Pregnancy Diet: Can it Prevent Eczema in Baby?

Especially if you have eczema yourself and your first baby may have gotten eczema also early in his or her life, you probably wonder if this has something to do with what you eat during your pregnancy.

A lot of expecting mothers are sharing the same thoughts and concerns; probably having read that their diet during pregnancy can increase the chance of their babies developing eczema.

Before you read on, please be informed that this article by no means reflects an intention to put any blame or guilt into your life. Instead, do think of this as a guidance on healthy eating or preventive measures that you may consider taking when preparing for your next child; paying attention to those foods that are good to consume more or those which you should avoid during pregnancy and so forth.

Pregnancy Diet and Eczema in Babies
What Does Research Tell So Far?

During pregnancy, essential nutrients are transported from a mother to the fetus across the placenta. Because of this, it might be possible that the maternal diet may already have an effect on the development of allergic conditions even in the uterus.

So far, there is no conclusive evidence to suggest that avoiding allergens by expecting mothers during pregnancy will protect their babies from eczema during the first 18 months of their lives. Meanwhile, another study suggests that maternal diet during the last 4 weeks of pregnancy can have an impact in terms of allergy developing in the babies. In other word, the findings are conflicting about whether a mother’s diet will lead to early sensitization or intolerance for the babies.

Nevertheless, it ultimately boils down to an overriding consensus about eating healthy and having a balanced diet that feeds yourself and your fetus well with lots of anti-inflammatory foods and nutrients. After all, a bad diet and eating habit will lead to a host of other health problems not just for the mother but may also have implications for the fetus as well.

Whether a baby will develop eczema is a hugely complicated issue and a complex interplay of so many factors including genetic changes, diet, environment, exposure to chemicals or microbes, etc. What you can do, as an expecting mother, is to be more conscious about eating as healthily and as balanced as possible during pregnancy.

As they say, an ounce of prevention is worth a pound of cure! We find this to be true from experience.

Foods or Supplements to Increase during Pregnancy

1. Fish Oil
A giant meta-analysis of over 400 different studies and 1+ million people examined the effect of pregnancy diet on a baby’s risk of developing eczema or allergies found that consuming fish oils or probiotics when pregnant can have positive effects on the baby.

Fish oil is a rich source of healthy fats, in particular, the Omega 3 essential fatty acids (EFAs) to help nourish skin, reduce inflammation and heal the gut. Norway researchers think that fish oil helps reduce Leukotriene B4, which is an inflammatory substance that plays a role in eczema.

• In a study, Omega-3 EPA fatty acids of 1.8g is associated with a significant reduction in eczema symptoms after 12 weeks.
• High fish consumption during the last 4 weeks of pregnancy seemed to decrease the risk of eczema in childhood.
• Journal Acta Paediatria reported infants of mothers receiving fish oil supplements during pregnancy and while breastfeeding were 16% and 13% less likely to have eczema and food allergies.
• Infants of mothers who took Omega-3 fatty acids during pregnancy was 30% and 38% less likely to develop egg allergies and peanut allergies respectively.

Most research studied the use of fish oil supplements instead of eating oily fish. Therefore, fish consumption by pregnant mothers should be in moderation as many species of fish may contain traces of mercury.

For vegetarians, the next best alternative is the flaxseed. Whilst it is true that Omega-3 is found in both flaxseed and fish oil, the fatty acids contained in both are different and may be anything but equal in their effects. Flaxseed is rich in ALA (Alpha-linolenic acid) whereas fish oils contain EPA (Eicosapentaenoic acid) and DHA (Docosahexaenoic acid). Most research on health benefits of Omega-3 had been done on DHA and EPA. As such, it is unsure if ALA is as powerful a health modulator as DHA and EPA found in fish oil.

2. Probiotics

In the same giant meta-analysis, the study makes it clearer that taking probiotics during pregnancy and breastfeeding may protect babies from developing eczema. There was already evidence showing that probiotic exposure in early life may reduce risk of eczema in babies.

It is thought that the probiotics supplementation changes the composition of breast milk; in this way, it also affects positively how the infant’s skin and immune system develop. Probiotics are known to nurture and restore healthy ‘good’ bacteria to populate our gut microbiome, at the same time, support and stabilize the gut barrier.

