Topical Treatment With Fresh Human Milk Versus Emollient on Atopic Eczema Spots in Young Children

A Small, Randomized, Split Body, Controlled, Blinded Pilot Study

Teresa Løvold Berents; Jørgen Rønnevig; Elisabeth Søyland; Peter Gaustad; Gro Nylander; Beate Fossum Løland

Disclosures

BMC Dermatol. 2015;15(7) 

In This Article

Background

Atopic eczema (AE) is a common, chronic, pruritic, relapsing skin disease which affects up to 20% of children in the Nordic European countries.[1] AE is strongly associated with other atopic disorders, such as allergic rhinitis and asthma.[2] The pathogenesis is interplay between barrier dysfunction, genetic, immunological, environmental factors and colonization by Staphylococcus aureus (S. aureus).[3]

The treatment algorithm in AE is based on treating the barrier defect, the inflammation, the infection and the pruritus.[4] First line treatment is treating the barrier defect with optimal skin care by the use of emollients and baths. If a clinical infection is present in the eczema, local antiseptics may be utilized; for severe cases systemic antibiotics are needed. The inflammation is treated with topical steroid creams. Topical steroids have been shown to be a well-tolerated treatment, but in spite of this many caregivers have steroid phobia, mainly because of the potential side effects.[5] A treatment option in chronic eczema is topical calcineurin inhibitors; these are however not to be used in children under two years of age.[4] Alternatives without side effects for young children are therefore of interest.

Human milk may represent a source with potential treatment properties. Knowledge of the immunological qualities of mammalian milk can be traced back to 1892, when Paul Ehrlich demonstrated that newborn mice were protected against the toxic effects of phytotoxins if they were fed milk from an immunized mouse.[6] Today, numerous studies have contributed to our present knowledge of the short- and long-term effects of human milk in the breastfed child.[7] Mammalian milk is species specific. Human milk contains specialized immune components, including factors with anti-microbial and anti-inflammatory properties,[8] which theoretically could be responsible for an effect on eczema spots when applied topically.

In Norway, public health nurses report several cases where parents have had positive experiences with topic applications of expressed human milk in eyes of children with conjunctivitis and on eczema spots in children with AE. We have not been able to find any studies investigating such treatment in children with AE. However, local use of expressed human milk has been studied for diaper dermatitis, rhinitis and conjunctivitis.[9,10]

The aim of this small pilot study was to assess the potential positive and/or negative effects of topical use of expressed, fresh human milk on eczema spots in young children with AE by evaluating the eczema areas. A secondary aim was to evaluate any bacterial transmission from human milk to the eczema spots, causing infection in the child. Finally the mothers' compliance to the treatment was of interest.

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