The daily application of emollients during infancy does not prevent eczema (BEEP)

Reference

Chalmers JR, Haines RH, Bradshaw LE, et al, for the BEEP study team. Daily emollient during infancy for prevention of eczema: the BEEP randomised controlled trial. Lancet 2020;395(10228):962-972.

Synopsis

These researchers randomized infants at high risk of developing eczema (at least one first-degree relative with eczema, allergic rhinitis, or asthma) to receive general skin care (parents were advised to use mild cleansers and shampoos specifically formulated for infants, and to avoid soap, bubble bath, and baby wipes; n = 701) or general skin care plus the daily application of an emollient (cream or gel based on parental preference; n = 693). The researchers tracked the infants over a 2-year period to determine if a physician had diagnosed eczema. Unfortunately, nearly 100 infants in each group were lost to follow-up (approximately 13% of the total). Nonetheless, after 2 years, there was no significant difference in the proportion of infants who developed eczema (25% in the control infants, 23% in the emollient-treated infants). The emollient-treated infants had a slightly higher rate of skin infections in the first year (mean 0.23 vs mean 0.16). A similar study with 2397 infants in the same issue of The Lancet (Preventing Atopic Dermatitis and ALLergies in childhood — the PreventADALL study ) also found that neither daily emollients nor early complementary feeding (the introduction of peanut butter at 3 months, followed by the introduction of cow's milk, wheat porridge, and eggs) prevented eczema or food allergies at 1 year of age.