Can Fish Help Prevent Childhood Eczema?

According to a recent study, infants who are fed fish may have a lower risk of developing eczema, an allergic skin disease, in early childhood.

The researchers followed nearly 5,000 children who were participating in a larger ongoing health study in Sweden. When the infants were six months old, the scientists asked the parents about their children's diets and signs of allergic eczema. The parents were interviewed again when the babies were one year old.

By six months of age, 14 percent of the babies developed eczema. This increased to 21 percent by one year of age. On average, symptoms of eczema occurred at four months of age. The researchers noted that the strongest risk factor for developing eczema in early childhood was having a mother or sibling with the condition.

This study, published in the Archives of Disease in Childhood, revealed that compared to babies who did not eat fish before nine months of age, babies who did eat fish were 24 percent less likely to develop eczema by age one. It did not appear to matter if the fish contained large amounts of omega-3 fatty acids. Although it has been suggested that omega-3 fatty acids, commonly found in fish oils, may help prevent allergic diseases, several recent studies have found no such effects.

The authors made several other observations. The age at which dairy products or eggs were introduced into the diet did not appear to affect the risk of developing eczema. Earlier guidelines recommended that parents delay the introduction of potential food allergens, including cow's milk, and eggs. The authors also found that smoking or having cats or dogs in the home did not appear to be risk factors.

Unexpectedly, breastfeeding had no significant impact on eczema risk in the infants. These results stand in contrast to the recent guidelines published by the American Academy of Pediatrics, which recommend that babies who are at high-risk for developing asthma and other allergic diseases be exclusively breastfed for the first few months of life.

Allergic diseases, including eczema have becoming increasingly common over the years, but the reason for this remains largely unknown. While researchers know that genetics play a big role, more research is needed to understand the impact of allergic foods, such as dairy, eggs, nuts and seafood.

Additional studies are needed before fish can be recommended as part of an infant's diet to prevent eczema.

For more information about fish and fish oil, please visit Natural Standard's Foods, Herbs & Supplements database.

Comments

[jane watson]

As the parent of a child with eczema and someone who gets eczema herself, I found this study on fish and childhood eczema very interesting. First, it's amazing to note that these infants were fed fish at such a young age, particularly in contrast to the typical diet of an American baby. I was surprised that the authors did not find a link to the omega 3 fatty acids in fish -- you would think that might play some role in skin allergies. It was also surprising to me that the authors did not find that breastfeeding offered more protection to the infants in this area. I'd like to see this explored more and hear responses from pediatricians.

[Tania]

My brother and I both had some eczema on our faces when we were babies, and I still have it reappear once in a while. I am wondering if incorporating more fish into my diet now would be helpful, but I’m curious as to how fish can be incorporated into a baby’s diet before nine months of age. Is there fish baby food that can be purchased, or is there a way to prepare fish for a baby?

[crystal]

I bet most will comment on these questions: How are babies to eat fish? How early should they eat fish? When can they chew? Should the fish be puréed, chopped, ground, etc.? And, what kind of fish should these babies/infants eat? Would it be fresh fish or fish from tuna cans? I think this is very interesting and is food for thought, but when studies are published, the answers to the above questions are certainly worth noting.

[mandy]

I think it will be interesting to see how this works in everyday practice. Children are picky eaters and often have not yet developed the taste to enjoy the same foods as adults. I feel like getting children to eat more fish would be difficult. Perhaps once more data are available on the actual component of fish that prevents eczema, the diets of young children could be supplemented with it, rather than trying the difficult process of forcing children to eat a food that is good for them.

[LT]

So can it (fish) really help prevent eczema in children? According to the published study, it seems that fish is associated with decreased risk of developing eczema in children less than 12-months old. Even though the study found significant risk reduction, these results need to be looked at carefully before making any conclusions. First, let’s keep in mind that this study is a prospective cohort study, thus, it can only suggest association. Secondly, the study was primary based on a questionnaire, thus, a possible bias was present due to problems recalling the answers.

