Alternative treatment – Does Manuka Honey help with eczema?

Manuka Honey

When my baby Marcie got hand-food-and- mouth disease, my brother introduced me to Manuka Honey as it supposedly can help to reduce the ulcers in the mouth. After doing a google search, I am surprised to find that there are many links relating to how manuka honey can help with eczema. Being curious, I did a little research and though the verdict is still not conclusive, Manuka Honey seems to be a fairly safe product with no known side effects.

What is Manuka Honey?

– Produced by bees that collect pollen from manuka bush native to New Zealand, proven to have anti-bacterial property above ordinary honey

– UMF stands for Unique Manuka Factors, where say a UMF 12 stands for 12% solution of antiseptic

How does it help with Eczema?

– Stops infection and reduces inflammation

Moisturize, soothe and repair dry, cracked and damaged skin

Other Benefits

Other benefits published in a 2006 article DailyMail.co.uk suggest ability to fight superbugs, bacteria that causes gum disease, soothes sore throat and helps with digestion

Word of Caution

– Got to find active manuka honey in cream form, rather than applying honey direct onto baby, o.w. so sticky (and yucky or yummy, depending on how you see it!)

– One teaspoon is recommended for adults, so not to be given in excess to children

– Not to be given to babies below one year old (some links recommend 2 year old)

Update: View this post in 2014 with a compilation of studies on honey’s effect on eczema

Is partially hydrolysed milk worth the money?

Partial Hydrolysed Milk sold in Singapore

Partially hydrolyzed milk formula, such as Enfalac HA and NAN HA, was recommended to my baby girl Marcie when her eczema was diagnosed by the paediatrician at one month old. It was a nightmare getting her to drink the less tasty milk formula and each bottle feed dropped from 85ml to 20ml! It seemed to improve when we made the switch from NAN HA to Enfalac HA but you never know if it was due to the milk or that the reflux or gassiness got better.

The irony is that when I brought Marcie for a skin prick test when she was seven month old, she isn’t actually allergic to cow’s milk! The paediatrician had assumed that Marcie’s eczema was caused by food allergy, when it was intrinsic. So, I began to google whether HA milk was worth the money and whether I should let my next baby have hydrolyzed milk from the start.

So, here’s what I’ve found on this:

1. Partially hydrolyzed milk is non-hypoallergenic

This really confused me since the label clearly stated hypoallergenic. However, it seems like unlike extensively hydrolysed milk (which is not available in supermarket), only part of the cow’s milk protein is broken into smaller pieces.

2. Partially hydrolysed milk is proven to reduce risk of food allergy

So far research suggests that partially hydrolysed milk reduced the risk of food allergy, but it is not recommended for babies which has a firm food allergy. That is, if your child is already tested allergic to milk, giving partially hydrolysed milk can still give rise to allergic reaction.

3. Everyone says the best is breast milk

Naturally, it is cited on all labels that WHO recommends breast feeding for first six months. Problem is, parents like you and I, who are already stressed out with dealing with babies with eczema are unlikely to have the rest or the time to drink fluid or have proper nutrition, to produce enough breast milk! Easy to say, but we all know the effort required to produce breast milk.

I think, given that eczema is hereditary and to spare myself from the trauma of switching baby’s formula from a normal sweeter one to a partially hydrolysed one (should my next baby also has eczema), I would just start off him or her with HA milk.

Update: I’ve interviewed nutritionist Judy Converse on partially hydrolyzed milk about 2 years from this post (time flies!) and click here to read her explanation. Also check out this post in 2015 that compiled the significant studies on partially hydrolysed milk’s preventive effect for eczema high-risk infants.

What happens when an eczema baby get HFMD

Since last Friday when my baby girl Marcie’s teachers called to say they suspected that she has hand-foot-and-mouth disease (“HFMD”), my life, my hubby’s and Marcie’s have been miserable. Today is the 6th day of her HFMD, counting from Friday, 1st day where red bumps showed up on her hands and in her mouth. Here are some quick questions answered on HFMD, especially what happens when a baby with eczema has it (btw, Marcie is 17th month old).

1. How do you know if your baby has HFMD? Will it be confused with eczema rash?

When I brought Marcie to the doctor to verify if she has HFMD, the doctor did seem to take longer to check but made the diagnosis of HFMD when he saw ulcers in the mouth. Below are some pictures taken from the Singapore’s Health Promotion Board’s website, provided by KK Women’s and Children’s hospital.

HFMD on non-eczema child

2. What is the difference when HFMD happens to a baby with eczema?

In Marcie’s case, it didn’t look much like the above but instead the HFMD red bumps appear where she has been scratching most frequently, like her hand and her foot. I’m not sure if the degree of ulcers got to do with the immune system of the baby, but Marcie, fortunately, did not get red sores on her tongue but her tongue seems to be swollen and she drooled a lot.

HFMD on baby’s eczema foot

3. Did the scratching get worse on the eczema skin patches?

It didn’t for Marcie and instead got less scratching, until when the red HFMD bumps subsided, she started scratching again.

4. Will a parent get the HFMD from the child?

Yes! Especially as I co-sleep with my baby, I actually got flu (fever, sore throat, running nose) a day before the ulcers showed up on my baby.

5. What food does a baby take given there’s ulcers in the mouth?

Hydration is key as a baby drool a lot when the mouth has ulcers. If you google, every child seems to have their own preference in times of HFMD. It was traumatic to come up with ten different meals/food just to get Marcie to eat some, here’s what she did eat if it helps:

a. Hard-boiled egg

b. Steamed bun

c. Yoghurt (she only ate when I let her explore the fridge!)

d. Noodle

e. Baby rice cereal with strawberry sorbet (even then the trick didn’t work after 2 meals)

She did drink her favorite pear juice, some chocolate milk and Vitagen. For the past 6 days, she lost 1 kg, and I’ve lost 2kgs taking care of her!

