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

Results

Study Population

Nine children, four male, were recruited for the study through advertisement posters from three different well baby clinics in Oslo, Norway in the period 2008–2011. Three of these nine children were lost to follow-up consultations; one experienced remission from AE, the second suffered from severe AE and was hospitalized, the third never met for follow up (Figure 1). Two children were treated with mothers' milk produced for a younger sibling. The mean age of the children was 18.5 months (min, max; 4, 32). At inclusion mean SCORAD was 35 (min, max; 22, 45) and at the end of the study mean SCORAD was 34 (min, max; 18, 52). The spots examined were localized on the arms or legs in five of the children and on the cheeks in one. The spots were similar in severity, however the extent differed some.

Figure 1.

Flow diagram. Nine children with atopic eczema and bilateral eczema lesions were assessed for eligibility to a small split body, controlled, physician blinded pilot study evaluating human milk and emollient versus emollient alone on eczema lesions. Three children were lost to follow up.

Changes in Measured Area of Eczema

The weekly change in the control and intervention eczema area related to baseline eczema area is illustrated in Figure 2. At the end of the study, child number one and seven displayed less area involvement in the area treated with human milk compared to the emollient treated area. In child number two, five and nine the emollient treated area showed at study end less involvement than the area treated with human milk. The eczema spots in child number eight disappeared after inclusion.

Figure 2.

Change in eczema area. This figure illustrates the weekly difference between control and intervention sites based on the area change from baseline in six children with atopic eczema included in a split body, controlled, physician blinded pilot study evaluating human milk and emollient versus emollient alone on eczema lesions. Each line represents one child. The difference is calculated as: control area week 1, 2, 3 or 4 divided by control area at week 0 minus intervention area week 1, 2, 3 or 4 divided by intervention area at week 0. Lines above zero represent improvement of the intervention area, and lines below zero represent the relative increase of the eczema areas of the intervention sites.

Most of the children showed an improvement of their general eczema, except for child five, who showed a slight increase. Child seven differs from the other children: this child experienced a worsening of the total eczema, having mild atopic eczema at inclusion, and severe atopic eczema at week four.

Changes in Presence of Bacterial Species

Four of the children had positive S. aureus cultures in their eczema once or more (Table 1). However, only in four of twelve occasions this coincided with clinical signs of infection. Gram-negative rods were found in child number one at one visit. S. aureus, alfa haemolytic streptococci or coagulase-negative staphylococci were detected in three of the 28 human milk samples. Only on one occasion the same bacteria (S. aureus) were detected in both the eczema lesions and the human milk (child number five), and signs of clinical infection were present (Table 1). The intervention areas differed some from the control areas, as S. aureus was found in intervention area but not in the control area on four occasions in three different children (Table 1).

Compliance

The mothers experienced the application of human milk as an uncomplicated treatment option.

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....