Children who experience more respiratory infections in their first three years of life have significantly higher rates of eczema development, according to a 2026 cohort study of 1,370 children published in JAMA Dermatology. Gram Research analysis shows kids with the most respiratory infections had 61-76% higher eczema risk compared to those with the fewest infections, with each additional infection increasing risk in a dose-dependent pattern. The association remained strong even after accounting for genetics and antibiotic use.
A major study of over 1,300 children found that kids who catch more respiratory infections (like colds) in their first three years of life are significantly more likely to develop atopic dermatitis, commonly known as eczema. Gram Research analysis shows this connection appears to be dose-dependent, meaning more infections mean higher risk. The research was conducted across two independent groups of children in Denmark and the United States, making the findings more reliable. Importantly, the link held true even after accounting for antibiotic use and genetic factors that influence eczema risk.
Key Statistics
A 2026 cohort study of 663 Danish children found that those in the highest tertile of respiratory infection episodes had a 61% higher risk of developing atopic dermatitis compared to those in the lowest tertile (adjusted odds ratio 1.61, P=.03).
According to research reviewed by Gram analyzing 707 American children, each additional respiratory infection episode in early childhood increased atopic dermatitis risk by 3% (odds ratio 1.03 per episode, P=.002).
A two-cohort analysis published in JAMA Dermatology in 2026 found that children with the most days spent with infections in their first three years had a 69% higher yearly prevalence of atopic dermatitis compared to those with the fewest infection days.
Respiratory infections drove the association between early infection burden and childhood eczema, while ear infections and sore throats showed weaker connections in the 1,370-child study across Danish and American birth cohorts.
The Quick Take
- What they studied: Whether children who get more colds and respiratory infections early in life are more likely to develop eczema later
- Who participated: Two groups of children: 663 Danish children tracked from birth to age 10, and 707 American children tracked from birth to age 6. Researchers carefully recorded every cold, ear infection, sore throat, and fever they experienced
- Key finding: Children with the most respiratory infections in their first three years had a 61-76% higher risk of developing eczema compared to children with the fewest infections. Each additional infection increased eczema risk
- What it means for you: If your child gets frequent colds early on, they may have a higher chance of developing eczema. However, this doesn’t mean infections cause eczema—other factors matter too. Talk to your doctor about monitoring your child’s skin health if they’re prone to respiratory infections
The Research Details
This was a cohort study, which means researchers followed the same children over time and tracked what happened to them. The main group was 663 Danish children from the COPSAC2010 birth cohort who were monitored from birth through age 10. Parents kept daily diaries recording every cold, ear infection, sore throat, pneumonia, stomach bug, and fever their children experienced, especially during the first three years of life.
The researchers then looked at which children developed eczema and compared infection rates between those who did and didn’t develop the condition. To make sure their findings were solid, they repeated the study with a second, independent group of 707 American children from the VDAART study, tracking them from birth to age 6. This “replication” approach strengthens confidence in the results because the same pattern appeared in two different populations.
The analysis accounted for important factors that could affect results, including genetic variations in the filaggrin gene (which influences skin barrier function) and whether children received antibiotics. This helps isolate the specific relationship between infections and eczema development.
Understanding what causes eczema is crucial because it affects millions of children and can significantly impact quality of life. Previous research on whether early infections protect against or increase eczema risk has been inconsistent and confusing. This study clarifies that relationship by following children prospectively (watching them over time rather than looking backward) and using two independent populations to confirm findings. The dose-dependent relationship—meaning more infections correlate with higher risk—suggests a real biological mechanism rather than a coincidental association.
This study has several strengths: it followed children over many years (longitudinal design), used objective daily diary records rather than relying on memory, included two independent populations that showed the same pattern, and adjusted for genetic and treatment factors. The sample sizes were reasonably large (over 1,300 children total). Published in JAMA Dermatology, a top-tier medical journal, it underwent rigorous peer review. However, the study is observational, meaning it shows association but cannot definitively prove that infections cause eczema. Other unmeasured factors could explain the relationship.
What the Results Show
In the Danish cohort, children in the top third for infection episodes (most infections) had a 61% higher risk of developing eczema compared to children in the bottom third (fewest infections). Children with the most days spent with infections had a 69% higher risk. Each additional infection episode independently increased eczema risk.
The American cohort showed similar results: children with the most infections had a 76% higher risk of eczema compared to those with the fewest infections. Each additional infection episode increased risk by 3%. Importantly, respiratory infections (colds, bronchitis, pneumonia) drove most of the association—ear infections, sore throats, and stomach bugs showed weaker connections.