Is steroid cream safe?

Elomet cream

In my post on “Are you suffering from Steroid-Phobia?”, I have encouraged parents to be open to using steroids under the doctor’s supervision. My baby girl Marcie has taken a one-time 3 weeks oral steroid course and has been applying steroid cream prescribed by her specialist doctor, like the o.1% Elomet Cream.

A recent research study confirmed that there is no major negative effect on the skin of children who have applied topical steroid over approximately 10 months. I couldn’t find the original study, supposedly published in Pediatric Dermatology. You can however find a summary of the report, widely published by numerous online news websites here. Main points reported by the online news are:

– 70 children tested versus a control group of 22 children

– 10 months’ usage with experts checking on skin transparency, flattening, shiny ‘glazed’ appearance or dilated blood vessels

– Result is no evidence of skin thinning, stretch marks or scars

– Do note that there is also comment that the sample size is too small, with information such as their age, doses not provided

For parents fearing the use of too potent steroid, below is a potency ranking chart from National Skin Centre’s website.

How to Shower your Eczema Child?

Having fun in water

Even a simple task like bathing can generate lots of different views. If you read online, you will find some people saying that children with eczema should bathe every few days while others say that up to 3 baths a day is acceptable. From what I understand from Marcie’s doctor, the important thing for bathing is to moisturize immediately after shower. As a quick guide, below are my top 5 FAQs on showering baby with eczema:

FAQ 1: How often to shower baby?

The general guide is not to lose moisture through showering but to retain or increase moisture from the routine. Frequent showering will lose moisture but for babies whose itch is triggered by heat and sweat like Marcie, she showers about twice a day. Once in the morning to get her off to a fresh start and once before bedtime to (hopefully) reduce scratching at night.

FAQ 2: What water temperature for the baby bath?

Lukewarm is recommended; warm is a no-no, again due to loss of moisture. Heat actually temporarily numbs the skin and reduces sensitivity of the itch nerves (from what I read). However, its permanent effect is a loss of moisture.

FAQ 3: What bath lotion to use?

Soap-free and perfume free. I use Dermaveen Colloidal Oatmeal bath oil (you can also try Aveeno’s) which is soap-free, moisturizing, non-greasy, lower skin pH and seals the moisture after baby’s bath.

FAQ 4: How long to bathe?

Usually soak for 10-15 minutes. As your baby gets older, she may no longer fit into the bath tub or prefers to bathe standing. Now Marcie will sit in the bath tub if she has toys to play or we blow bubbles to keep her amazed and seated in the tub.

FAQ 5: What to do after shower?

Don’t slip if you have just used the colloidal oatmeal bath lotion!

Wrap baby in towel, pat dry, don’t rub towel against skin. Moisturize immediately (you can refer to this post on the choice of moisturizer).

Update: About a year and half after this post, I’ve interviewed Dr Jennifer Shu and you can refer to her advice for bathing for babies with eczema here.

Top 10 Cooling Places to go with your child in Singapore

Having fun at Sentosa

We all love a good weekend outing and I’m sure if you are parenting a child with eczema, you would have figured that the stress level can hit sky high if your child is scratching.

First and foremost, you would have to figure out what triggers your child’s itch. For my baby Marcie, it’s the heat and sweat and Marcie’s doctor has told us to keep her fresh all the time. So a cooling place, well ventilated, preferably air conditioned is my top priority. After bringing Marcie out from one month old till now, 17 month old, here are my top 10 cooling places to go.

1. IMM – Apart from free parking for the 1st 3 hours, the place is huge enough that even on a weekend, the crowd has not ‘crowded out’ the cool air. There are also bookstore, toy stores and children stores with children rides around the mall. The latest addition is a 7-meter tall tree house playground at level 3. Fish & Co and Café Cartel have aircon that is cooling enough and also serve kids meal.

2. Libraries – Here you have to try out which library is cooling enough. For me, Bukit Banjang and Jurong West libraries have strong aircon but Jurong East’s aircon is too warm plus the children section in the basement have quite stale air. One drawback of libraries is that there is no diaper changing area.

3. Tanglin Mall – This mall is not crowded and have many children stores plus an organic shop that also sells baby food. Marcie could even eat in the food court as it is well air-conditioned. From Tanglin mall, you can walk to Forum the Shopping Mall which also has many children stores and Toys R Us.

4. Ikea – Though crowded over the weekend, Ikea has shopping trolleys that have child safety belts. Marcie loves sitting in the trolley so even if it is crowded, she can be distracted enough not to scratch. The dining area is always crowded but fortunately, there is a mini playground to keep Marcie busy.

5. Vivocity – Marcie loves the fountain and we let her play in it once. There is a baby changing area inside the female toilet, located very near to the entrance facing the fountain. The food court is far too stuffy and warm, don’t venture there if your baby itches when hot.

For outdoor places, it really depends on the weather. So far, we have brought Marcie to the following places where she didn’t scratch much.

6. Singapore Zoo – We went on a rainy Saturday and though it’s crowded, Marcie was attracted to the animals and the show and didn’t scratch.

7. Sentosa

Playing with the mist at Sentosa

We went on a crowded flower festival event over the Chinese New Year. It turned out well as we took a break in the air-conditioned visitor centre plus let Marcie play with the mist that comes out from the ground. The climb up to the cable car station is torturous though with throngs of people wanting to go up the escalators.

8. Qian Hu Fish Farm – This is cooling since the fish need a cool environment. Everywhere is sheltered and your child will likely be amazed with the range of fish. Some will even follow your finger on the tank and it’s quite fun for Marcie! The canteen can get fairly warm on a hot day though, so don’t plan your meals there.

