Do probiotics reduce allergy symptoms? It’s complicated! | Image credit: Contemporary Pediatrics

Probiotics probably have no effect on reducing atopic dermatitis in infants with cow’s milk allergy (CMA), and it’s uncertain whether they can help such infants acquire tolerance. In addition, probiotics probably do not influence the development of tolerance among children with peanut allergy or CMA; however, the LLG strain has a significant benefit in inducing tolerance among infants with CMA when used for 2 or more years. These were the main findings of a meta-analysis of 13 studies on probiotics’ role in allergy symptoms, involving a total of 1608 children.

In 3 studies evaluating the effects of probiotics on eczema, probiotics groups reported a greater reduction in symptoms than placebo groups, but only when the allergy was IgE mediated. Conversely, in children with non-IgE–mediated allergy, the placebo group showed a 13.5-point reduction in scoring atopic dermatitis measures compared with an 8.6-point reduction for those taking probiotics. One study found significantly reduced gastrointestinal and respiratory symptoms among infants with CMA after 6 months of probiotics compared with those taking a placebo. Another investigation found that treatment with probiotics for 3 months significantly lowered allergic symptom scores among children with food allergies. However, results were inconclusive in the 3 studies that addressed the effect of probiotics on reducing eczema occurrence.

THOUGHTS FROM DR FARBER

There is a category called GRAS, which stands for generally recognized as safe. I suggest expanding this to GRASBU (GRAS but unproven). Probiotics in children fall into this category, whether used for colic conditions, allergic conditions as here, or other entities. As such, I tend not to recommend them but do not actively discourage them either.

Reference

Tan-Lim CSC, Esteban-Ipac NAR. Systematic review and meta-analysis on probiotics as treatment for food allergies among pediatric patients: a 2024 update. Pediatr Allergy Immunol. 2025;36(1):e70028. doi:10.1111/pai.70028