• In a study by University of Otago, a probiotic involving Lactobacillus Rhamnosus HN001 reduced eczema risk among high-risk babies by half by age of 2. The study also recommended daily probiotics to be taken by pregnant mothers no earlier than 36 weeks and through the first 6 months of nursing.
• When mothers took probiotics during 3rd trimester, they could reduce baby’s risk of developing eczema by 29%.
• Breastfeeding mothers who consumed probiotics might reduce that risk by 40%.
• When babies were given probiotics directly, the risk was reduced by 20%.
• Another study found children who were given probiotics for first 2 years were less likely to develop eczema than those who didn’t.

3. Vitamin D

We know that Vitamin D is also known as the sunshine vitamin. It can be synthesized in the skin with moderate sun exposure (UVB light). Alternatively, it can be obtained through dietary means.

People with eczema are found to have lower levels of Vitamin D than those with healthy skin. The lower the Vitamin D levels are, the more severe the symptoms of eczema are. Children with eczema who have low levels of Vitamin D are also more likely to develop other skin problems such as infections than those with higher levels. It was also found that by supplementing Vitamin D in those with deficiency, the eczema condition improved.

Vitamin D deficiency can trigger flares up because this vitamin is crucial in playing a role in reducing inflammatory cytokines and increasing the amount of good anti-microbial proteins in the skin that destroys invading germs and bacteria. The dosage in the studies are as follows:

• 1,000 IU for children with eczema for 1 month.
• 1,600 IU for children aged 14+ with eczema for 2 months.
• 2,000 IU for adults with eczema for 3 months during winter.

In phototherapy (light therapy) treatments that are commonly used for severe eczema cases, UVB light is used to penetrate the skin and slows or suppresses the growth of skin cells that lead to inflammation in eczema. Sometimes, it can’t keep us from wondering if part of the reasons that light therapy may improve eczema is due to the increase in Vitamin D level associated with the light therapy.

4. Evening Primrose Oil (EPO)

Most of us get too much Omega-6 in our diet but not enough of Omega-3. The exception to this rule of not eating too much Omega-6 is Gamma Linoleic Acid (GLA). GLA is an Omega-6 fatty acids that are abundant in evening primrose oil, borage oil and black currant seed oil.

Whilst most Omega-6 fatty acids increase inflammation, GLA reduces it. It reduces water loss through the skin and hence, minimizing skin itchiness and scaly texture. It was found in a study that GLA administered to people with dermatitis leads to less skin roughness and improved skin suppleness. However, some studies found no benefits or effects with GLA.

Despite the inconclusive finding, if you are keen to supplement GLA, a good starting point is 500mg a day. Take caution that these supplements are not to be taken by those having seizure disorder or taking blood thinners. They are also not suitable for pregnant women as it may induce pre-term labour.

Foods to Avoid during Pregnancy

The same large cohort study also reported high dietary intake of Omega-6 fatty acids, a polyunsaturated fatty acids (PUFAs) is closely related to increased risk of developing allergic diseases due to their pro-inflammatory effects.

In particular, the consumption of margarine, vegetable oils, deep-frying vegetable fat, celery, citrus fruit, and raw sweet peppers was found to be related to either eczema or allergy in children up to age of 2 years.

• Avoid margarine and too much vegetable oils.
• Avoid citrus fruits and celery(But a 2010 Japan study showed green and yellow vegetables as well as citrus fruits reduced risk of infant eczema – so we can’t exactly say to consume or to avoid citrus?).
• Avoid potentially allergenic foods e.g. nuts or peanuts, dairy, gluten and eggs.

In conclusion, eczema is more than skin deep because if it is by nature a problem that has to do with just the make-up of the skin, topical cream would have provided a ‘cure’ and our children and many more would not have suffered. As such, we see eczema rash as a symptom of a deeper problem in the body and feel strongly about fetal exposure in uterus during a mother’s pregnancy and its impact on the babies after birth.

