Using skin care in babies to help prevent eczema and food allergies
Updated
Abstract
A total of 25,827 participants were involved in 33 randomized controlled trials assessing skin care interventions for infants.
- Skin care interventions during infancy probably do not change the risk of developing eczema by one to two years of age.
- Evidence regarding the impact of skin care interventions on the risk of IgE-mediated food allergy is unclear due to limited data.
- There may be a slight increase in the risk of immediate allergic reactions to cow's milk due to these interventions.
- Skin care interventions probably increase the risk of skin infections in infants during the intervention period.
- No significant influence of factors such as age or hereditary risk on the effectiveness of interventions for preventing eczema was observed.
Simplified
Funding
Competing interests
Maeve Kelleher: I have received honoraria (personal payment) for speaking at educational conferences organised by Allergy UK, University of Oslo, and Nutricia, which does not manufacture/market any of the interventions or potential comparators in this review. Suzie Cro: None known. Victoria Cornelius: None known. Emma Axon: None known. Karin C Lodrup Carlsen: My institution received money from multiple sources: the Regional Health Board South East, the Norwegian Research Council, Oslo University Hospital, the University of Oslo, Health and Rehabilitation Norway, Østfold Hospital Trust, Norwegian Association of Asthma and Allergy, the Kloster Foundation, Norwegian Society of Dermatology and Venereology, Arne Ingels' legacy, Fürst Medical Laboratory, the Foundation for Healthcare and Allergy Research (in Sweden), the Vårdal Foundation, Swedish Asthma and Allergy Association’s Research Foundation, Swedish Research Council, the Initiative for Clinical Therapy Research, the Swedish Heart‐Lung Foundation, SFO‐V Karolinska Institutet, Hesselman Research Foundation, and Thermo‐Fisher (Uppsala, Sweden). My institution received an honorarium and travel expenses from Thermo‐Fisher (Uppsala, Sweden) for a lecture at the European Academy of Allergy and Clinical Immunology (EAACI) Congress 2018. Håvard Ove Skjerven: My institution received money for the PreventADALL study from the two largest governmental grant agencies in Norway, The South‐Eastern Norway Regional Health Authority and the Norwegian Research Council, which are not commercial sponsors (Lødrup 2018). Eva Maria Rehbinder: I declare no real or perceived conflict of interest for the present review; however, I have personally received honoraria in the last 36 months for presentations on atopic dermatitis and psoriasis from Sanofi Genzyme, Perrigo, MEDA, Novartis, and Norwegian patient organisations for atopic dermatitis and psoriasis. Adrian Lowe: My institution has received National Health and Medical Research Council grant and fellowship funding to undertake a skin barrier intervention study. I also declare that Primus Pharmaceuticals and PuraCap Pharmaceuticals have donated EpiCream (a skin barrier treatment) for use in these studies, free of charge. Eishika Dissanayake: None known. Naoki Shimojo: My institution has received grants from the Japan Agency for Medical Research and Development (AMED‐CREST) (15652274). I have received personal payment for the development of educational presentations from AstraZeneca, Maruho, Novartis, Torii, and Miyarisan. Funding and payments for educational lectures from these pharmaceutical companies do not influence any activities related to this review article. Kaori Yonezawa: My institution has received grants from the Mitsubishi Foundation (this grant supported the following published research: doi: 10.1111/1346‐8138.14080) and the Mishima Kaiun Memorial Foundation (which supported the following published research: doi: 10.1186/s13223‐019‐0385‐7), as well as from Hoyu Science Foundation and JSPS KAKENHI Grant Number 17K17676 12288;20H03995. Yukihiro Ohya: I have received honorarium for lectures from AbbVie, Kao, Kyorin Pharmaceutical, Maruho, Mylan, Natural science, Sanofi, Taiho Pharma, and Torii pharmaceutical. I received payment for consultancy from Maruho for opening a forum and a grant from Yakult. All were personal payments. Kiwako Yamamoto‐Hanada: My institution has received grants from The Japan Society for the Promotion of Science (JSPS) KAKENHI, Japan Health Foundation, the Environmental Restoration and Conservation Agency (ERCA), the National Center for Child Health and development, and the Japanese Society of Allergology. I have personally received travel/accommodations/meeting expenses unrelated to activities listed from Thermo‐Fisher Scientific. Kumiko Morita: Outside this work, I have personally received speakers' honoraria from Maruho, Japan, and Astellas Pharma, Japan. Christian Surber: I have personally received money for consultancy, lectures, and development of educational presentations from LEO Pharma (Switzerland, Germany, & Denmark), for explaining galenical concepts including supersaturation; and for lectures and development of educational presentations for explaining galenical concepts including nano emulsions, from Almirall, Germany. Michael Cork: My institution received a grant from Hyphens Pharma for ‘An investigation of the effects of a barrier repair cream on the structure and function of the skin (BARRIER)’ (clinical trial). My institution received a grant from L'Oreal (La Roche Possay) for ‘An investigation of the skin barrier restoring effects of a cream containing ceramides in a multi vesicular emulsion in people with dry, eczema‐prone, skin (RESTORE)’ (clinical trial). My institution received a grant from Johnson & Johnson for ‘A randomised controlled trial of a specially designed wash product and lotion for the maintenance of healthy skin and mind in babies (BOND)’. My institution and I personally received payment for study design and steering, for travel to meetings for study or other purposes, and for participation in review activities (such as data monitoring boards, statistical analysis, end point committees) from Hyphens Pharma, L'Oreal (La Roche Possay), and Johnson & Johnson. I received personal payment for consultancy, travel/accommodations/meeting expenses