9. Hay Diaries Goat’s Farm – The goat farm has milking time in the morning when the goats will be brought up a ramp to the milking area where the staff will pump the milk. It’s fascinating to watch and it’s also sheltered with a ceiling fan. Feeding of goats is no longer allowed but you can still walk around to view the goats from a distance.

10. Jacob Ballas Children Garden – There is a little fountain for children to play but it’s not shaded. Though suitable for kids who can walk and climb very well (there is a tree top house), I suggest giving this a miss on a hot day.

Are you suffering from Steroid-Phobia?

Eczema on baby’s face

You may be fearful of using steroids, as many parents (myself included) are. The fear could partly arise due to the negative news on steroid abuse by athletes and partly due to its side effects. If you have googled steroids, you will find numerous websites ‘promising’ treating eczema without using steroids. When Marcie’s doctor put her on oral steroid, I had a lot of reservations and fear and remembered scaring myself to death googling all the side effects.

But after going through resisting steroid use to using mild steroid lotion & cream and a 3-week oral steroid course for Marcie, I like to encourage you not to fear using steroids but instead use it under the instruction of your doctor, preferably a specialist.

How much steroid is ok?

Where there is no inflammation, just dry skin that’s itchy – I’d recommend using lots of moisturizer. Keeping the skin cool helps to relief the itch, so try turning the air-conditioner colder. (I sometimes give Marcie a cold drink bottle to hold and its works!)

Where there is inflammation and the skin is reddish and itchy – I’d clean the skin with cool liquid chlorhexidine (antiseptic) and apply mild steroid lotion or cream. For areas with delicate skin such as the face, I’d apply a 0.5% hydrocortisone and for other areas like the knees or elbows or hands, I’d apply a 1% elomet cream. Marcie’s doctor’s instructions were not to apply more than twice a day. So far, I have only needed to apply 2 to 3 days in a row, not exceeding twice a day, and the skin will go back to normal.

You can refer to this chart extracted from patient.co.uk for how much to apply, measured using fingertip units (ftu):

For a 3-6 month old child

  • Entire face and neck – 1 FTU
  • An entire arm and hand – 1 FTU
  • An entire leg and foot – 1.5 FTUs
  • The entire front of chest and abdomen – 1 FTU
  • The entire back including buttocks – 1.5 FTUs

For a 1-2 year old child

  • Entire face and neck – 1.5 FTUs
  • An entire arm and hand – 1.5 FTUs
  • An entire leg and foot – 2 FTUs
  • The entire front of chest and abdomen – 2 FTUs
  • The entire back including buttocks – 3 FTUs

What happened to Marcie after taking oral steroid?

You may be wondering why I’m encouraging parents to be open to using steroids when I initially did not even apply steroid on Marcie. It was very difficult to get the eczema under control and her eczema will suddenly just flare and affect her whole body. However, a one-time 3 weeks reducing dosage of oral steroid, prednisolone, really helped to keep the eczema manageable.  Marcie’s rashes disappeared within the first 2 days of the oral steroid, but gradually came back as the dosage is reduced. I worried a lot after reading the side effects of steroids such as thinning of skin, acne and damage of blood vessels. I am very glad that I chose to trust Marcie’s doctor and persisted with the 3 weeks course despite being fearful everyday. After the 3 weeks course, Marcie’s doctor said he will not give Marcie any treatment that is not 100% safe and will not give her another oral steroid course because that will not be safe. I read later that stopping an oral steroid course halfway causes more harm than following through and makes it more difficult for the doctor to decide on the next step.

After the oral steroid course, there are still rashes on and off, triggered by hot weather, sweat but never affecting her whole body with no reason. This makes it a lot easier to manage and Marcie has been a much happier baby since.

Taking the fear out of the Skin Prick Test

Skin Prick Test (image from eatstudy.co.uk)

Sending a baby or a young child to a skin prick test may be fearful for you or your child.

My baby girl, Marcie, had her skin prick test about 7 months old when I gave up trying to identify what triggered her eczema flares (some days I thought it’s the stage 1 food she was having and some nights I drove myself paranoid researching all sorts of allergies). Prior to the skin prick test taken at Singapore’s National University Hospital, I had some fears of the skin prick test myself; I imagined that Marcie’s skin will be pricked all over with many holes to test for all possible food she will eat in her lifetime and I also imagined the needle to be like a syringe that will inject the possible allergens into her skin.

A Quick Prick that tells a lot

It turned out that the skin prick test is about 20 minutes, starting with the medical staff cleaning Marcie’s inner forearm and applying the possible allergens (egg, dust mite, cat’s hair, dog’s hair, milk, mold) onto her arm. While one staff proceeded to prick Marcie’s skin with a needle to allow the substance to enter her skin, another staff was playing with Marcie. Marcie did not cry or even whine but I think that’s because her usual itch is far more ‘painful’ than that little prick. We had to wait 20 minutes or so before the medical staff examined the size of the wheal, i.e. reddish swelling to determine if Marcie is allergic to any of the substance.

What the Skin Prick Test Results say

All the results tested negative and as mentioned, this takes a lot of stress out – no worries over food allergy (apparently, testing for milk and egg is sufficient for food allergy; no need to prick 100 holes to test for all possible food to be consumed in a lifetime).

Don’t try pricking at home

It was a blessing that Marcie did not show any allergic reaction. However, if there is a reaction to the allergen, there will be swelling that is bigger than the dummy test and also itching. The test is not to be done at home without medical staff in case of severe reactions to the allergen. The skin area to be tested must also be free from rashes, otherwise, the reactions will not be visible. Plus, consumption of anti-histamines should be avoided otherwise the skin may not show a reaction (when there should be one).

