Doctor Q&A

Rise and Shine Expo – Dr Peter Sears on Raising Smart, Well-Behaved Child – Parenting Balance

Parenting Rise and Shine Dr Sears
Raising well behaved and smart kids with Dr Peter Sears

This is a 2-part series on a workshop that I’ve attended at Singapore Rise and Shine Expo, by Dr Peter Sears, ‘Raising smart and ALSO well-behaved child – Is it true that we shouldn’t spare the rod and spoil the child?’ Last week was on parenting styles, and Dr. Peter Sears is board-certified by The American Academy of Family Practitioners.

Balance in Parenting

Dr Peter Sears shared that balance is a key aspect in parenting and a few areas which tend to be off-balance are:

Father/Child relationship – For some families, the father may not be as involved as the mother, particularly in the early years. Dr Sears encouraged dad’s early involvement, instead of waiting till the child is preschooler age. This is especially so as trust between parent and child is built from young.

Mom Helicopter Parenting – This refers to the mother monitoring the relationship and ‘hovering’ the interaction between the father and child. Doing so risk the child growing up thinking that dad is ‘secondary’ to mom and mom is the real authority figure in the family.

Mother Burnout – Many scenarios exist that increase the likelihood of mother burnout and the two common ones are dads’ inadequate involvement and moms controlling every situation (even when the dad wants to be involved!). If there is conflict in parenting styles between mom and dad, Dr Peter Sears cautioned that disagreement should not be in front of the child as that would confuse the child.

Couple disagreement should not be in front of the child as that would confuse the child

Emotional Balance – As a baby can pick up facial cues and mirror feelings, parents should adopt a calm and firm presence/face when disciplining. The baby’s brain has ‘mirror neurons’ and thus anxiety can be picked up.

Conveying Limits – Parents often say ‘No’ or ‘Stop’ to the child, but negative language does not help the child to focus on what should be done (instead, what should not be done). Dr Peter Sears shared a parenting moment from his dad (Dr Bill Sears) who instead of saying ‘No’ to his daughter for speaking rudely to his wife, told her that ‘I will not tolerate such behavior to the woman who I love’. This enables the child to connect the impact of her action. In general, instead of saying no, direct the child on what should be done.

I will not tolerate such behavior to the woman who I love

Dr Bill Sears

The Science of Attachment Parenting

Dr Sears believed in attachment parenting, where its 7Bs also include balance. The science behind attachment parenting is that being close and responsive to the baby benefits both mother and child.

(i)            Mother’s Brain

The mother’s brain changes to cater to nurturing babies, and attachment parenting and breastfeeding help boost hormones that facilitate caregiving – amygdala, cingulate, prolactin and oxytocin. Mothers who practice attachment parenting are better to trusting themselves on the needs of the child.

(ii)           Child’s Brain

Attachment parented infants have higher growth hormones and brain enzymes, and more likely for the neurons to make the right brain connections. The child grows up with an inner control mechanism, knowing what should be done and able to think through consequences. Conversely, for a baby who is left to cry it out, their cortisol is off balance (too high and too low) with prolonged high stress hormones that slow growth and depress immunity.

On the other hand, detached parenting set up ‘undiscipline’, leading to a fearful, fussy and clingy baby who may be shy or exhibit stranger anxiety. Other characteristics of a child with detached parents are not able to share or play with peers, blank unhappy stares and possibly become a bully due to lacking an inner control mechanism.

Dr Sears also shared briefly on the importance of nutrition, more from last year Dr Bill Sears’ talk here.

MarcieMom’s questions to Dr Sears

On Diet – What foods would you recommend for a baby with eczema, and would it be different for a toddler or a preteen?

Dr Peter Sears: Eczema often has an association with underlying food or environmental allergies. For children with moderate to severe eczema, we usually recommend having allergy testing done by a licensed allergist (if this is financially feasible). Identifying underlying allergies can help control eczema.

In addition, I often recommend that my patients with eczema take a daily Omega-3 DHA/EPA fish oil supplement as well as daily Probiotic supplement. Omega-3 fish oil has been shown to be beneficial for skin health and various types of eczema/ dermatitis due to it’s anti-inflammatory properties. Probiotics have been suggested to be beneficial as well.

On Colic – Is reflux something more commonly seen in children with eczema? If so, why? What formula would you recommend for eczema babies?

Dr Peter Sears: There has been an association between eczema and acid reflux. Theories on this suggest that this may be related to milk or dairy sensitivity or dairy allergy. Children with milk sensitivity/allergy may be more likely to exhibit symptoms of acid reflux and skin manifestations of eczema.