Given this judgment formed among various other studies, we tend to support the importance of eating a healthy diet during pregnancy, believing that an expecting mother’s diet and vitamin levels may help prevent early sensitization or problem before it starts.

 

References:

• LISA Study Group; Maternal diet during pregnancy in relation to eczema and allergic sensitization in the offspring at 2 y of age, The American Journal of Clinical Nutrition, Volume 85, Issue 2, 1 February 2007, Pages 530–537, https://doi.org/10.1093/ajcn/85.2.530.
• Dietary supplementation with very long-chain n-3 fatty acids in patients with atopic dermatitis. A double-blind, multicentre study. Institute for Nutrition Research, University of Oslo, Norway, British Journal of Dermatology. 1994 Jun;130(6):757-64.
• Modulation of atopy patch test reactions by topical treatment of human skin with a fatty acid-rich emollient. Skin Pharmacology and Applied Skin Physiology. 2002 Mar-Apr;15(2):100-4.
• Fish again for dinner! The role of fish and other dietary oils in the therapy of skin disease. Journal of the American Academy of Dermatology. 1988 Dec;19(6):1073-80.
• Influence of low-dose polyunsaturated fatty acids supplementation on the inflammatory response of healthy adults. Nutrition. 2007 Oct;23(10):724-30.
• Omega 3 polyunsaturated fatty acid constituents of fish oil and the management of skin inflammatory and scaly disorders. World Review of Nutrition and Dietetics. 1991;66:425-35.
• G Márquez Balbás et a. Study on the use of omega-3 fatty acids as a therapeutic supplement in treatment of psoriasis. Clin Cosmet Investig Dermatol. 2011; 4: 73–77. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3133503/rch, University of Oslo, Norway, British Journal of Dermatology. 1994 Jun;130(6):757-64
• C. Furuhjelm et al. Fish oil supplementation in pregnancy and lactation may decrease the risk of infant allergy. Acta Paediatricadoi: 10.1111/j.1651-2227.2009.01355.
• Ehlayel M, Bener A, Sabbah A. Is high prevalence of vitamin D deficiency evidence for asthma and allergy risks? Eur Ann Allergy Clin Immunol. 2011;43(3):81–88.
• Cheng HM, Kim S, Park G, Chang E. Low vitamin D levels are associated with atopic dermatitis , but not allergic rhinitis , asthma , or IgE sensitization , in the adult Korean population General characteristics. J Allergy Clin Immunol. 2012;133(4):1048–1055. doi:10.1016/j.jaci.2013.10.055.
• Litonjua AA. Vitamin D deficiency as a risk factor for childhood allergic disease and asthma. Curr Opin Allergy Clin Immunol. 2012;12(2):179–185. doi:10.1097/ACI.0b013e3283507927.Vitamin.
• Dombrowski Y, Peric M, Koglin S, Ruzicka T, Schauber J. Control of cutaneous antimicrobial peptides by vitamin D3. Arch Dermatol Res. 2010;302:401–408. doi:10.1007/s00403-010-1045-4.
• Akan A, Azkur D, Ginis T, Toyran M, Kocabas CN. Vitamin D Level in Children Is Correlated with Severity of Atopic Dermatitis but Only in Patients with Allergic Sensitizations. Pediatr Dermatol. 2013;30(3):359–364. doi:10.1111/pde.12058.
• Peroni DG, Piacentini GL, Cametti E, Chinellato I, Boner AL. Correlation between serum 25 -hydroxyvitamin D levels and severity of atopic dermatitis in children. Br J Dermatol. 2011;164:1078–1082. doi:10.1111/j.1365-2133.2010.10147.x.
• Horrobin DF1. Essential fatty acid metabolism and its modification in atopic eczema.Am J Clin Nutr. 2000 Jan;71(1 Suppl):367S-72S.
• Mutgi K, Koo J. Update on the role of systemic vitamin d in atopic dermatitis. Pediatr Dermatol. 2013 May- Jun;30(3):303-7.
• Hata TR, Audish D, Kotol P, et al. A randomized controlled double-blind investigation of the effects of vitamin D dietary supplementation in subjects with atopic dermatitis. J Eur Acad Dermatol Venereol. 2013