Eczema in Babies – Troubleshooting the Itch

To us, eczema was more than just an itch. Eczema disrupted good sleep habits, restricted my diet, changed our wardrobe, and broke my heart over and over again. My baby started developing eczema at around 5 months. He is now 16 months old and his skin is clear most of the time but it has been a frustrating journey to get to this point. I had read that eczema patients often have “flare-ups” at which point their eczema becomes active; well my son’s eczema was continuously “flared-up” with me having to apply the prescribed steroids almost every day. Although the steroids would eventually clear up the redness in his skin, it would never completely relieve the itching associated with eczema. The best advice I can give to fellow parents of eczema sufferers, based on my experience, is to be alert to what triggers your baby’s eczema off and try and eliminate or control these triggers. Be aware however, that your child’s allergy triggers and the associated symptoms will change as he/she grows.

 

This article documents my investigation into what triggers my son’s eczema, as well as measures we put in place to eliminate or reduce the reaction to triggers. Take note that eczema triggers vary from baby to baby, so conduct your own investigation for your little one and take the appropriate associated steps to relieve your loved ones eczema.

 

Trigger 1: Laundry Detergents

My son’s eczema first started showing when we changed his laundry detergent. We had run out of our usual baby detergent and so we used a different brand of baby detergent. Our cutie’s skin was rough to the touch on all the areas of skin exposed to the clothes. When we changed back to the previous baby detergent, his skin showed improvement.

As he became more sensitive, we noticed that when we held him against our own clothes, whilst carrying him or putting him to sleep, it caused his cheeks to light up bright red. We then started washing all our laundry with his baby detergent. Our clothes are none the worse for the change in detergent and it helped reduce his flare ups.

Lesson Learnt: Not all detergents, even those marketed as baby detergent’s, may be compatible with your baby’s skin.

 

Trigger 2: Wool

We had put a woollen jersey onto our son after a long time and within an hour he was all shades of red on the areas that the jersey collar was in contact with his face… he is allergic to wool! To eliminate this trigger we use only cotton clothes, blankets (with exception of baby sleep sacks which do not come into contact with his skin) and duvets on the baby. We have also removed woollen rugs from his play areas and replaced with rubber mats (much like yoga mats) which also serve as a great non-slip protective cushion on which to learn how to crawl and walk.

 

Trigger 3: Lanolin

After realising that my son was allergic to wool, I stumbled upon an article that stated that if you are allergic to wool then you are likely to have a hypersensitivity to lanolin. This made a lot of sense to me when I realised that the bum cream that previously caused him a red bum had contained lanolin. Lanolin is a by-product of wool, or more accurately stated, it is a wax secreted by the sebaceous glands of sheep or other wool bearing animals. Several cosmetic products contain lanolin including baby moisturisers, nipple creams, sun-blocks and bum creams, as well as many moisturisers and aquaphors recommended for eczema.

We had then changed to a far cheaper, lanolin free bum cream and he has not suffered with a diaper rash since. We also stay away from products containing lanolin. By 11 months, our son seemed to be over his wool and lanolin allergy.

 

Trigger 4: Cow’s Milk Allergy

Cow’s milk was my son’s main eczema trigger and the reason that he was suffering from almost continuous eczema. My son has been exclusively breast fed so I was not aware that he was allergic to cow’s milk till I fed him cereal that contained cow’s milk. He broke out into hives around his face and neck about a minute into the feed. By the time we had got to the doctor’s rooms, he had mostly cleared up but began vomiting violently. Yes, my boy is truly a bundle of allergies…. Cow’s milk protein, specifically casein is the culprit here. After reading that casein does pass through into breast milk in trace amounts, I stopped consuming dairy – this made all the difference to his eczema. I had previously tried to stop consuming dairy for a week to see if this was related to my boy’s eczema, but his eczema had only become worse in this period. The problem was that I had not tried long enough. This time it took me more than 2 weeks of going without dairy before I had started seeing an improvement; his eczema again had become worse before it became better. His eczema is now almost completely clear with only occasional minor flare-ups due to temperature changes. Most notably, he no longer develops eczema in his ears, and when he does flare- up it is minor and limited to his cheeks and elbows.

At 13 months I reintroduced dairy into my diet whilst still breastfeeding with no noticeable change in his eczema profile, despite blood tests showing that he is still highly allergic to cow’s milk. This may be because his allergy symptoms have changed.

