Consumption of oral probiotics and fish oil supplements during late pregnancy and lactation may be associated with a reduced risk of offspring developing eczema or allergic sensitivity to certain foods, according to a study published in PLoS Medicine.

Vanessa Garcia-Larsen, PhD, of the Department of International Health, Johns Hopkins School of Public Health in Baltimore, Despo Ieradiakonou, MD, PhD, of the Department of Medicine at Imperial College London, associates conducted a systematic review and meta-analysis to assess the link between maternal diet during pregnancy and infancy and offspring allergic or autoimmune disease development.

The two primary authors collected several studies and findings to review results and biases in both observational and interventional studies regarding diet during pregnancy, lactation, or the year following infant birth. Grading of Recommendations Assessment, Development and Evaluation (GRADE) technique was used to confirm or reject credibility of findings.

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The investigators reviewed an interventional trial that promoted breastfeeding and 259 other studies on milk feeding (n=964,143 individuals) as well as 173 studies involving other maternal or infant diets (n=542,672); 80 studies were interventional.

Milk feeding and other dietary studies had bias risks of 48% and 25%, respectively.

Eczema risk reduction was reported in 19 interventional trials in which mothers were administered oral probiotic supplements to consume during late pregnancy and lactation (risk ratio [RR], 0.7), and 6 trials reported a reduction in egg allergy sensitivity when fish oil supplements were consumed during the same phases (RR, 0.69).

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GRADE analysis was moderate for these findings and low for findings including reduced eczema risk during breastfeeding, reduced type 1 diabetes risk with increased, exclusive breastfeeding duration, and reduced risk of allergy to cow’s milk with maternal probiotic consumption.

No evidence was found supporting allergic and autoimmune disease risks and maternal prebiotic supplemental intake, allergenic food circumvention, or fruit, mineral, vegetable, and vitamin consumption.

“Guideline committees will need to carefully consider the key findings together with an evaluation of the safety, acceptability, and cost implications of advising probiotic or fish oil supplementation for pregnant and lactating women,” reported the authors.


Garcia-Larsen V, Ierodiakonou D, Jarrold K, et al. Diet during pregnancy and infancy and risk of allergic or autoimmune disease: A systematic review and meta-analysis. PLoS Medicine. 2018;15(2): e1002507.