I strongly encourage parents to bring their child for the skin prick test, otherwise, you may drive yourself paranoid guessing what causes the eczema..

Help! What moisturiser to use on your eczema baby?

Choosing the right moisturizers for your baby

Navigating through all the moisturizers out there to find the right one for your baby can be a nightmare.

My baby Marcie has tried various lotions and creams (I remembered when the household budget burst due to many trial and error purchases and our cabinets stacked full of different moisturizers) and finally settled on using Physiogel AI cream, Physiogel body lotion and QV body lotion. As you are figuring out which moisturizer to use, it is important to remember the one advice that I had from Marcie’s doctor, “You Can’t Moisturize too Much”.

The Undecipherable Information out there on Moisturizer

Whether over the internet or on product labels, I have this conclusion after trying to no avail to sum up the pros and cons of different moisturizers – We, as parents and layman, can’t figure out from reading the information available. I have tried at least 3 times to make sense of all the information out there, including comparing all the ingredients, and given up (all three times). I can only let you know that Physiogel and QV work for Marcie which are also recommended by Marcie’s doctor (I didn’t accept any advertising fees from these two brands and neither do I see these brands sold at the clinic that Marcie’s doctor works in).

What Moisturizers worked for Marcie’s Eczema

Physiogel AI cream works quite well but due to its high cost, S$35 for 50ml, I only use it on her face and after  swimming. Physiogel AI cream is able to neutralize free radicals which when produced in excess, damages skin cells. Physiogel body lotion also works for Marcie but also due to its cost, I use when her rashes are affecting her badly (on top of using mild steroid). On a daily basis, liberal amounts of QV body lotion is slathered on Marcie and her infant care teachers have also been reassured not to worry about slathering too much.

What has not worked for Marcie’s Eczema

Aqueous cream which contains emulsifying ointment, paraffin and preservatives – I tried this as it was recommended by a friend’s dermatologist but it hasn’t worked for Marcie. She scratched the area and was crying with frustration the two nights we applied for her. Also read that some doctors say this cream will cause thinning of skin over long period of use.

California Baby – no improvement and my hubby who has eczema felt that it stung on his eczema skin

Gaia Natural Baby – no improvement and too expensive to use liberally

Both the organic cream, California Baby and Gaia Natural Baby, are gifts from friends. Read that organic does not necessarily mean non – allergenic as some people can still be allergic to the organic ingredients. Also the use of the word ‘organic’ is not regulated.

Calamine lotion – not suitable as told by a doctor whose kids have allergies. I think it’s because one of the key ingredient, zinc oxide, absorbs moisture and that’s why it doesn’t help to moisturize the skin but helps to dry up weeping wounds.

Prickly heat powder– not suitable as told by same doctor above. My own guess is that it doesn’t have any moisturizing function.

Some common items to look out for in labels

  1. Hypoallergenic – means less chance of developing allergy
  2. Suitable for eczema baby or child
  3. Free of fragrance and perfumes
  4. Free from dyes, colors, conventional emulsifiers, preservatives, mineral oils, paraffin

In general, lotions are more easily absorbed but not as long-lasting as creams. For me, I prefer lotion as Marcie is too fidgety for me to have the time to get the cream from the tub (and ensuring no contamination) and apply over her body.

Do persevere in moisturizing as dry skin leads to itching and do so liberally all day and immediately after your baby’s shower.

Update: Almost a year after writing this post, I’ve interviewed a dermatologist Dr Verallo-Rowell for a 13-part Sensitive Skin Product Series, and in this post, she provides the list of ingredients and their different names to avoid. 

Alternative treatment – Stemtech AFA, is it safe for your baby?

Recently, one mom recommended Stemtech AFA and out of curiosity, I decided to google and see what this product is. My personal view is to stick to moisturizing for eczema and consult a specialist for your child. Given that there is no cure nor quick fix for eczema, I will not give my child any oral medicine or in this case, dietary supplement, unless it is confirmed 100% safe by an independent doctor.

Here is the information on this dietary supplement, Stemtech AFA, obtained from its site:

– AFA is short for aquatic botanical Aphanizomenon Flos-Aquae, an extract of blue-green algae

– Support release of stem cells from bone marrow and increase the number of circulating stem cells (that will travel to areas of body most needed)

– Dietary supplement, not required to be approved by FDA

– Company is founded in 2005 by Christian Drapeau and its products sold through network marketing

There is no google search linking Stemtech AFA to treatment for eczema, but there is a post on a Dr Dale Peterson’s website who pointed out that there is potential toxicity and that bone marrow cells promote cancer growth and metastases (spread of cancer growth). Here are extracts of the post:

– Dr Milena Bruno, leading authority in blue-green algae, replied that a substance present in blue-green algae, Microcystin-LA, has several chronic consequences, they are clastogenic, strong tumor initiators and promoters, they are also endocrine disruptors, and  their effects are synergistic.

– Publication by Zhang, et. al. in the January 2007 issue of Environmental Toxicology which shows that microcystins not only accumulate in the liver and other tissues of adults, but are passed on to their offspring.

Dr Donald Orlic, whose work is cited by Christian Drapeau, replied that noone, to his knowledge, has ever suggested that there is benefit derived from a daily supplement of a bone marrow stem cell releasing product when administered to normal individuals.

There is an open lawsuit from a case of a girl who died from liver failure

– Various research cited by Dr Dale that bone marrow stem cells play a role in cancer growth

Above is what I googled and I don’t want to judge parents who opt for alternative treatments, knowing how stress we all are managing our children’s eczema. For me, I just stick to moisturizing and steroid use under doctor’s instruction.