[chowder]

If you search "fish baby food" on the Internet, you'll find a number of articles and sites (with recipes) with suggestions on how (and when) to introduce fish to your baby. Just make sure you click on the links for feeding HUMAN BABIES with fish, not feeding BABY FISH with whatever they eat (unless you have simultaneous interests in raising baby humans and baby fish).

[liz]

I agree with the author that additional studies are needed before recommending fish as part of an infant's diet to prevent eczema. Is there a fish baby food that is 100 percent free of any toxin (heavy metals)? If not, I am concerned about mercury exposure at such a young age.

[kay kelley]

Infant weight is lower than adult weight, thus one would expect low doses to impact infants, and that is what we are seeing here. The level of omega-3 fatty acids varied in the type of fish consumed by the children in this study, yet there still was a 24% drop in likelihood of developing eczema. This just shows that even small amount of fish oil has a sizable impact on infants.

What we do not know is the long-term impact to those infant that ate fish that had the higher levels of fish oil. Hopefully, the researches will follow up on the long-term benefit and identify the range of omega-3 fish oil in the fish consumed by the infants.

[SUMA]

This study seems to contradict a lot of information out there regarding food introduction, breastfeeding, etc. It also stated that it did not appear that the amount of omega-3 fatty acids in the fish had any effect on the development of eczema. As a result, I am not sure what the benefit was of eating the fish -- the omega-3s are supposed to be the anti-inflammatory agents.

Also, I wonder how difficult it was to get the babies to eat fish -- it is a challenge to get adults to eat it!

The potential mercury contamination is a great concern.

I think more information needed to be provided regarding other confounding factors. For example: did these children or their moms receive antibiotics prior to or immediately after delivery? If so, what effect did this have on their gut flora and Th1/Th2 balances? What was mom’s intake of fish and fish oil during pregnancy? Did this play a role in the baby’s immune status?

I agree that more research needs to be done, as reducing/eliminating allergies and eczema is a worthwhile cause.

[Tamara.S]

Recently, the prevalence of allergic disease, including atopic eczema has increased, and I started seeing a lot of kids with eczema. It appears that fish might actually make a positive difference, although there has been a been a fear of early fish introduction, especially in infants with a family history of allergic disease.

The type of fish consumed had no effect on the risk of developing eczema, suggesting that omega-3 fatty acids, had nothing to do with the benefit? This gives researchers a really good opportunity to start following this and see if it makes a difference or not.

[Dana]

LT, you are right. At this point, researchers have only found a possible link between eating fish and reducing the risk of developing eczema. Hopefully, more research will be directed towards how exactly fish affects eczema because this is a condition that occurs in a lot of children. I had it myself as a child and still have it now. Prescription ointments and creams only provide temporary relief, and it would be nice to know if a change in my diet would also help.

[Helen S.]

I did not think about the possibility of mercury exposure, but that is a valid point. Liz, you are definitely correct about the need for additional studies before fish is recommended in an infant's diet. Later research may show that the benefits of eating fish at an early age does not outweigh the risk of mercury consumption. I think it is especially risky to include things in an infant's diet that we are unsure of since their systems may not be able to tolerate it.

[Dan]

Interestingly, the research also states that "beneficial effects were seen from introducing fish before nine months of age or having a bird in the home." I am not really sure how having a bird around the infant would be beneficial. I would assume that pets and animals would be likely to cause allergic effects.

[carole]

What’s interesting is that if you go to MedlinePlus and read on eczema in the medical encyclopedia, you will find in the prevention section, suggestions for dietary restrictions, such as breast-fed milk versus cow’s milk. More relevant, it states that other dietary restrictions may include eggs, peanuts, soy and fish. Although this page on eczema was last updated in July 2007, I am curious as to when studies like this one will produce enough evidence for government health Web sites to be convinced.

[Anna]

As an aunt of a seven-month-old, exclusively breastfed baby, the article was interesting, as well as disappointing. I would unrealistically like to think that by breastfeeding a baby, one would protect him/her of all evils, not this time though.