Parents should always consult with their doctor before switching formulas. Of course, we always recommend breastfeeding whenever possible. Hypoallergenic formulas may be beneficial for infants with dairy sensitivity and/or eczema.

On Parenting – Eczema families are more stressed, more chores to do (if there’s house dust mite allergy) and may even be more stretched financially as emollients, doctor consultations or having to have one parent stay home results in a loss of income. What do parents have to watch out for in their parenting to ensure that eczema doesn’t come in the way of them raising a happy and successful child?

Dr Peter Sears: This is a difficult question because every household and family dynamic will be different. To generalize, we would say that it is very important that there is a strong family support system and that both mother and father (as well as other capable family members) be as involved as possible in day to day care of this condition. This goes back to my talk about balance in the home with childcare.

Thank you to Dr Peter Sears for going through what he had shared in the Rise and Shine Expo workshop and also giving useful tips for eczema families. For those unsure about parenting styles, check out last week Dr Sears’ talk here.

Doctor Q&A

Rise and Shine Expo – Dr Peter Sears on Raising Smart, Well-Behaved Child – Parenting Style

Rise and Shine Dr Sears Raising Smart and Well Behaved Child - parenting style
Raising well behaved and smart kids with Dr Peter Sears

This is a 2-part series on a workshop that I’ve attended at Singapore Rise and Shine Expo, by Dr Peter Sears, ‘Raising smart and ALSO well-behaved child – Is it true that we shouldn’t spare the rod and spoil the child?’ Last year, I attended his father, Dr Bill Sears, at the same expo on raising healthy child and attachment parenting.

Dr. Peter Sears is board-certified by The American Academy of Family Practitioners. His primary passion in medicine is to promote well-being and health through the practice of preventive medicine at all ages along with using traditional and complementary treatments for curing of disease. More on Dr Peter Sears

Which Parenting Style Works Best?

Dr Peter Sears started the talk reminding parents that no one technique will work for every child, but instead he believes that forming a trusting bond with the child is the foundation for parenting. Dr Sears (family) believe in attachment parenting, which is being responsive and close to the baby especially in the first six months of birth. It is the natural way to parent because it is nurturing the baby according to the mother’s instinct.

More on attachment parenting, the 7 Bs in Dr Bill Sears’ talk
  • Birth bonding
  • Breastfeeding
  • Baby wearing
  • Bed Sharing
  • Believe Baby’s Cries
  • Beware of Baby Trainers
  • Balance

With attachment parenting as the foundation to build trust between parent and child, Dr Sears observed in their family practice that it will lead to the following desirable C Outcomes in kids:

  • Caring kids
  • Compassionate
  • Communicative
  • Connected
  • Comfortable with intimacy
  • Confident kids
  • Confident parents

Dr Sears’ Pros and Cons in Parenting Styles

Authoritarian Style – This parenting style tends towards a command and control approach with a focus on wrong-doing and punishment. Spanking is often part of this parenting style. The positives of this style is that it is very clear to the child that the parent is in-charge and the child needs to obey. The parent being in-charge is important as a growing child needs guidance, direction and security.

The negative of this style is the potential pitfall of taking love from the parent-child relationship and inadequate positive reinforcements for the child. There is also a danger of the child engaging in the desired behavior out of fear, instead of out of respect. Moreover, the desired behavior does not come from self (child) who is able to think through the consequences and exercise inner control.

Permissive Style – This parenting style is characterized with warmth and affection, but with few or unclear limits. While it is good that there is much positive reinforcement given to the child, the negative is that the child takes control.

Authoritative Style – A more balanced parenting approach is to combine the positives of the above two styles, which gives the child love and warmth with structure. While this parenting style allows the child to thrive the best, it also requires more dedication, responsibility and creativity from parents. (It takes MORE work!) An authoritative parenting style fosters competence and mature moral judgment in the child, lowering the risk for problem behavior.

Is Spanking OK?

Dr Peter Sears explained that cultural and society settings affect whether spanking is involved in parenting. For instance, many European countries, Canada and New Zealand have legislation prohibiting spanking. This comes from studies that spanking has adverse effects that are associated with anti-social behavior, decreased rate of school performance and more behavioral and mental issues (for instance, depression and bi-polar).

Spanking may also send the wrong message that physical force is the way to resolve conflicts or issues.

It is also very easy for parents to cross the line as physical force may be used when parents are stressed or a stronger force may hurt the child.

Dr Peter Sears provided alternatives to spanking, such as time-outs and explaining the consequences of misbehavior. Parents can engage in re-wind/ replay scenarios with the child to guide the child towards right behavior.

