 , B. lactis AD011 , and Lactobacillus acidophilus AD031 , or placebo , starting at 4 - 8 wks before delivery and continuing until 6 months after delivery . Infants were exclusively breast-fed during the first 3 months , and were subsequently fed with breastmilk or cow 's milk formula from 4 to 6 months of age . Clinical symptoms of the infants were monitored until 1 yr of age , when the total and specific IgE against common food allergens were measured . A total of 68 infants completed the study . The prevalence of eczema at 1 yr in the probiotic group was significantly lower than in the placebo group ( 18.2 % vs. 40.0 % , p=0.048 ) . The cumulative incidence of eczema during the first 12 months was reduced significantly in probiotic group ( 36.4 % vs. 62.9 % , p=0.029 ) ; however , there was no difference in serum total IgE level or the sensitization against food allergens between the two groups . Prenatal and postnatal supplementation with a mixture of B. bifidum BGN4 , B. lactis AD011 , and L. acidophilus AD031 is an effective approach in preventing the development of eczema in infants at high risk of allergy during the first year of life Background The prevalence of allergic diseases in infants , whose parents and siblings do not have allergy , is approximately 10 % and reaches 20–30 % in those with an allergic first-degree relative . Intestinal microbiota may modulate immunologic and inflammatory systemic responses and , thus , influence development of sensitization and allergy . Prebiotics – non-digestible oligosaccharides that stimulate growth of probiotic bacteria – have been reported to modulate immune responses and their supplementation has been proposed as a preventive intervention . Objective The World Allergy Organization ( WAO ) convened a guideline panel to develop evidence -based recommendations about the use of prebiotics in the prevention of allergy . Methods The WAO guideline panel identified the most relevant clinical questions about the use of prebiotics for the prevention of allergy . We performed a systematic review of r and omized controlled trials of prebiotics , and review ed the evidence about patient values and preferences , and re source requirements ( up to January 2015 , with an up date on July 29 , 2015 ) . We followed the Grading of Recommendations Assessment , Development and Evaluation ( GRADE ) approach to develop recommendations . Results Based on GRADE evidence to decision frameworks , the WAO guideline panel suggests using prebiotic supplementation in not-exclusively breastfed infants and not using prebiotic supplementation in exclusively breastfed infants . Both recommendations are conditional and based on very low certainty of the evidence . We found no experimental or observational study of prebiotic supplementation  in pregnant women or in breastfeeding mothers . Thus , the WAO guideline panel chose not to provide a recommendation about prebiotic supplementation in pregnancy or during breastfeeding , at this time . Conclusions WAO recommendations about prebiotic supplementation for the prevention of allergy are intended to support parents , clinicians and other health care professionals in their decisions whether or not to use prebiotics for the purpose of preventing allergies in healthy , term infants BACKGROUND Probiotic administration may be a useful method for preventing allergies in infants ; however , there have been controversial results about the efficacy . We investigated the effects of bifidobacterial supplementation on the risk of developing allergic diseases in the Japanese population . METHODS In an open trial , we gave Bifidobacterium breve M-16V and Bifidobacterium longum BB536 prenatally to 130 mothers beginning 1 month prior to delivery and postnatally to their infants for 6 months . Another 36 mother-infant pairs served as controls and did not receive the bifidobacterial supplementation . Development of allergic symptoms in the infants was assessed at 4 , 10 and 18 months of age . Fecal sample s were collected from the mothers and infants . RESULTS The risk of developing eczema/atopic dermatitis ( AD ) during the first 18 months of life was significantly reduced in infants in the probiotic group ( OR : 0.231 [ 95 % CI : 0.084 - 0.628 ] and 0.304 [ 0.105 - 0.892 ] at 10 and 18 months of age , respectively ) . Pyrosequencing analyses indicated an altered composition of the fecal microbiota at 4 months for infants who developed eczema/AD at 4 and 10 months of age . The proportion