Fish is pretty much not recommended for babies that young, and the repertoire is very restricted in breastfeeding moms due to the high levels of mercury. I wonder if, in this case, the medicine won’t be worse than the disease. However, it is great that such a study has been done. Later on, they might be able to identify the fish component that helps prevent eczema and later use it to develop lotions, supplements, etc.

[ana]

The findings from this study seem to suggest that there is a genetic component involved in the development of eczema in babies. If a sibling or the mother had eczema, the baby is at higher risk of developing eczema. Thus, a suggestion for parents would be give fish to the baby if there is a history of eczema in the family. Another thing to keep in mind is that they could have a bird as pet instead of dog or cat in the house, as the study also found that families that had pet birds also saw a significant number of results lower than what was expected.

[PK]

When I read the article abstract, I did not see a reference to allergic eczema specifically. There are many types of eczema ranging from essentially dry skin to atopic, or allergic, eczema. Although the researchers did not see an association between the level of omega-3 fatty acids and the development of eczema, perhaps adding any level of these beneficial fats generally improved this skin condition in those who ate fish.

[karen]

I’ve never liked fish growing up. I don’t know how my child will eat it. It’s hard enough as it is to get him to eat his baby food. Since I don’t particularly like it, it’ll be a real challenge to fake a smile or play airplane to get convince him to eat it. If they’ve come up with fish to prevent eczema, maybe they’ll come up with other ways to prevent it too. I hope!

[misty]

Liz brings up a good point. The higher levels of mercury in fish in a child's small body could have serious adverse effects if one is not careful. More research into this aspect of the study is definitely necessary in order to make appropriate recommendations in our young children.

[erika]

I’m not arguing against feeding fish to infants; however, I would give fish with caution. There are many types of fish, and I would also be concerned about where the fish comes from, i.e., polluted waters. Some have already commented on mercury content. A little mercury is OK in adults but may be toxic (i.e., to brain development) in children. Shellfish may be potential hazardous and cause allergic reactions, especially if there is a strong family history for this allergy.

[lisa]

The strength of the links found in this study and the fact that eczema, as the newspapers confirm, is on the increase, suggests that this is an important area for study. More research, preferably a randomized-trial design, could provide a clearer estimate of the degree of protection, if any, provided by eating fish or keeping birds.

[darlene]

As Dana said, prescription ointments and creams do, unfortunately, provide only temporary relief. I think a change in diet -- in this case, eating fish -- will also provide temporary relief. This definitely warrants future studies that examine more closely the role of the omega-fatty acid and eczema. If it’s just the omega-fatty acid, then I would think that we can avoid feeding infants mercury-contaminated fish and give them capsules instead...if deemed safe.

[Becca]

It makes sense that fish intake could be beneficial for infants with eczema, given the benefits of fish oil on skin in adults. The authors looked at the introduction of cow’s milk, eggs and breastfeeding, which did not seem to affect eczema in infants. Although fish was effective in infants younger than nine months of age, it is not clear if this is due to the increased intake of omega-3 fatty acids. More studies should be done, especially since the high levels of mercury in some fish have not been discussed in most studies that have been done.

[matt]

Should the same results be expected if we were to supplement the diets of young children with omega-3 fatty acids, rather than trying to feed infants fish? The taste of fish on such a young palate may not be the most pleasing, and perhaps it would be more efficient to supplement with omega-3 fatty acids?

[Beth]

More studies need to be conducted to fully understand the implication of this study. The study speculates that omega-3 fatty acids are not what's really at work here. Therefore, finding which component of the fish and understanding the true mechanism of action may lead to additional treatment options for all eczema suffers, especially if it can be developed in to a different administration form. Feeding fish to infants is major concern, and eating fish may not be an option for some vegetarians.

[JC]

The decreased risk of developing eczema by age one may not be a good endpoint. According to some sources, cradle cap, a form of seborrheic eczema that is common in infants, may develop within six months. In some instances, infants will continue to have symptoms throughout childhood. This study should have compared babies who ate fish to babies who didn’t. They also should have studied infants who were younger than nine months old...maybe six months old instead.