2017 update: Stemtech International had filed for bankruptcy, read here

Why Scratching Feels So Good but is So Bad for your child

Is baby scratching happily?

Scratching. Maybe my baby knows this word better than Daddy or Mommy.

Since about a month old, Marcie started to be able to scratch her head and soon it’s her face, hands, legs and body. Scratching is like a reflex and a relief to itch and studies are still being carried out to understand the science behind it. So far, it seems that by scratching, the nerves trigger the body to release endorphins that makes your baby feels good and block off pain information. Also, scratching damages the itch nerves which take from seconds to hours to be repaired.

BUT Scratching is very bad for your child

Scratching

1. damages the skin barrier, making it more vulnerable to irritant

2. damages the skin cells, causing the cells to release more itch signals

3. causes inflammation and infection

Knowing that scratching is like a reflex and a relief, I stop myself from scolding Marcie for scratching but instead calmly apply my “top 10 tricks to keep baby’s fingers busy“. If you or your child suffers from habitual scratching, you may be interested in the Combined Approach series with Dr Christopher Bridgett.

What Triggers Itch?

Scratch marks on knuckles and knees

In my page on eczema tips, one of the most important step is to “know the triggers in order to control them“. I feel that this is very crucial, because it takes a lot of guesswork (and stress out) of managing your child’s eczema. I remembered that at one time when Marcie started on solids, I got soooooo paranoid that everywhere I looked, I saw potential triggers. A skin prick test eliminated a lot of what I thought might be a trigger, thus immediately reducing a lot of anxiety relating to cleaning the house and monitoring food allergy (which both Marcie tested negative to). So what are the common triggers? In order of highest probability (extracted from the book “Eczema Free for Life”):

1. Heat and Perspiration 96%. Heat is the ONE thing that I’m most afraid of. Even in an air-conditioned restaurant where not-so-cold air comes out from only certain air vents, Marcie would scratch her neck out before we even ordered the meal.  Don’t be afraid to walk into a restaurant and ‘feel the air’ and ask for the coolest seat. Sweat contains chemicals that may trigger itch, so keep your baby fresh all the time. Sudden changes in temperature or humidity may also be a trigger.

2. Wool 91%. Scratchy fabrics are to be avoided, including nylon and polyester, which may irritate the skin. Wear light cotton for your baby.

3. Stress 81%. Baby gets stressed too, so let your baby have a routine and keep her occupied with toys. I co-sleep with my baby as I feel it reduces her stress too.

4. Spicy food/ hot beverage 49%. I know this is going to be controversial – I give Marcie cold baby fruit juice from fridge. My parents and the infant care teachers freak out at this and blamed a lot of Marcie’s problems on cold drinks. But I know she’s happy and almost immediately stopped scratching and took her mind off the itch. When I’m out, I may buy her a cold drink just so she can hold the cold bottle (it works!). For the record, I read that the only negative impact of cold drinks/food is that the baby takes more energy to digest them, thus reducing the energy left for your baby’s body.

5. Alcohol 44%. Not an issue with children but don’t apply alcohol on your baby’s skin though it’s cooling when the alcohol evaporates. It may dry her skin further. Drinking alcohol is of course a no-no. It expands the blood vessels near the skin, causing the skin to be more sensitive.

6. Cold 36%. I’m not sure about this one – whether the cold triggers the itch or simply a baby with cold feels cranky and scratches.

7. Dust mite droppings 35%. Marcie is tested to be not allergic to dust mite droppings but I still steam her clothes and the bed sheet, pillow cases in hot water to kill the dust mite. (Please buy a good steam washing machine if you like to do this; boiling water yourself and soaking the clothes take too much of the little time you have).

More possible triggers below:

Soap, perfume, laundry detergent. I use soap-free bath oil for Marcie, nothing she uses is perfumed and the laundry detergent is children-friendly. Plus my washing machine has an allergy function that washes off the chemical in the detergent thoroughly.

Chlorinated water. Bathe and moisturize after swimming, check out this post.

Pet fur. Marcie is tested not allergic to dog’s and cat’s hair. Do get your baby tested too. Plus pets bring in lots of allergens from outside the house, do keep them at least out of your baby’s bedroom.

Mold. Marcie is tested not allergic to mold too. Do get your baby tested.

Saliva. This is quite a common irritant for even non-eczema children. Baby’s cheeks and areas around the mouth usually get red with rashes due to constant contact with saliva, especially when they start teething and playing with their saliva! I use cool boiled water to wipe Marcie’s face before her bedtime.

Food. Though food is the most worrying for most parents, it is seldom the trigger. Marcie is not allergic to peanuts nor cow’s milk or egg, but the doctor’s advice is to wait till one year old to try these food. Mango is another fruit that many people balked at me for letting Marcie eat, citing that it is a ‘heaty’ food. I read somewhere later though that the area around the mango skin may cause itch, so just take care to let your baby eat the flesh inside. Mango is a very good fruit with vitamins, don’t ignore it and baby loves them with yoghurt!

Final point – do a skin prick test. Don’t guess and drive yourself crazy.

Is Co-Sleeping good or bad for eczema baby?

Sound asleep baby

There is a whole debate out there on whether co-sleeping is good or not. Generally speaking, the ‘against-side’ has more support citing early independence for the baby. Personally, I am for co-sleeping with my baby, mainly because A LOT of scratches have been prevented as I can hold her hands anytime she scratches at night. Of course, the sacrifice is huge – lack of good sleep for me and almost no couple time with my hubby. Let’s take a closer look at the pros and cons in the context of taking care of eczema children:

For Co-Sleeping

1. Help baby sleep better. I believe this is true and especially important for an eczema baby whose itch may be preventing her from sleeping well.

2. Help build a stronger bond with parents. I think this is true too. When I was a stay at home mom and my hubby worked, after a few months, Marcie didn’t seem to get too excited when daddy came home. But if daddy co-sleep with her for two nights in a row, Marcie would display much more warmth towards daddy. For me, I just love to look at my baby’s face when she’s asleep and smelling her milk-breath!

Against Co-Sleeping

1. Risk suffocating baby. The verdict is still not out on this one. Some say the risk is higher while some say lower. My personal suggestion is to let your baby sleep alone in a very cool air-conditioned room but wrap her up to prevent scratching. When Marcie got too big to be swaddled, we tied her hands to her legs for a few nights but she couldn’t sleep well. That’s when we decided she’s big enough to not get suffocated/ crushed by us on our bed and it’s also the only way we know whether she’s scratching. Marcie started scratching ‘covertly’ at about 7 months old, when it became more difficult to know that she’s scratching as practically no sound was made. So the only way I knew was sleeping with her and detecting her scratching fingers move.

2. No good sleep for parents. That is so true especially when Marcie has eczema flare or teething which causes her body temperature to rise and somehow causes her skin to be more sensitive and itchy. For me, it’s a sacrifice I make and I compensate by sleeping earlier with Marcie.

3. Increase heat to baby. That is also true. I give off less heat compared to my hubby and I’m more aware when Marcie scratches. So I co-sleep with Marcie more often. Regarding the additional heat, you can compensate by turning the air-con cooler and dressing your baby light.

4. Make it difficult for baby to sleep if parent isn’t co-sleeping. Good news is babies adapt quickly and Marcie has no problem sleeping at infant care now. This was a great relief for me as I was worried whether Marcie could nap in school.

5. Prevent baby to be independent. No research results cast in stone for this one. Some studies now believe that making babies feel more secure will enable them to be more independent at an older age.

6. Prevent parents from their own couple time. This is true. Again we compromise by letting Marcie sleep alone first, and when she wakes up, I will then stop whatever I’m doing (usually watching dvd with my hubby) and quickly hop into the bed with her. We used to put Marcie in her cot but realise that she sleeps better on our bed.

I do take precaution though. Marcie likes to lie flat on her stomach but she has good neck muscles at an early 3 month age. She’s always in the centre of our bed, without the possibility of wedging between the wall and the bed and our bed has no bed frame that may trap her.

There’re also going to be a lot of objections from people around you if you choose to co-sleep. I think for parents with eczema children, it goes back to being confident about how you are helping your child with her eczema.

& always believe that You are the Best Parent for your eczema child

10 reasons why parents with eczema child have a tougher time

Stressed out Mom

How often do you feel like tearing your hair out? Pretty often for me, especially when Marcie was between one to ten months old. Her eczema was all over her body, scalp and face and she didn’t know how to distract herself from scatching.

Having been both a stay-at-home and a working mom, I fully understand the additional demands of taking care of children with eczema, whether or not you’re working. I didn’t have a helper or another adult to help out during the day. I was alone at home, trying my best to stay calm taking care of my baby and to be a good home maker. The stress level was sky high, knowing that any attention lapse could result in scars/broken skin on my baby.

If your spouse/ family member is taking care of a child with eczema, do emphatise with them as you can see below it’s a lot tougher to care for an eczema kid.

1.       Not even a minute’s break. A child with eczema will scratch when the skin is ‘triggered’, tired, sleepy, hungry or for no reason at all. Marcie scratches whenever she’s not occupied or when left alone. At one point, I couldn’t go to pee or poo or bathe until my hubby return from work.

2.       Fatigue from lack of sleep. A child with eczema tends to wake up in the middle of the night and scratch. I am still co-sleeping with Marcie so that I can hold her hands whenever she scratches. Lack of sleep leads to fatigue which also raises the stress level. Since Marcie was born, I haven’t slept throughout the night (but I’ve got used to it).

3.       No time to eat! If the restaurant is not cool enough or contains allergens that a child is sensitive too, the child will start scratching soon enough. I lost more weight than my weight gain during pregnancy plus, I’ve got into a habit of gobbling down my food as I know I only got a few minutes before Marcie starts to scratch.

4.       No time for exercise! It is extremely difficult to gather the energy to exercise when (and that is a BIG WHEN) there is a little free time. When I do have the chance to jog, the exercise routine only last for 2 weeks before my baby changes her routine. Most days, I choose to chill with my hubby ‘cos we have so little time to ourselves.

It’s no wonder why you or a parent with an eczema child is so high-strung. The basic needs of sleep, eat, exercise, pee & poo can’t even be met properly. There is this study that concludes the stress levels in mothers caring for young children with eczema are equivalent to those mothers of children with severe disabilities. Below are some other emotional issues that you or the parent may face.

5. Guilt. It is easy to feel guilty when you are the only care giver and your baby ends the day with blood. I remembered feeling guilty when I dozed off for a minute and heard my baby scratching her neck. I remembered checking on her when I finished cooking and saw that she woke from her nap and scratched till blood from her ears run down to her face. I remembered checking on her when she was in a baby chair and realized she scratched her neck against the metal frame till bleeding. I remembered questioning myself if it was right to tie her up for a few minutes when I prepared her milk. It took me some time but I know now that I’m the best mom for Marcie and there’s no reason for guilt.

6. Isolation. A stay-at-home mom has no one to share your day and you lost your work status. For parents with eczema kids, it is very difficult to share with people who have not gone through the same. Worse, you tend to get suggestions that somehow point to you ‘mis-caring’ for your child.

7. Anger and blame. Eczema is an immunology disorder and it is half the time inherited. It took quite a few months before I stopped accusing my hubby about him passing on his ‘bad gene’. It does no good and doesn’t help our relationship.

