This is another blog, long overdue. I see many babies with eczema and I feel I need to give you a few pointers to help your little bubba's itch a little less.
I've had eczema myself since the age of 13 years old and at times it has been quite yucky and sore. So I understand a lot about how they're feeling.
In the UK I was a nurse prescriber and we had special training on how to manage eczema.
What is eczema?
It is an inflammatory process and can affect up to 1 in 3 babies and children, so it's an extremely prevalent chronic atopic condition. It can last a long time and in some cases is a chronic disease, i.e. it is always present. It presents as irritated and mainly dry skin, however, there are different types of eczema and they all react differently to treatments. It depends on the type of eczema and if it's wet or dry as to how its best treated. There is not a one size fits all approach. Babies usually grow out of it by childhood. Their skin repairs itself so well there is usually no permanent scarring. However, teenagers and adults will generally have this as a lifelong condition.
How does it look?
The skin often feels rough and scaly to the touch. Young babies often develop it on their faces, their cheeks can feel hot, dry and look very red and inflamed. They may also develop it in their skin creases, particularly behind the knees and elbow folds, then it spreads to other parts of the body. Some babies have wet and weeping eczema, this can start as tiny blisters underneath the surface of the skin. Others may have discoid eczema that looks like a circle of tiny blisters and/or rough scaly skin.
Seek medical advice. It's important you check out your baby's skin with your GP or Paediatrician, to confirm if, it is eczema. It is important to do this as you may be treating a different skin condition.
Here's a previous blog you might like a look at. It was Miss Kit and the hat and her wool hat had led to eczema on her face.
What causes eczema?
- Environmental factors - dust mite, moulds, grasses and plant pollens, amount of moisture in the air, pollutants in the child's' environment e.g. what you wash the babe's clothes in, clothing type (wool and acrylic), pet fur (dog and cat), bath and skin products, overheating and air-conditioning, cigarette and tobacco smoke
- Genetic causes. There may be a family history of eczema, asthma and/or hay-fever. If both parents have eczema there is an 80% chance the children will too.
- Food sensitivities and allergies - cows milk protein is a big allergen - look for mucousy or slimy poo
- Stress - very important your baby has a good restful sleep. This has been shown to reduce cortisol (stress hormone) levels.
How do you prevent an outbreak of eczema?
Many preventative things can be done to avoid an eczema outbreak. Most importantly, the skin should be kept moist by using a daily moisturiser.
- Wearing 100 per cent cotton or soft fabrics such as merino wool - avoiding rough, scratchy fibres and tight clothing. Acrylic and some wool fibres are rough and abrasive on the sensitive and delicate skin.
- Having lukewarm baths, using a non-soap cleanser or hypoallergenic bath oil such as BABE atopic bath gel or QV oil. It takes 10 minutes to get the oil in the bath into baby's skin so your bath should not be so short that this cannot occur or so long that it has the opposite effect and dries the skin out.
- Gently patting, not rubbing, the skin dry with a very soft towel
- Applying a moisturiser within three minutes after bathing to "lock-in" the moisture. Apply in a downwards direction following the hair follicles. This minimises abrasion on the skin.
- When possible, avoiding rapid changes of temperature - so not too cold or too hot. In Australian summers using a fan for sleep is helpful.
- Removing carpets and rugs from houses (if possible) and keeping pets outside or vacuum up daily and use a vacuum cleaner that has a HEPA filter such as a Dyson. Vacuum beds and couches.
- Ventilating the house as often as possible
- Avoiding stuffed toys which harbour dust mites
- Changing bed linen regularly, using specialized dust mite prevention covers
- Avoid using Napisan to soak clothes and bedsheets.
- Use a non-biological detergent to wash baby's clothes such as Lux Flakes or Aware (see below).
- Avoid perfumed moisturisers. I've found Johnsons products and baby products that are scented and have sodium laurel sulphate and lots of additives are not great for babies with eczema.
- Reducing daily stress and making sure your baby has good quality sleep. Lots of love and cuddles will help as well!
- Learning your baby's eczema triggers and how to avoid them.
- Avoid using wet wipes that have an ingredient MI - see link below for more info
How do you treat and manage eczema?
- Moisturise the skin 4-6 times a day with a good quality moisturiser that is the right one for your baby's eczema skin type. Never allow the skin to dry out. Once that occurs it cracks and allows bacteria to penetrate the skin and then the eczema is really hard to heal and may need antibiotics. It's a case of different ointments and creams work for that individual baby or child's' eczema.
- Try my very own eczema balm in my online store
- You've got to experiment and find what works. What's good for one child's' eczema may not be for another.
- Use an emollient (oil such as QV or QV flare-up) in the bath
- Oatmeal in the bath
- Cotton clothing next to the skin
- Manage flare-ups with a mild steroid ointment/cream used topically on the skin, as directed by your GP, Paediatrician or Dermatologist. This may be 1% hydrocortisone such as Sigmacort or Dermaid. Use 3 times a day for 3 days to get eczema under control and use a moisturiser in-between times and as well as.
- Try to continue breastfeeding. It has been shown to reduce the risk of eczema. If your baby has mucous poo or eczema outbreaks it is worth trying a 2-4 week elimination diet and removing all dairy products and soy from your diet to see if this helps your baby's eczema.
- If formula feeding use an HA formula with a probiotic. There s research to show that a partially hydrolysed formula may reduce the risk of atopic disease in infants. Talk to your doctor or child and family health nurse about this. Aptamil Allerpro is a great choice for particularly severe eczema as it is a 'treatment' formula. http://pediatrics.jwatch.org/cgi/content/full/2010/512/1
- It may be a good idea to introduce a probiotic into your baby's diet. These can be given from newborn as a powder mixed with a little milk and fed to the baby. Baby Biotics by Bioceuticals is a good brand.
- There is research to show the benefits of enhancing the gut flora and so benefiting the immune system. http://altmedicine.about.com/od/skinconditions/a/Probiotics-For-Eczema.htm and maybe in pregnancy in at-risk families they may be a good idea http://altmedicine.about.com/od/skinconditions/a/Probiotics-For-Eczema.htm
- Be careful about how you introduce solids to your baby. Talk to your doctor or child and family health nurse about this. ASCIA is a helpful guide http://www.allergy.org.au/health-professionals/papers/ascia-infant-feeding-advice
- Cover hands and eczema-prone body areas with special eczema clothing - https://www.thesleepstore.com.au/shop/clothing/eczema-clothing
I know it's a long list of things to do but eventually, it all becomes second nature. As I said different eczema responds to different lotions and potions. There is not a one size fits all but keeping that skin moisturised is key.
I've used all sorts of things in my search for a cure including chickweed infusions, calendula ointment and vaseline. And for the past few years, I've been lucky not to have had a major outbreak but maybe that's because I keep my stress under control!