By Dr Mounavi Vemula
December 2025
There is a close relationship between the gut, immune system and skin – often referred to as the ‘Gut–Skin–Immune Axis’. Research increasingly shows that a child’s gut health plays an important role in the development of food allergies and eczema, especially early in life. The gut is home to trillions of bacteria that help guide and “train” the immune system. When this microbial community is healthy and diverse, it supports immune balance and tolerance. However, when the microbiome is disrupted- for example with reduced diversity, fewer helpful bacteria such as Bifidobacterium and Lactobacillus, or an increase in more inflammatory bacteria – this imbalance can lead to exaggerated allergic responses.
Healthy gut bacteria also help break down dietary fibre into important substances called short-chain fatty acids, including one known as butyrate. These metabolites play a key role in supporting the development of immune cells and antibodies that promote tolerance, and by strengthening the gut lining itself. When these helpful bacteria are reduced, less protective substances are made, which may weaken the gut barrier and allow food proteins to trigger inflammation. This gut imbalance can also contribute to cross-reactivity, where the immune system mistakes one protein (from food or microbes) for another, leading to broader or unexpected allergic reactions.
Because of the link between gut health, food allergy and eczema, many families explore changing their child’s diet in hopes of improving symptoms. However, food elimination or restriction should only be done under the guidance of a specialist or dietitian. Unnecessary or prolonged avoidance, particularly in infancy and early childhood, can increase the risk of developing true IgE-mediated food allergy to foods that were previously tolerated. It can also place children at risk of nutritional deficiencies which can impact growth and development. The key is a balanced approach that protects gut health and supports safe, ongoing food diversity.