8. Almost no time with spouse. That’s a big issue when the child takes so much attention, from both parents. I have yet to learn to enjoy the moment with my hubby when our baby is with us.

9. More housework. If the trigger for your child’s eczema is dust mite dropping, then you may spend more time vacuuming the house, changing bed sheets and cleaning the toys. More housework again means less time with spouse (and seldom both agree on how much housework to do!)

10. Less money. Moisturisers, bath oils, steroid, specialist appointments all don’t come cheap. Financial burden may place additional stress on the couple relationship.

One thing I’m glad to report though, it is possible to manage all of these better overtime. One good that comes out of taking care of Marcie for the past 15 months is that I’m proud of myself, my hubby for managing it so well and is more confident of our ability to weather difficulties together…

& always believe that You are the Best Parent for your eczema child

Top 10 Tricks to keep baby’s fingers busy

Keeping your baby’s fingers busy would likely be a big thing for you, as it is for me. Your baby may have already formed the habit of scratching, such as Marcie has. Marcie started scratching intensely from 3 months old and now scratches our hands, her legs or anything that is close to her. Our little relief from scratching came when she’s 8 months old, when she started to explore the world around her. I’m sure you would have your own ways to keep your baby’s fingers occupied, but here’s mine!

1. Let your baby play with cold teether

Teether with Water

Teething ring filled with water that can be placed in the fridge worked wonders for Marcie from about 5-7 months old. Besides the obvious use for biting, Marcie loves holding cold stuff. Now, at 15 months when she’s scratching say in a cafe, I’d buy a small bottled cold drink for her to hold. That can buy me enough time to feed her and myself.

2. Never mind that the magazine or tissue is torn

Babies somehow love to tear tissue paper, magazines and pamphlets. Marcie has not only torn them but also eaten quite a fair bit of her books. To date, Marcie has eaten rubber ball, phone leather straps, paper and plastic film! As much as I don’t like her biting inedible stuff, I figured that it beats scratching her scalp out.

3. Have her hammer some balls!

Hammering toy

Hammering toys are a hit for babies of about 12 months. Your baby can learn to grip the hammer, practice her hand eye co-ordination to hit the balls, get a kick watching the balls roll down and probably end up biting the balls or the hammer! Main point is it keeps your baby occupied and her fingers active.

4. Never leave the home without finger food

Banana Milk Rusks
Graduate Puffs

One item that I definitely have to bring out is biscuits. Teething rusks that your baby can hold and eat on her own will occupy her hands. Marcie’s favorite is banana flavored teething rusks, followed by small star shaped puffs and baby rice rusks. I never leave home without them.

5. Catch the Wind in the stroller

Stroller Fan

If your baby has a tendency to scratch her head in the stroller, letting her play with the stroller fan is a good idea. Marcie has destroyed one fan by pulling out and tearing the wings but I’m fine as long as she’s not scratching her head. Do peep into the stroller every now and then as you never know when your baby will wake up and start scratching.

6. Or Read a Buggy Book

Buggy Book

Your baby may like flipping the book and Marcie particularly likes this peek-a-boo book as there are felt flaps to flip up to reveal hidden kids. Of course, she chews the book too!

7. Offer a Juice Cup but Watch out for the straw chewer

Juice Straw Cup

Baby loves juice and Marcie likes it cold best. I offer about 120ml to her daily and juice is another item I never leave home without. Once she has finished her juice, ate enough of finger food, I will offer her water bottle. Sometimes, I let her play with straws but watch out that your baby doesn’t chew and swallow the plastic straw of the juice cup (which Marcie did and ate the straw up too, I suppose it feels like jelly beans?)

8. Move and Groove and Play

Chasing after a car

Trust me. It gets easier when your baby is able to crawl and walk. Having more things to do such as crawling after a toy, kicking a ball will definitely take your baby’s mind off the scratching.

9. Hit the TV

This one is not an ideal thing to do but will certainly give you some time to work in the kitchen while your baby watches the TV and hit on the ‘items’ she wants to catch from the screen. My LCD screen hasn’t broke but is always dirty with food stained hand prints.

10. Push a chair

Junior Chair

This one works too! Marcie also pushes her high chair and crawls under the table.

There may be some items listed here that you find questionable, such as biting stuff and hitting TV. You don’t have to agree with all of them as these are the tricks that I use to keep Marcie busy. To me, raising a kid with eczema involves more trade-offs and these are some that I’m willing to compromise. Have a good day with your child and enjoy your time together.

Go Swimming with your baby

Marcie’s First Swim

Try it if you haven’t. I was advised by allergy specialist to bring Marcie for a swim and she’s a water baby! Pool water contains chlorine which may irritate the skin. I brought Marcie for her first swim at 9 months, bathed and moisturized her immediately. There’s no problem with her skin after every swim though she caught a cold twice!

I also heard from another talk by dermatologists that you may want to literally “test the waters” because your child’s skin may react differently in different pools, due to the different way of cleaning and treating the pool water. Other advice given in the forum (read my forum notes here) was to use SPF50 sunscreen, try not to go once the pool has been chlorinated nor before the pool is due to be clean (too strong chlorine or too much bacteria), always shower immediately and moisturize thereafter! Also good to find out cleaning schedule and the percentage of bacteria or amount of chlorine used.

Does your baby have eczema and cradle cap

Cradle cap

My baby Marcie does. The cradle cap developed the same time as her eczema rash, at about 2 weeks old. It’s greasy, yellow, crusty and difficult to scrape off. I applied olive oil onto the cradle cap, and combed it off when the crust soften. Cradle cap can develop above eyebrows and inside the ears too!

