Understanding the Role of the Gut Microbiome in Baby Eczema - Gladskin

Understanding the Role of the Gut Microbiome in Baby Eczema

As a parent, you want to cherish every moment of your little one's journey, making their comfort and well-being your number one priority. When eczema makes its debut on their delicate skin, it can cause both you and your baby significant distress.

Recent scientific research has shed light on what causes eczema in babies, and one key factor seems to be the gut microbiome. While there are many eczema triggers (genetics, the environment, an imbalance of the skin microbiome), nurturing a healthy gut microbiome in the early days can play a role in reducing the risk of or managing eczema symptoms.

Read to the end to find out:

  • How the gut microbiome develops in the first 1000 days of life
  • How your gut is related to your skin
  • What gut bacteria are related to risk of eczema
  • How to support your baby’s gut development and reduce risk of eczema symptoms


The gut microbiome in the first 1,000 days of life

The gut is home to trillions of microorganisms–including bacteria, viruses, and fungi–collectively known as the gut microbiome. These microbes play a crucial role in maintaining gut health and influencing the immune system.

But babies aren't born with a fully mature gut microbiome. It starts developing at birth and grows into an adult-like microbiome within 3 to 5 years [1], [2], [3]. How a baby enters this world is one of the things that influences early gut microbiome composition [4], [5].

Ideally, before a baby starts solid foods, their gut microbiome is dominated by beneficial bacteria such as Bifidobacterium and Bacteroides. These bacteria feed on special sugars -known as HMOs- found in breastmilk and in some formula brands, and use them to produce short-chain fatty acids (SCFAs) [6]. SCFAs help keep unfriendly gut microbes and inflammation at bay [7], [8].

When your baby fully transitions to solid foods, their gut microbiome starts to gradually shift towards an adult-like, more mature and diverse community [3]. This means lower numbers of Bifidobacterium and new types of bacteria that are good at digesting the fibers found in plant-based foods. Just as with HMOs, bacteria use fiber from food to produce beneficial SCFAs.


How is the gut connected to your skin?

You may think your gut and your skin have nothing in common, but they share one particular characteristic: they’re in constant communication with the environment around us and the world inside of us.

The so-called “gut-skin axis” is a bidirectional communication system that works via complex interactions between the gut microbiome, the gut barrier, and immune cells [9], [10], [11], [12], [13].

Here is how your baby’s gut health may impact their skin:

  • An altered gut microbiome: An imbalance of the gut microbiome, with an increase in unfriendly bacteria and a decrease in beneficial bacteria, can contribute to the production of pro-inflammatory molecules, impacting both gut and skin health [14].
  • Increased permeability of the gut barrier: A healthy gut barrier regulates the passage of nutrients and other substances from the gut to the bloodstream. Imbalances of the gut microbiome and inflammation make this barrier more permeable. Intestinal barrier permeability has been detected in those with eczema and asthma [15].
  • Activation of the immune system: An imbalanced gut microbiome and a weakened gut barrier can overstimulate immune cells, which will release pro-inflammatory compounds known as cytokines. These cytokines can circulate in the bloodstream and reach the skin, leading to inflammation and irritation [10].
  • Food triggers: Inflamed gut tissue may become more susceptible to food sensitivities, where certain foods can trigger an exaggerated immune response. This may result in the release of pro-inflammatory compounds that may reach the skin and cause allergic reactions [16], [17]. 


The eczema gut microbiome signature

By looking at the gut microbiome of babies with and without eczema, scientists have identified certain gut bacteria that are possibly associated with a higher or lower risk of developing eczema. A few examples are:

  • Increased Akkermansia muciniphila. These are beneficial bacteria that help regulate gut mucus production and maintain the integrity of the gut barrier [18], [19]. For adults, it’s good to have A. muciniphila, which may even offer protection against metabolic syndrome [20], [21], [22]. That said, studies have found that babies younger than 6 months that have eczema have more A. muciniphila in their guts compared to babies without eczema [23], [24].
  • Increased Enterobacteriaceae. This is a family of mainly unfriendly bacteria that many of us have at low levels in the gut. They are the kind of bacteria that are often resistant to antibiotics. While low levels of Enterobacteriaceae in little ones can actually be good because these bugs help train the immune system, too much has been linked to eczema in babies younger than 3 months [25].
  • Decreased Faecalibacterium. These are beneficial bacteria that produce butyrate. Low levels have been found in babies with eczema from 3 weeks to 12 months, compared with healthy babies [23], [25].

Tiny Health’s baby gut test can help you determine whether your baby has what we call a microbiome signature for eczema or an increased risk of developing eczema, from a gut microbiome point of view.

Detecting such a signature early on allows you to implement changes that can potentially reduce the risk of eczema. Or if your child is older, it can also help uncover any underlying imbalances in the gut that may be contributing to symptoms. That said, it’s important to remember that when it comes to eczema prevention or resolution, the gut microbiome is only one of the many factors involved in the development of this condition. Some babies may have a signature and have already developed the condition, in which case, supporting the gut microbiome may help manage symptoms. Other babies may develop eczema without a gut microbiome signature because their eczema is caused by different factors.

How to Support Your Baby’s Gut Microbiome

How can you support your baby’s gut microbiome to reduce the risk of developing eczema or minimize symptoms? Here are several steps you can take.


Feed beneficial bacteria with HMOs

For babies that haven’t started solids, breastmilk is the ideal food. It contains HMOs that feed beneficial gut bacteria [6]. That said, we know that it is not possible for all parents to breastfeed. If using formula, try to choose one that is supplemented with HMOs. There’s also the option of providing HMOS through a separate supplement.


Determine if probiotics are necessary

Unfriendly gut bacteria that promote inflammation can flourish when there’s not enough beneficial bacteria to fight them off. You can see if that’s the case for your baby with a gut health test like those from Tiny Health. If your baby has low levels of beneficial Bifidobacterium, a Bifidobacterium probiotic specifically formulated for little ones -in terms of strains, dose, and backed up by clinical evidence- can help restore balance of the gut microbiome. A test is highly recommended before supplementing with this type of probiotic, as Bifidobacterium might already be present in the gut at high levels. We only want to provide more of these species when really needed. [Use code GLADSKIN20 at checkout to save $20 off your first Tiny Health Gut Health Test].

Lactobacillus probiotics are different, as these bacteria are unlikely to colonize your baby’s gut. Despite that, Lactobacillus are beneficial bacteria that provide benefits to gut health while transiently passing by. One particular Lactobacillus strain that has been shown to reduce eczema symptoms is Lactobacillus rhamnosus GG [26], [27].


Gently promote diversity

Even if we want to see the baby’s gut dominated by beneficial Bifidobacterium, a little bit of variety is good in the early days. And this becomes more and more important as your little one’s gut microbiome matures.

Gentle ways of promoting gut diversity include: