Combined interventions
Dissanayake et al explored the utility of a combined intervention approach in a 2x2 factorial trial where one group received a combination of synbiotics and a ceramide-based emollient from birth to 6 months, a second group received synbiotics only, a third group emollient alone and a last group with no intervention (Table 1).38However, they found no differences in food sensitization or FA prevalence by age 1 year between any of the groups. PreventADALL also had four study arms: skin intervention alone; early allergenic food introduction alone; combined skin and food intervention; and no intervention. FA prevalence was only reduced in the arm receiving early allergenic food introduction as compared to no intervention, akin to the LEAP study,3 but no difference compared to the skin intervention group.