Can you prevent baby eczema with emollients or complementary foods?

March 2, 2020 / Duncan Fisher
Not according to the latest study

New parents worry sometimes about allergies in their infants. One of the ways they worry is to fret over accidental exposure to things that might cause these allergies to develop.

There are things that can indeed do this. They’re spoken of as ‘allergens’.

But allergy itself is a very complex topic, really part of the field of molecular immunology. We’ve written about this elsewhere. Where infant allergy is concerned, there is much to misunderstand, and there are plenty of things that popular wisdom says to do, or not do, that may or may not be grounded in science.

Some home-based ways of calming your baby’s eczema really do work, like modified bathing techniques, trigger-avoidance, and steroid creams. Others, like pouring in bath emollients, have been shown not to.

Emollients remain part of popular discussion all the same, not just as a way easing allergy symptoms, but as a way of preventing allergy in the first place. Related to this, possibly, are parallel concerns people have over food allergies. Allergy mechanisms being so complex, it may be reasonable that food and topical exposure to things be studied together.

That’s just what an international research team lodged at the University of Oslo has done, and published about this month.1

Building on data from earlier studies, they asked, as part of an enormous, ongoing, multi-center trial, whether skin emollients used early in infancy might prevent atopic dermatitis, a form of eczema, and whether early introduction of foods that are associated with skin allergy might also reduce the rate at which infants developed those allergies.

Mothers were recruited at the Oslo University Hospital and Østfold Hospital Trust, in Norway, and the Karolinska University Hospital, in Stockholm. One group of their babies was given bath additives and skin cream, a second group was introduced to complementary peanut, cow’s milk, egg, and wheat, a third group was given both, and a non-treated ‘control’ group was given neither, just to see what would have happened anyway.

Their findings?

Among the 2,397 newborn babies who went through the study, 11% of the skin treatment group developed atopic dermatitis, 9% showed skin changes associated with possible food allergy, and only 5% of the combined group presented any changes at all. By comparison, the untreated group developed atopic dermatitis at a rate of 8%.

There were no serious symptoms of any allergy in any of the babies, such as troubled breathing. The common symptoms in the treated groups, which were itchiness, swelling, rashes, and hives, were no more frequent than in the untreated control group.

The conclusion?

Skin emollients and early complementary feeding were not associated with the development of atopic dermatitis in the first year of these babies’ lives.

What does that mean?

It means that, instead of trying to prevent allergy with emollients or this particular diet, parents can fret about other things instead. It’s good news.

1 Skjerven HO, et al., Lancet 2020 Feb 19. pii: S0140-6736(19)32983-6. doi: 10.1016/S0140-6736(19)32983-6. [Epub ahead of print]

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