of Proteobacteria was significantly lower ( P = 0.007 ) in mothers at the time of delivery who received the supplementation when compared with the control group and was positively correlated ( r = 0.283 , P = 0.024 ) with that of infants at 4 months of age . No adverse effects were related to the use of probiotics . CONCLUSIONS These data suggest that the prenatal and postnatal supplementation of bifidobacteria is effective in primary preventing allergic diseases . Some limited changes in the composition of fecal microbiota by the bifidobacterial supplementation were observed In this r and omized controlled trial , we examined the effect of early LGG infant supplementation in decreasing the risk of childhood eczema .  OBJECTIVES : To determine if probiotic administration during the first 6 months of life decreases  childhood asthma and eczema . METHODS : We conducted a r and omized , double-blind controlled trial of Lactobacillus rhamnosus GG ( LGG ) supplementation on the cumulative incidence of eczema ( primary end point ) and  asthma and rhinitis  ( secondary end points ) in high-risk infants . For the first 6 months of life , intervention infants ( n = 92 ) received a daily dose of 10 billion colony-forming units of LGG and 225 mg of inulin ( Amerifit Br and s , Cromwell , CT ) , and control infants ( n = 92 ) received 325 mg of inulin alone . We used survival analysis methods to estimate disease incidences in the presence or absence of LGG and to estimate the efficacy of LGG in delaying or preventing these diseases . RESULTS : Infants were accrued over a 6-year period ( median follow-up : 4.6 years ; 95 % retention rate at 2 years ) . At 2 years of age , the estimated cumulative incidence of eczema was 30.9 % ( 95 % confidence interval [ CI ] , 21.4%–40.4 % ) in the control arm and 28.7 % ( 95 % CI , 19.4%–38.0 % ) in the LGG arm , for a hazard ratio of 0.95 ( 95 % CI , 0.59–1.53 ) ( log-rank P = .83 ) . At 5 years of age , the cumulative incidence of asthma was 17.4 % ( 95 % CI , 7.6%–27.1 % ) in the control arm and 9.7 % ( 95 % CI , 2.7%–16.6 % ) in the LGG arm , for a hazard ratio of 0.88 ( 95 % CI , 0.41–1.87 ) ( log-rank P = .25 ) . CONCLUSIONS : For high-risk infants , early LGG supplementation for the first 6 months of life does not appear to prevent the development of eczema or asthma at 2 years of age Background : Probiotic supplementation to women during pregnancy and lactation can modulate breast milk composition , with immune benefits being transferred to their infants . Aim : The aim of the study was to evaluate the effect of high-dose probiotic supplementation to women during late pregnancy and lactation on cytokine profile and secretory IgA ( sIgA ) in breast milk and thus to study if differences in breast milk composition can affect lactoferrin and sIgA levels in stool sample s of newborns . The safety of maternal probiotic administration on neonatal growth pattern and gastrointestinal symptoms were also evaluated . Methods : In a double-blind , placebo-controlled , r and omized trial , 66 women took either the probiotic ( n = 33 ) or a placebo ( n = 33 ) daily . Levels of interleukins ( IL-6 , IL-10 and IL-1β ) , transforming growth factor-β1 ( TGF-β1 ) , and sIgA in breast milk ; and the level of sIgA and lactoferrin in newborn stool sample s were analyzed at birth and then again at one month of life . Antropometrical evaluation and analysis of gastrointestinal events in newborns was also performed . Results : Probiotic maternal consumption had a significant impact on IL6 mean values in colostrum and on IL10 and TGF-β1 mean values in mature breast milk . Fecal sIgA mean values were higher in newborns whose mothers took the probiotic product than in the control group . Probiotic maternal supplementation seems to decrease incidence of infantile colic and regurgitation in infants . Conclusion : High-dose multi-strain probiotic administration to women during pregnancy influences breast milk cytokines pattern and sIgA production in newborns , and seems to improve gastrointestinal functional symptoms in infants
We found no evidence to support a protective association between perinatal use of probiotics and doctor diagnosed asthma or childhood wheeze .
R and omised controlled trials to date have not yielded sufficient evidence to recommend probiotics for the primary prevention of these disorders .
OBJECTIVE To evaluate the association of probiotic supplementation during pregnancy or infancy with  childhood asthma and wheeze .