The Gut-Skin Connection: What Parents Should Know About Gut Health and Eczema in Babies
Medically reviewed by: Lauren Mahesri, RD
As a mom to a toddler with severe eczema, I know how painful it is to watch your child battle red, scaly, and relentlessly itchy skin. The flare-ups that cause open, bloody scratch wounds and disrupted sleep are some of the toughest parts of managing eczema. Like many parents, we tried everything—topical steroids, switching detergents, swapping shampoos, and every “eczema-friendly” product we could find, but nothing seemed to work. What I didn’t realize was how deeply gut health is connected to skin health.
Read on to learn more about the gut-skin axis and how your baby’s gut microbiome may be influencing their eczema and overall skin health.
What is eczema in babies?
Eczema, or atopic dermatitis, is a chronic inflammatory skin condition that affects up to 1 in 4 children in the United States. It causes dry, red, cracked, and intensely itchy skin that often appears in inflamed patches. The constant itching and irritation can often lead to open, bloody, or infected wounds.
Eczema looks different in each child, and its severity can vary widely. Some children have small, localized patches, while others experience symptoms across the whole body. In babies, eczema most commonly appears on the cheeks, scalp, and face. As children grow into the toddler and preschool years, eczema often shows up in elbow creases, behind the knees, on the wrists, or around the eyes.
What causes eczema in babies?
Eczema is caused by a weakened skin barrier and can be triggered by an overactive immune system. In some babies, a genetic mutation affects filaggrin, a protein that strengthens the outer layer of the skin and helps retain moisture. When filaggrin levels are low, the skin dries out more easily and has a harder time protecting against irritants and bacteria, which can cause the immune system to overreact.
Although some causes are genetic, eczema is complex and influenced by many factors such as:
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Chemicals in soaps or laundry detergents
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Dry or harsh weather
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Sweating
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Emotional stress
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Dust
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Pet dander
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Pollen
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Synthetic fabrics
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Fragrances
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Tobacco smoke
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A weakened gut
Understanding the eczema and the gut
Your baby’s gut is connected to many parts of their body, including their immune system, hormones, metabolism, and skin. The gut and skin communicate through the gut-skin axis, a two-way connection between the gut microbiome and the skin. When the gut is out of balance, irritants and harmful microorganisms can more easily break through the gut barrier, which can contribute to inflammation and skin issues like eczema.
“People with eczema often have decreased microbial diversity, fewer beneficial bacteria, and more potentially pro-inflammatory species in the gut,” says Danielle Zold, RD, LDN, CLC, CGN, Pediatric Registered Dietitian and Founder of Nourished Pediatrics. For babies who have an imbalanced gut (also known as gut dysbiosis), the ratio of “good” to “bad” bacteria is disrupted. This imbalance affects how the gut normally functions and can weaken the gut-skin barrier, making the skin more sensitive to inflammation.
Supporting a healthy gut to help manage eczema
Supporting your baby’s gut microbiome can help manage eczema, and works best alongside pediatrician guidance and a healthy skincare routine. Below are several strategies to promote a balanced, healthy gut:
Probiotic supplements
Probiotics are the “good” live microorganisms that are found in the gastrointestinal tract and support a healthy gut. They can improve digestion, support the immune system, and promote a strong gut-skin barrier. Probiotic supplements can help reinforce the intestinal lining, making it harder for harmful microbes and irritants to pass through.
Because of this gut-skin connection, certain probiotic strains may play a role in preventing or managing eczema. Studies suggest that giving probiotics to mothers during late pregnancy and to infants in early infancy may help reduce the risk of developing atopic dermatitis. “[This is because] probiotics can be beneficial for increasing regulatory T cells (Treg cells) and suppressing T helper cell (Th) responses,” explains Zold. In other words, probiotics may help regulate the immune system to prevent excessive skin inflammation.
However, a 2017 meta-analysis concluded that while early research is promising, there is not enough high-quality evidence to confirm that probiotics reliably improve eczema symptoms in children. More recent studies have also found mixed results, highlighting the need for further research.
If you’d like to add a probiotic supplement to your baby’s diet, speak to your doctor first. They can guide you on safe dosages and what’s appropriate for your baby’s individual needs. Probiotic supplements are not safe for babies who are premature or immunocompromised.
Prebiotics
Think of prebiotics as “food” for the good bacteria in your baby’s gut. They’re types of dietary fiber that help probiotics grow and thrive to keep the gut microbiome balanced. A healthy gut, in turn, supports a stronger immune system and healthier skin.
Combining prebiotics with probiotics may be more effective than probiotics alone. For example, one study found that children with moderate to severe atopic dermatitis showed greater improvement when given a mix of prebiotics and probiotics compared to probiotics by themselves. When your child is ready for solid foods, consider adding gentle, prebiotic-rich options such as mashed bananas or oatmeal, and serve them alongside probiotic-rich foods like yogurt or kefir.
Support gut-friendly milk feeding
If you’re able and choose to breastfeed, breast milk naturally supports your baby’s gut health. It promotes the growth of beneficial bacteria, such as Bifidobacterium and Lactobacillus, and it contains special carbohydrates called Human Milk Oligosaccharides(HMOs) that help keep the gut balanced. Interestingly, breastfeeding may delay the onset of eczema. “Babies who are breastfed or receive a combination of breast and formula fed experience a delayed onset of eczema compared to babies fed formula only,” explains Zold.
If your baby is formula-fed, you can still support their gut health. Look for infant formulas fortified with HMOs, or discuss with your pediatrician whether a probiotic- and HMO-based prebiotic supplement might be appropriate. These steps can help nurture your baby’s gut microbiome and potentially support healthier skin over time.
Frequently asked questions (FAQs)
Does diet affect eczema?
“Diet doesn’t usually cause eczema, but it can make symptoms better or worse by shaping the gut microbiome and influencing inflammation in the body,” says Zold. “Kids who eat more fruits, vegetables, and omega-3-rich foods often have lower rates of allergic conditions like eczema, while diets high in processed snacks and saturated fats tend to lead to more inflammatory patterns.”
Does the way my baby was born (C-section vs vaginal) affect their eczema risk?
Babies delivered via cesarean section (C-section) may have a slightly higher risk of developing eczema, though studies are mixed. Babies delivered vaginally typically receive a higher level of beneficial bacteria from their mother as they pass through the birth canal. On the other hand, babies born by C-section often have different early gut bacteria, may be exposed to antibiotics earlier, and may have other contributing factors, including genetics. Some research has linked these differences to an increased risk of developing eczema by around age 3, particularly in infants who show eczema symptoms as early as 3 months.