[PK]

After re-reading the article, I noticed that it stated that the level of omega-3 fatty acid in the fish did not appear to have an effect on the decreased risk of developing eczema. Perhaps there is another component of fish that we have not considered that is responsible for this apparent correlation, or perhaps the children who were given fish at a younger age also had other healthy foods in their diets not reported. Perhaps one of the causes of the worldwide increase in allergic diseases is the increase in processed foods that we all consume.

[randy]

I just attended a homeopathy lecture, and this topic came up. Instead of feeding fish to babies, maybe homeopathy therapy should be used for this condition. I don’t know if there is a study about this, but it would be great to know if this therapy can help.

[lee]

While this study is interesting, it seems that it would need some long-term research in order to see if these results would be maintained over the long term. Do fish prevent the development of eczema or just delay it?

[Janice]

I’m with Matt on this topic. Instead of fish, could omega-3 fatty acids be given? No bones, no pungent fish odor, etc. Moreover, the way the capsules come, I think they are capsules filled with gel. So a parent could puncture the capsule and squeeze the contents out and mix food right? How convenient!

[tommy]

There’s nothing sweet about it. I can’t imagine how frustrating it would be to feed an infant fish. Although eczema is a very common condition in infants, it’s a condition that resolves in more than half the patients by age five. Knowing this, parents don’t have to be too disheartened if their little ones can’t bare the taste of fish.

[K. Kelley]

Infant weight is lower than adult weight, thus one would expect low doses to impact infants and that is what we are seeing here. The level of omega-3 fatty acids varied in the type of fish consumed by children in this study, yet there still was a 24 percent drop in the likelihood of developing eczema. This just shows that even small amounts of fish oil have sizable impacts on infants. What we do not know is the long-term impact to those infants who ate fish and had the higher levels of fish oil. Hopefully the researchers will follow up on the long-term benefits and identify the range of omega-3 fish oil in the fish consumed by the infants.

[abbyfromtx]

Yet another use for omega-3 fish oil. (My fav to take is the one that Neurovi makes -- neurovi,com -- super pure, no contaminants and pharmaceutical grade. Plus I got to order online so that was a plus.)

It's IMPERATIVE that we increase omega-3's!! I think a recent poll stated that more than 100 million people in the United States alone suffer from eczema, and that's not counting people who suffer from psoriasis or other skin allergies.

Doctors recommend that a balance of omega-3 AND omega-6 be consumed to stabilize the deficiency, which can be difficult! And we have waistlines to prove it, as the average consumer takes in 20 times more than the recommended amount of omega-6!!! Call me a health nut, but these facts are fascinating.

[Jenni D.]

We always hear how good fish and omega-3 is for us, yet to also prevent eczema and possible other allergies is astounding! Fish gets a bad reputation due to high mercury levels, yet everything in moderation is my motto!

Many people run to their dermatologist to treat eczema, as it is truly a very common skin condition. I would rather eat something natural any day instead of taking a pill or putting chemicals on my skin.

Just as the author noted, I too have noticed more people with allergic diseases, including myself, over the years. So where is all of this coming from? Chemical toxicity? Pollutants?

[Bob]

I am also interested to know exactly how these children were fed fish and what percent of children get fed fish in Sweden and in other parts of the world as well. In America, it seems very uncommon for an infant or a child to get fed fish. Would it even be possible to feed them fish? How likely are American parents to feed their children fish if this study was validated later on?

[michaela]

In the September issue of Thorax, doctors noted that in addition to maternal intake of vitamin E, vitamin D and zinc during pregnancy, maternal consumption of apples and fish may reduce the risk of children developing asthma or atopic diseases. If these results are confirmed, recommendations on dietary modification during pregnancy may help to prevent childhood asthma and allergy.

[Denise]

After reading the comments on this blog, I have to pose the same question as many others have: How do you get American babies to eat fish at such a young age? As an American of Vietnamese descent, I am familiar with many baby foods that incorporate fish and vegetables into a rice gruel. It is my understanding that most Americans do not follow a similar diet, especially for newborns. It seems like this study may require additional research. It's difficult to say whether this study holds substantial value once you question what other diets were given to the baby at the same time. Breast milk? No breast milk? Veggies? What veggies?