Cradle cap is caused by overactive oil glands and usually occur in infants. I was told by doctors that it’s related to eczema and can last up to 2 years old. Marcie still has it but it is no longer as pervasive. It’s itchy for her though and I do apply 0.05% steroid lotion when the scratching is really intense.

A few ways you can manage the cradle cap:

1. Use a cradle cap shampoo. I use it once a day for Marcie and realised that you have to massage the scalp quite firmly in order for it to be effective.

2. Brush baby’s hair and keep it short. I find that once Marcie’s hair is longer, she gets warm and somehow starts scratching. I’m not sure if it has anything to do with cradle cap, but I’m not choosing beauty hair over comfort.

3. The yellow flakes must be removed early. I learnt that the hard way by letting the cradle cap/flakes build up and when I wanted to remove the thick crust, lots of hair got removed along it. There’s some damage done and even after half a year, some parts of scalp still can’t grow hair. 🙁

4. Don’t forget to wash off the olive oil on baby’s scalp. I did that once cos I was too tired to shampoo Marcie after removing the cradle cap crust. It was a huge mistake cos somehow it got so itchy that she scratched her scalp so bad that night. (Update on 8 Jun – just read that olive oil contains oleic acid which some babies may be allergic to, may want to consider using virgin coconut oil)

Lastly, know that cradle cap will eventually go away in a few months time. So take a deep breath and not let the crust ruin your day.

How do you know if your baby has eczema

Rashes on 2 month old baby’s face

Determining  if your baby has eczema may not be so straight forward. Being a first time mom, I remembered reading a checklist from the paediatrician on what is normal and not normal in a newborn. Rashes is one of the items listed as normal, no need to see a paediatrician.

My baby Marcie has eczema from 2 weeks old and I only realised that her rashes were not ‘normal’ on her 1st month checkup. The paediatrician diagnosed Marcie with eczema after looking at her rashes and linked it as an allergy to milk (which turned out to be not the cause).

If you are wondering if your baby has eczema, the signs and symptoms listed below can serve as a guideline:

1. Itch – Itch causes scratching (and keeping my baby from scratching really stresses me out!)

2. Inflammation – Damage to skin cells caused by scratching. The redness in skin is caused by increased blood flow and the skin feels warm to touch and swollen.

3. Scaly Skin – More than usual dead cells on skin; can come in various forms, including white/powdery, cracked, thin/transparent sheets that peel off or thick/yellow flakes/chips

4. Lichenification – Thicker, darker and rougher skin from scratching/rubbing

5. Brown skin color – Brown spot where eczema used to be, caused by cells in skin (‘melanocytes’) releasing extra pigments from scratching

6. Scratch marks

7. Crusts – Caused by leaking serum, the liquid part of blood that heals inflammation

8. Cracking

9. Small blisters

10. Nails – Thick & rough nails, pitted/ ridged

11. Dry skin

There are more signs and symptoms listed in the book “Eczema Free for Life” by Adnan Nasir, but listing all that here will be information overkill.

The One Advice from Specialist

Physiogel
QV Skin Lotion

Moisturize. Moisturize. Moisturize.

A recent article published in Singapore Straits Times on 13 Jan 2011 is about how a mother tried many ways to relieve her 5-year old son from the eczema itch. Apparently, after reading this article, many other parents wrote in offering to help with their own remedies.

I can fully understand how desperate one can be, trying to find a cure to eczema. But there is no cure and trying many remedies including ‘alternative treatment’ only creates stress and disappointment. I only stick to one advice that I got from NUH’s Prof Hugo Van Bever (Head and Senior Consultant, Paediatric Allergy, Immunology & Rheumatology Services) – Moisturize. Moisturising will keep the skin from drying which often leads to itch. In his words, ‘You can’t moisturize too much’.

For baby Marcie, I use Physiogel AI cream when the itch/ rashes from scratching gets quite bad, at other times, I use Physiogel lotion on her face while QV lotion on the rest of her body. Physiogel AI is the most effective so far, but it is very expensive, cost about S$38 for a 50ml tube. It is easier to use lotion over cream for my baby Marcie as it is much faster to apply, given that Marcie keeps fidgeting when I moisturise her.

If you are living in Singapore, you can use baby bonus card to pay for Physiogel AI cream at GP clinic if your baby visited the doctor and obtained AI cream for prescription. That means the government foot half the bill!

I will research and compare the moisturisers for eczema but meantime, do not stress yourself with trying too many treatments for your child. Just stick to moisturising.

Turning Blues to Bliss

Marcie’s Mom

Hello to all parents out there, particularly to stay at home moms raising kids with eczema or allergies.

It’s nice to meet you here and I hope your day has gone on well – no emotional breakdown, no shouting/crying. And you have got your toilet break and time to grab a glass of water and lunch.

I know what you are going through as I have gone through the same. It’s no joke to take care of a baby diagnosed with chronic eczema – apart from the already heavy workload required to take care of a newborn, there is the struggle with getting baby to drink the less tasty hypo-allergenic milk and preventing baby from scratching her skin/scalp. My baby Marcie has eczema from 2 weeks old and I quit my job to take care of her. Staying at home also give me the blues, surrounded by four walls with noone but a contantly irritated and ‘scratchy’ baby to talk to.

I’ll be sharing my journey with you, hoping to offer some real-life tips to deal with eczema rather than giving you tons of facts and figures. I know how you feel sometimes, looking at all the facts, googling into the middle of night hoping to find a cure, but all you get seems to make you more fearful of what you could possibly be doing wrong. This blog is meant to do the opposite, to provide a light-hearted and heart to heart sharing with you, hoping to inject some blissful moment into your day when you know things are still on track.

& always believe You are the Best Parent for your eczema child

Keep in touch.