Our struggle with eczema began early on, around 2 months of age. He had a pretty severe baby acne followed by a cradle cap that started to spread onto his face, his thighs, his arms, his neck. At that time we didn't know what we were dealing with. We thought that those were just symptoms of a cradle cap. Finally, at 4 months, his pediatrician diagnosed him with the eczema. However, like most pediatricians he gave us very generic and unhelpful advice - such as, apply Aquaphor on the affected areas, at night give Benadryl to help with the itching.
It took us another 5 months of reading and experimenting to fully understand and tame this disease. I would like to share our experience with other parents to make their journey easier and to help their babies suffer less.
1. If you are breastfeeding, like I was - what you eat may be crucial to your baby's health.
Initially, I was against this idea, I thought that this is an old wives' tale, especially that each time our little guy would have another outbreak my mother-in-law would ask me what I ate . I was always against dieting, thinking that cravings were just body's signals that some nutrient is missing from the diet. I thought that if I followed my body's internal voice it would guide me and I would eat just the right things in the right amounts. As you might have guessed it doesn't always work that way. Especially when you are breastfeeding. All of a sudden you have a voracious appetite that seems to never go away. If time and resources allowed you could munch and snack your way throughout the day and the night. Secondly, if your baby has eczema, there is a high chance that it might be triggered or worsened by certain foods you eat. Sadly, it took me a really long time to figure it out. Instead of going cold turkey and quitting eating all of the potentially allergenic foods, I started dropping them one by one. It was a frustrating and long process. I strongly recommend you do it the right way - stop eating all of the potential suspects (list below) and once your baby's skin condition improves reintroduce the foods one by one to figure out the triggers.
List of most common food allergens:
eggs
diary
nuts from trees (including hazelnuts, walnuts, almonds, and Brazil nuts)
peanuts (groundnuts)
shellfish (including shrimps, mussels, and crab)
soy
wheat
sesame seeds (!)
2. Ask your doctor for a blood allergy test for your baby and a referral to a pediatric dermatologist (if your insurance allows that).
The blood test results become significant once baby is over 9 months old. The test is helpful in confirming if your food allergen guesses were right, plus it tells you if your baby is allergic to pet dandruff, pollen, dust mites etc.
Visit to the dermatologist is not necessary however it is helpful. Their knowledge is most up-to-date, and they have years of experience dealing with baby eczema. Unfortunately, some pediatricians teach wrong ways of dealing with eczema - dermatologist will straighten this out and answer all of your questions.
3. Moisturize, moisturize, moisturize.
Your baby may not initially like the feel of moisturizer on his skin - it might be cold (try warming it up in your hands before applying) or if applied to raw eczema patches it might sting. But it has to be applied multiple times a day. In a hot, dry weather when eczema gets worse I usually apply it at least 5 times a day - each time I change his diaper I try to slather some lotion on. It keeps eczema at bay.
It is also very important to use the right kind of moisturizer - we tried so many different kinds and spent so much money on Mustela, Cetaphil, Aveeno, babyganics, The Honest Company, Eucerin, the list goes on and on. Finally, we found CeraVe, and it does wonders for the little guy. I highly recommend it. We also like EpiCeram, it is a super concentrated moisturizer prescribed by a physician. It gets kinda pricey so we only use it on the baby's face.
4. Use humidifier.
We have Crane Drop Ultrasonic Cool Mist Humidifier. You really want to prevent drying of the skin, plus it helps the baby breathe better.
5. When eczema flares up.
There is really no way to clear eczema without the use of steroid topical creams. You have to stop the inflammation to restart your moisturizing regimen. Moisturizing alone will not help at this point. Your baby is suffering. Eczema is extremely itchy and makes the baby irritable, disrupts his sleep, interferes with normal stages of exploring the world and developing.
We were really afraid to use topical steroids and avoided them for too long. Once we started using them we would shorten the treatment thus decreasing their effectiveness. Avoid our mistakes - topical steroids have minimal side effects if used properly. Use the creams with the lowest steroid percentage that helps effectively clear your baby's eczema. Apply it only to the affected area until the eczema (red, patchy skin) clears up plus one more day, then switch to your regular moisturizer. Take a break between the steroid application. Ideally, you want to take a 7 day break between each steroid application. In reality, if you only use steroid cream for 4-5 days, you can start using it again after 4-5 days. You just want to make sure you don't use it all the time. That could lead to serious side effects. It is really helpful to make a chart (on a whiteboard or hanging calendar) and document when you applied the creams, it will help over application and show you the patterns of the flare ups which may help you determine its triggers.
6. Bathing and swimming is OK.
Newest research shows that everyday bath does not worsen your baby's eczema. Of course, when your baby is very young he or she may not need to be bathed everyday, but once they start crawling or walking you will probably want to clean those sticky little hands and feet.
There are few rules though:
-use tepid water preferably with addition of colloidal oatmeal or a mixture of epsom salt and baking soda (2 cups epsom salt and 1 cup baking soda per bathtub)
-keep the bathtime to 10 minutes maximum
-don't use washcloth, don't scrub
-don't use soap unless necessary, I usually just use it for diaper area, hands, feet and neck
-use soapless cleanser, my dermatologist has recommended CeraVe Hydrating Cleanser and it works for us
-don't rub, gently pat dry baby's skin
-immediately apply the moisturizer to lock the moisture in
If you decide to take your baby to a swim class just make sure to rinse him under clean water once you get out of the pool and immediately follow up with your moisturizing regimen.
7. Prevent scratching.
Scratching and discomfort are unavoidable, flare ups will happen, you just want to shorten their duration and frequency. However, you don't want to give up to your baby's unstoppable need to scratch. He will hurt himself, cause bleeding wounds that may lead to a potential infection. Also scratching prevents the healing process it leads to greater skin irritation compounding the eczema vicious cycle.
The best way to prevent scratching is to keep the itchy areas covered with long sleeve tops, long leg pants, socks, bandana bib around the neck (also great for catching the drool). For the night I have sewn mittens onto a long sleeve onesie and for the car rides I put mittens on and try to distract him with a movie.
That's all I can think of right now. I hope that you will find some of the information useful. The good news is that baby eczema resolves with time and most of the children grow out of the their food allergies. It will only get better!
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