Atopic Dermatitis Prevention: the Facts (Moisturizers, Breastfeeding, Hydrolyzed Milk, Diet, Prebiotics, Probiotics, Vitamin D)

Primary prevention of Atopic Dermatitis (AD) in high risk children remains a controversial issue. Measures including skin barrier repair, breastfeeding, hydrolyzed formula feeding (enzyme digestion of some proteins contained in milk), maternal dietary avoidance, consumption of probiotics and Prebiotics, and Vitamin D intake as primary prevention of AD is shown here (literature review on Medline, Google Scholar and the Cochrane database)

1. Daily use of emollients since birth in newborns with high risk of developing AD may be a novel and simple approach to AD primary prevention.
2. The protective role of breastfeeding for at least 6 months may reduce eczema incidence in high risk infants who have family history of atopy.
3. There is limited evidence that prolonged feeding with a hydrolyzed formula compared to cow’s milk formula reduces infant and childhood allergy and infant cow’s milk allergy.
4. Antigen avoidance diet to a high-risk woman during pregnancy or lactation is unlikely to reduce her risk of giving birth to an atopic child and may have an adverse effect on maternal and fetal nutritional status, or both.
5. The role of probiotics in the prevention of allergic disease is still not clear. Efficacy, if any, may depend on the timing, dose, duration, and specific probiotic used.
6. There is current conflicting evidence about the role of vitamin D in the prevention and development of AD. Further randomized control trial is required to determine its role in AD.

Lai D. Prevention of Atopic Dermatitis – an Evidence-Based Review. Atopic Dermatitis Symposium – Oct 2016 – Hong Kong