unrelated to activities pre‐mentioned, and lectures from Regeneron in collaboration with Sanofi Genzyme with regard to biologic drug trials for atopic eczema; Pfizer with regard to biologic and topical drug trials for atopic eczema; and Galapagos and Kymab with regard to biologic drug trials for atopic eczema. My institution received grants/grants pending from Regeneron in collaboration with Sanofi Genzyme with regard to biologic drug trials for atopic eczema; Pfizer with regard to biologic and topical drug trials for atopic eczema; and Galapagos and Kymab with regard to biologic drug trials for atopic eczema. My institution and I personally received payment for review preparation from Regeneron in collaboration with Sanofi Genzyme with regard to biologic drug trials for atopic eczema; Pfizer with regard to biologic and topical drug trials for atopic eczema; and Galapagos and Kymab with regard to Biologic drug trials for atopic eczema. My institution received payment for development of educational presentations from Regeneron in collaboration with Sanofi Genzyme with regard to biologic drug trials for atopic eczema. I am or have been an Investigator and Consultant for the following organisations: Astellas, Boots, Dermavant, Galapagos, Galderma, Hyphens, Johnson & Johnson, Kymab, LEO Pharma, L’Oreal, Menlo, Novartis, Oxagen, Pfizer, Procter & Gamble, Reckitt Benckiser, Regeneron, and Sanofi Genzyme. . Alison Cooke: I was funded by a National Institute for Health Research Doctoral Research Fellowship paid to my institution for the OBSeRvE (Oil in Baby Skincare) study (Cooke 2015). This work was independent research supported by the National Institute for Health Research (Doctoral Research Fellowship DRF‐2012‐05‐160). The views expressed in any Cochrane publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health. I was an invited expert to an advisory panel on infant skin care; my consultancy fee from Johnson and Johnson was paid to my institution. I was an invited expert speaker at a neonatal skin care symposium at the Royal College of Midwives Annual Conference and at the European Midwives Association Conference, for which I received personal payment from Johnson and Johnson. Danielle McClanahan: None known. Lien Tran: None known. Lisa M Askie: None known. Lelia Duley: None known. Eleanor Van Vogt: None known. Jochen Schmitt : I have acted as a consultant for Lilly and Sanofi (personal payment), and received institutional grants for investigator‐initiated trials outside the submitted work from Novartis, LaRoche, Sanofi, ALK, and Pfizer. Eric Simpson : I have received personal payment for the following: board membership (from TARGET‐DERM, LEO, and Pfizer); consultancy (from AbbVie, Eli Lilly, and Pfizer); travel/accommodations/meeting expenses unrelated to activities listed (from Lilly, LEO Pharmaceutical, and Sanofi Genzyme); and review preparation (from Regeneron, Dermira, and Sanofi Genzyme). My institution received grants/grants pending from Eli Lilly, Incyte, and Kyowa Hakko Kirin. My institution and I personally received payment for lectures including service on speakers bureaus from Forte Bio Rx, Incyte, and Sanofi Genzyme. For more than 17 years, I have been actively involved in epidemiological, clinical and translational research centered on atopic dermatitis (AD). My experience leading multi‐centre AD clinical trials and directing our clinical research center for over 10 years shows my commitment to AD research and specifically disease prevention, clinical trial quality, and team science regardless of any previous financial support and activities. Stephan Weidinger : My institution received grants from La Roche Posay for investigator‐initiated study NCT03376243 and from LEO Pharma for investigator‐initiated study 2019‐000598‐22. I received personal payment for advisory board membership from Sanofi Genzyme, Regeneron, LEO Pharma, AbbVie, Pfizer, Kymab, and Eli Lilly. I received personal payment for lectures from Sanofi Genzyme, Regeneron, LEO Pharma, AbbVie, Eli Lilly, and Novartis, as well as a personal payment for development of educational presentations from Sanofi Genzyme. I am an investigator in a number of clinical trials in atopic dermatitis and psoriasis sponsored by a wide range of pharmaceutical companies. I have received institutional research grants from Sanofi Genzyme, LEO Pharma, and L'Oreal. I have acted as a consultant for Sanofi Genzyme, Regeneron, LEO Pharma, Eli Lilly, AbbVie, Pfizer, Kymab, and Novartis. I have lectured at educational events sponsored by Sanofi Genzyme, Regeneron, LEO Pharma, AbbVie, and Galderma, outside of the submitted work. Joanne R Chalmers: My institution received money from NIHR for a research for patient benefit grant to conduct this IPD, on which I am a co‐applicant. I am co‐applicant on the BEEP trial and the BEEP pilot trial, both of which are included in this review (Chalmers 2020). Hywel C Williams: I was director of the NIHR Health Technology Assessment (HTA) Programme until 1 October 2020. HTA is part of the NIHR, which also supports the NIHR systematic reviews programme from which this work is funded. I am chief investigator for the BEEP study (Chalmers 2020), which was funded by NIHR HTA and is included in this review. Funds go to my University (Nottingham) from the National Institute for Health Research (public funds) as a result of open competition. Robert J Boyle: I have received personal payment for participating in advisory boards for DBV Technologies and Prota Therapeutics, which develop allergy diagnostics or treatments; have received payment for designing a clinical trial for Dairy Goat Co‐operative; and have received personal payment for providing expert testimony in a class action related to an infant formula health claim concerning the development of allergic conditions. Reports an NIHR RfPB grant awarded to Nottingham University Hospitals Trust. My employing institution, Imperial College London, has a formal research and innovation partnership with Nestle. This partnership does not directly involve me, and I do not think it is relevant to this review, but Nestle do have skin care products and products for prevention or treatment of allergic conditions within their portfolio.
PubMed