 

Trigger 5: Dry Air Conditions

Dry air gives you dry skin which increases susceptibility to eczema. The following tips help us prevent and relieve dry skin in our baby:

  • Bath with Epimax or aqueous cream instead of soap;
  • Moisturise twice in a day with coconut oil and Epimax after bath or wipe down;
  • Moisturise face often since it is always exposed to the air and wash several times a day after meals;
  • Apply an extra barrier layer of unscented petroleum jelly on the face if the air is particularly dry;
  • Keep a humidifier on to increase air moisture content. The humidifier is especially necessary if you are using a heater at home. If you do not own a humidifier then place a shallow dish of water (out of reach of your child) in the room in which the heater is in use.

 

There are several other triggers that could set off your baby’s eczema. Keep alert to identify those things that are causing your precious baby to itch.

 

Trigger 6: Drastic Temperature Changes

This is a tricky trigger to control because it is almost impossible to control the temperature of every environment to which we expose our babies. My son’s first major eczema flare-up on the face was due to the sudden and drastic increase in ambient temperature conditions due to change of season. His face was red, peeling and so itchy he could not sleep soundly. We tried to cool him down with air-conditioning but the problem was that we only had air-conditioning in our bed room and so he was exposed to drastic changes in temperature when he moved in and out of the room which only worsened the eczema.

Also, sweat build-up in the folds of his skin aggravated his condition.

Steps we have taken to guard against eczema triggers due to sudden temperature changes:

  • limit exposure to air- conditioning
  • If we do use air- conditioning we do not change the ambient temperature too drastically, so that there isn’t a big temperature difference experienced when location is changed. We also keep a humidifier on, to guard against drying out of the air which will ultimately lead to drying of his skin.

Eventually my son acclimatises to the new temperature and his eczema heals. We take control measures listed below to reduce the symptoms of a breakout.

 

Daily Skin Maintenance

As thorough as you may be in the effort to keeping your little one away from his/her eczema triggers, flare-up’s do happen. This is my daily routine to prevent and control those incidents:

In the morning I give my baby a “top to toe”. I wipe each part of him with a soft face cloth and warm water. I apply coconut oil or almond oil followed by baby moisturiser whilst that part of the body is still wet; the wet skin enables better absorption of the oil and moisturiser. If he is drooling excessively or if the air is particularly dry, I follow up with some Vaseline on his chin and cheeks.

In the evening we bath him with aqueous cream or Epimax Junior followed by another massage with coconut oil and moisturiser while his skin is still warm.

When my baby’s eczema was very severe, I would re-apply moisturiser every hour on his face. I would also use the prescribed steroid ointment if needed and as often as recommended.

Alternatives to Cow’s Milk

Do you or a loved one suffer from cow’s milk allergy or lactose intolerance? Or have you or a loved one chosen the noble route of going vegan? No idea what to cook? I was there when my son was diagnosed with cow’s milk allergy and both he and I had to go dairy free. There are alternatives to cow’s milk that will help keep you going in the kitchen. Do take note that these milks cannot be the main source of milk for infant feeding as with cow’s milk, however, they can be used for cooking and food preparation. Remember that breast milk is the best source of milk for your infant. This is the experience I have had with the milk alternatives I have tried:

 

Almond milk

Almond milk tastes great in desserts but is not suitable for savoury dishes because it is very sweet. You may even find that you have to omit or reduce the amount of sugar you use in your dessert recipe. I have heard of unsweetened almond milk but have yet to find it in my grocery store. I have also found it to be significantly more expensive than other milk alternatives.

 

Soya milk

Soya milk is a versatile milk and can be used for both savoury and sweet dishes. However, it does have a stronger flavour than cow’s milk which can come through in lightly flavoured dishes. Soya milk is easy to drink by the glass when in the form of a milk shake but that is probably not the healthiest option especially for diabetics or those watching their weight. Also, my dietician has mentioned that soya milk is contraindicated for babies with cow’s milk allergy since there is close cross linking which can sometimes trigger a soya milk allergy. My paediatrician’s wise advice is to consume everything in moderation to manage allergies.

