Prebiotics
For prebiotics, Bozenky et al. 54 performed a
randomized controlled trial in 6-8 weeks old high-risk infants (family
history of allergy in first-grade relatives), who were given a
hypoallergenic formula, either supplemented with or without 0.5g/100 ml
of galacto-oligosaccharides. They noted a decreased, but not
statistically significant, SCORAD score in both groups. Similarly, Boyle
et al. 55 showed in an international multi-center
study that in high-risk infants, partially-hydrolysed whey protein
formula (pHF-OS) supplemented with neutral scGOS, lcFOS and
pectin-derived acidic OS (pAOS) (vs the same formula without the
prebiotics) did not prevent eczema in the first year of life. In the
PIPA study (Prebiotics in the Prevention of Atopy),
galacto-oligosaccharide/polydextrose (GOS/PDX)-supplemented formula
showed no significant difference in the cumulative incidence of eczema
in the first year of life in high-risk infants compared to standard
formula and breastfeeding.56 Lastly, daily
administration of kestose, the smallest FOS, for 6 weeks in 2- to
5-year-olds was significantly correlated with higher fecal F.
prausnitzii levels and an improvement in SCORAD severity scores (rs
=0.52, p = 0.04).57