World Allergy Organization (WAO) position paper on probiotics and allergy

Thursday, Feb 01, 2018


Fiocchi A, Burks W, Bahna SL, Bielory L, Boyle RJ, Cocco R, Dreborg S, Goodman R, Kuitunen M, Haahtela T, Heine RG, Lack G, Osborn DA, Sampson H, Tannock GW, Lee BW; on behalf of the WAO Special Committee on Food Allergy and Nutrition. Clinical Use of Probiotics in Pediatric Allergy (CUPPA): A World Allergy Organization Position Paper. World Allergy Organ J. 2012 Nov;5(11):148-67. Link to PubMed

  • Background:
    Probiotics administration has been proposed for the prevention and treatment of allergic manifestation. World Allergy Organization (WAO) Special Committee on Food Allergy and Nutrition reviewed the evidence and published scientific opinions on the clinical effectiveness.
  • Comments on the quality of clinical studies reviewed:
    Literatures on probiotic consists mainly of reviews, few of them are systemic, and meta-analyses are rare.
  • Subject populations in studies reviewed:
    • Infants, pregnant women – newborn pairs in most studies
    • Teenagers and adults in a few studies
  • Key findings of literatures review:
  • Probiotics and food allergy:
    • The WAO's DRACMA* and NIAID** Guidelines neither mentioned nor recommended the use of probiotics for milk or food allergy.
    • Studies yield inconsistent findings on the usefulness of probiotics in food allergy.
  • Probiotics and atopic eczema:
    • No meta-analytic evidence showed probiotics are clinically effective for treating established eczema.
  • Probiotics and asthma:
    • No primary prevention study has been able to demonstrate an effect of probiotics supplementation in asthma in human.
    • Positive studies are of relatively small sample size and short period.
  • Conclusion:
    • Safety issues are of utmost importance when probiotics are added to cow's milk formula intended for general use.
    • There is no established role of probiotics supplements for the prevention or treatment of allergy.

*DRACMA = Diagnosis and Rationale for Action against Cow's Milk Allergy
**NIAID = National Institute of Allergy and Infectious Disease



Latest Articles

Academic Activities

Scientific symposium – Critical connectivity: Assessing and supporting the development of brain and behaviour


  • Dr Henry Au Yeung Cheuk-lun (Hong Kong)
  • Professor Weili Lin (USA)
  • Dr Daniel Chiu Cheung-shing (Hong Kong)
  • Dr Fanny Lam Wai-fan (Hong Kong)

The 28th International Congress of Pediatrics (IPA) (NEW!)

17-22 August 2016, Vancouver, Canada

Science Updates

Deciphering the antibacterial properties of human milk oligosaccharides (HMOs) (NEW!)

The authors have identified several HMOs with potent antimicrobial activity against the pathogen Group B Steptococcus, and uncovered the mechanism of action of HMO antimicrobial activity such as by increasing bacterial cell permeability.


Picky Eating eBook

Practical tips to overcome picky eating behaviours by Kate Di Prima, an accredited practicing dietitian specializing in Paediatrics and a spokesperson for the Dietitians Association of Australia. 

Growth Charts

The WHO Child Growth Standards were developed using data collected in the WHO Multicentre Growth Reference Study (MGRS)1.