The relationship held true even after researchers accounted for antibiotic use and genetic factors affecting skin barrier function. This suggests the infection burden itself, not just treatment or genetics, influences eczema development. The findings were consistent across both cohorts, strengthening confidence that this is a real phenomenon rather than a chance finding.
The study found that respiratory infections specifically—rather than all types of infections—were the primary driver of increased eczema risk. Ear infections and sore throats showed weaker associations. The timing appeared important: infections during the first three years of life showed the strongest connection to later eczema development. The relationship was dose-dependent, meaning the effect increased gradually with more infections rather than appearing suddenly at a threshold.
Previous research on early infections and eczema has been contradictory. Some studies suggested that early infections might protect against eczema (the “hygiene hypothesis”), while others found no relationship or even increased risk. This research clarifies that early respiratory infections appear to increase eczema risk in a dose-dependent manner. The use of two independent birth cohorts with consistent findings helps resolve previous inconsistencies and suggests this relationship is robust across different populations.
This study shows association but cannot prove that infections directly cause eczema—other factors could explain the relationship. Researchers couldn’t measure all possible confounding variables (other factors that might influence both infection rates and eczema risk). The American cohort relied on parental report of eczema diagnosis rather than clinical assessment like the Danish cohort, which could introduce inconsistency. The study doesn’t explain the biological mechanism explaining why respiratory infections increase eczema risk. Results may not apply equally to all populations or ethnic groups.
The Bottom Line
Parents should not try to prevent all infections in young children, as some infection exposure is normal and important for immune development. However, if your child experiences frequent respiratory infections in early childhood, discuss eczema risk with your pediatrician and monitor skin health closely. Standard eczema prevention measures (moisturizing regularly, avoiding irritants, maintaining skin barrier health) remain important. This research does not suggest avoiding vaccines or other protective measures. Confidence level: Moderate—the association is clear, but the mechanism and clinical implications need further study.
Parents of young children, especially those with family histories of eczema or asthma, should be aware of this connection. Pediatricians and dermatologists should consider early infection burden when assessing eczema risk. Children with frequent respiratory infections warrant closer skin monitoring. This research is less relevant for families with minimal infection exposure or those without genetic predisposition to eczema.
Eczema typically develops within the first few years of life, with most cases appearing by age 5. If your child experiences frequent respiratory infections, skin changes might appear within months to a few years. However, not all children with frequent infections develop eczema—individual risk varies based on genetics and other factors.
Frequently Asked Questions
Does getting colds as a baby cause eczema?
Research shows a strong association between early respiratory infections and eczema development, but association doesn’t prove causation. Other factors like genetics and skin barrier function also play important roles. The relationship appears dose-dependent: more infections correlate with higher eczema risk.
Should I try to prevent my child from catching colds to avoid eczema?
No. Some infection exposure is normal and important for immune system development. Instead, focus on standard eczema prevention: daily moisturizing, avoiding skin irritants, and maintaining a healthy skin barrier. Discuss your child’s individual risk with your pediatrician.
At what age is my child most vulnerable to developing eczema from infections?
The first three years of life appear to be the critical window. Respiratory infections during this period showed the strongest association with later eczema development. However, eczema can develop at any age, and multiple factors beyond early infections influence risk.
If my child gets lots of ear infections, will they definitely get eczema?
Not necessarily. While the study found associations between infection burden and eczema risk, many children with frequent infections never develop eczema. Genetics, skin barrier function, and other environmental factors significantly influence individual risk. Discuss your child’s specific situation with your doctor.
What should I do if my child has frequent colds and develops eczema?
Work with your pediatrician and dermatologist to develop a skin care plan emphasizing daily moisturizing and irritant avoidance. Monitor infection patterns and skin flares to identify triggers. Standard eczema treatments remain effective regardless of the underlying cause.
Want to Apply This Research?
- Log respiratory infection episodes (colds, coughs, fever) and eczema flare-ups separately, then review monthly to identify patterns. Track infection frequency during ages 0-3 specifically, as this appears to be the critical window
- Set reminders to moisturize skin daily, especially during and after respiratory infections when eczema risk may be elevated. Create a notification to discuss infection patterns with your pediatrician at regular checkups
- Maintain a 12-month rolling view of infection episodes and skin condition changes. If your child averages more than 6-8 respiratory infections annually in early childhood, flag for pediatrician discussion about eczema screening and preventive skin care strategies
This research shows an association between early respiratory infections and eczema development but does not establish definitive causation. Individual risk varies based on genetics, environment, and other factors not measured in this study. This information is educational and should not replace professional medical advice. Parents concerned about their child’s eczema risk or skin health should consult with a pediatrician or dermatologist for personalized guidance. Do not attempt to prevent all infections in young children, as some exposure is important for normal immune development.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.