 

Rice milk

Rice milk is lightly flavoured with a lovely scent and a hint of sweetness. It can be used in both savoury and sweet dishes. However because it is slightly sweeter than cow’s milk, you may want to increase the savoury element in your dish and decrease those elements that add sweetness (for e.g. onions) to try and achieve a balance in savoury dishes. I was using rice milk for many months without questioning it’s safety because it was listed as an option for cooking with by a paediatrician we had visited, but I have recently read that there is some controversy over rice milk since rice milk and other rice products were found to have higher than average levels of inorganic arsenic. The truth on the matter… even the FDA (U.S. Food and Drug Administration) does not seem to have made their mind up on the subject yet. I have two cartons of rice milk in my cupboard and I am not sure what to do with them either…

 

Coconut milk

Coconut milk is often my milk alternative of choice. Coconut milk is a versatile milk which can be used in both sweet and savoury dishes. It is often used in curries and is a popular ingredient in Thai cuisine such as the famous Thai green curry. Coconut milk adds a creaminess to your dish that most other milk alternatives do not. Some may prefer coconut milk over cow’s milk whilst others tire easily of the coconut flavour it often imparts. I would recommend it to balance acidic curries, in desserts and for use in your toddler’s cereals. It is also high in saturated fat which is an important component for your growing child’s brain.

Do Cow’s Milk Allergens Pass Through into Breast Milk?

I am baffled as to how many differing opinions I have received from medical professionals about whether or not allergens pass through into breast milk. I have spoken to a paediatrician that said the cow’s milk allergen cannot pass through into breast milk, I have spoken to paediatricians and an allergist that has supported that it can, and I have spoken to a dietician that revealed that the medical world has yet to come to a conclusion on this important topic. Well I need no further convincing on the matter, I have witnessed first-hand the effect of allergens in breast milk and this is my story.

My son has had eczema since he was around 4 months old. On hearing through my nephew’s paediatrician that breast fed babies can be sensitive to cow’s milk in the mothers diet, I omitted dairy from my diet for just less than a week. His eczema did not abate… in fact it just got worse. But my story is not yet complete.

We then discovered that he was highly allergic to cow’s milk when he was 6 months of age when he reacted to a bite of cereal containing cow’s milk. A cow’s milk allergy means that the body is over reacting specifically to a protein called casein found in cow’s milk. So with new encouragement from my ever supportive mother in law, and in a desperate effort to calm my sons raging eczema I omitted dairy strictly from my diet again, this time for a month. The resulting change in my son’s constant eczema was drastic and unquestionable… his eczema again got worse and then … it almost disappeared! His skin was smooth and soft to the touch for the first time in many months and the constant itchiness that not even steroid topical treatment could relieve was finally gone. Most importantly, I no longer had to resort to using steroids to try to offer my son relief from his eczema, and this was a huge relief to me! I then read that casein can take about a month to leave the body and so it can take this long to see any resulting change in a baby’s eczema and that symptoms can sometimes get worse before it gets better; and then it all made sense. This is, I assume, the same concept as when we detox, where the body purges toxins through our skin when we stop consuming those toxins.

During the months that followed I would consume dairy to test if he still reacted in the same way, and his eczema would always flare up. After a while I stopped testing and just resigned myself to my fate. I went strictly without any form of dairy for a whole 6 months. At 12 months we tested my son for allergies via a blood test, and he was still highly allergic to cow’s milk. But then, an allergist/paediatrician advised me that his allergy would be changing as he develops and therefore (much to my excitement) I should try to start eating dairy again, and if his reaction was not severe I should continue consuming dairy. She explained that it is important for babies with allergies to be exposed to the allergens so that they are given a chance to get over their allergies (this advice is probably not prescribed to those who have life threatening reactions such as anaphylaxis, or maybe such actions will be conducted in a more controlled environment).

I started consuming dairy and he did not react, but after two months of consuming dairy I am noticing that he is reacting to breast milk feeds with a red rash around his mouth and itchy ears. This may be because I am consuming more dairy now than when I first started including dairy back in my diet; or that casein is building up in my body and therefore concentrating in my breast milk; or that he is drinking more breast milk in one sitting because I have reduced feeds; or it could be a combination of these factors. At 16 months old my son is still allergic to cow’s milk but can consume butter with no reaction. He has reactions to breast milk feeds which clear up quickly.

Although more studies are definitely needed in this subject to better understand and help our poor little allergy sufferers, I need no further convincing that cow’s milk proteins definitely do pass through into breast milk. If you do abstain from dairy to see if it will give your little one relief from allergy symptoms, remember that it can get worse before it gets better and remember to go sufficient time without the allergen to allow the allergen to be completely flushed from the body so that the true effect can be observed. Remember also that our baby’s allergies do change and hopefully eventually disappear altogether, so do keep testing. May we all overcome our allergy challenges soon!