There is much balance required in parenting and next week, we will be sharing various aspects from Dr Peter Sears. Gratitude to Dr Peter Sears for taking time to review this blog post.

Doctor Q&A

Rise and Shine Feature – Parenting with Dr Sears

Dr. Bill Sears is one of America’s most renowned pediatricians, father of eight children, and author of over 40 books on childcare. He is the Associate Clinical Professor of Pediatrics at the University of California, Irvine, School of Medicine. Dr Sears Lean has a series on this blog that covers many aspects of raising healthy kids. Dr Sears shared many tips in this Singapore workshop ‘Keeping Your Child Healthy’.

Raising healthy babies and successful children with Dr Bill Sears

Dr Sears mentioned that the number 1 reason that children grow up to be criminal is the lack of capacity to care and lack of empathy. Success is defined differently by every parent but emphasis ought to be on the character.

Dr Sears’ TEN Tools for Success

  1. Empathy and Compassion – Start in infancy with attachment parenting which lead to childhood Cs, with a lower likelihood that the child will turn out to be the school bully. Ask empathy questions like “How would you feel if…?”, raise siblings who care (role playing) and engage in empathy games.
  2. Ability to make wise choices – This refers to the ability to think through what you’re about to do, and knowing that choices have consequences. Children can be engaged in ‘replay’ scenarios, pretend choices and parents be aware of teachable moments. A career is a major decision in life, and Dr Sears believe that instead of influencing children’s career choices, it ought to be emphasized ‘whatever you do, do it well’.
  3. Good communicate skills – Teach the child to speak eye-to-eye, touch the child as you talk, speak naturally to the child and parents should pay attention to their body language and listening to the child. Always remember that the parent is the child’s cheer counsellor. On speech development, a child needs to learn to speak comfortably before speaking correctly, therefore the parent should not unduly correct the language but can speak back the correct way.
  4. Sense of responsibility – Children who depend most in the first two years turned out to be independent adults, teach responsible attitude like ‘I did it, I’ll fix it’. Children can be given jobs, responsibilities to gain that sense of responsibility.
  5. Sense of moral reasoning – Children should be taught to think before they act, and raising a successful child include working on their character, kindness and manners.
  6. Health attitude about sexuality – Always be the first resource children turn to by letting them know they can turn to you early in their life, for instance let the child know ‘if you tell me, I won’t get angry’.
  7. A love of learning–  Parents who value learning, create harmonious homes, have family meals, stretch NOT stress kids, involved in school can help children to adore learning!
  8. Confidence – Encourage your child, frame the child positively, play and observe the child to discover the talent/intelligence they have which can go beyond reading or logic, into areas like music, dance and drawing.
  9. Joyful attitude – To raise a joyful child, encourage him, help him relax, introduce music, help him/her to feel positive about own self and most importantly, let children know that they cannot control circumstances but can always control their reaction.
  10. Healthy LEAN habits – Health Lifestyle, Exercise, Attitude, Nutrition go a long way to helping to raise happy, healthy children, see here for the first of DrSearsLean series on this blog.

Dr Sears on Sibling Rivalry & Tantrums

Have the siblings do a task together, or to help one another.

Dr Bill Sears

Tantrums are common for children under two, as they have yet to be able to verbalize; however, this should be differentiated from manipulative tantrum which parents should not be pulled into. Discipline is based on right relationship than the right techniques.

I didn’t get to have Dr Sears vet through this post before publishing, any and all mistakes mine. It was a lovely day listening to Dr Sears during the Rise and Shine Expo in Singapore.

Doctor Q&A

Rise and Shine Feature – Baby Health with Dr Sears

Dr. Bill Sears is one of America’s most renowned pediatricians, father of eight children, and author of over 40 books on childcare. He is the Associate Clinical Professor of Pediatrics at the University of California, Irvine, School of Medicine. Dr Sears Lean has a series on this blog that covers many aspects of raising healthy kids. Dr Sears shared many tips in this Singapore workshop ‘Keeping Your Child Healthy’.

Raising healthy babies and successful children with Dr Bill Sears
Listening to the esteemed Dr Sears speak on healthy child is a privilege!

What to Feed the Smart Baby

Omega 3 (seafood) is recommended as it is important for the brain’s development. Other foods recommended by Dr Sears for brain development are fruits (blueberries), greens and nuts for children over 2-year old. Smoothie can be prepared to include these foods, also salads, spice and appropriate supplements.

Rice cereal is no longer recommended as a first food as it does not contain the essential fats.

Picky Eaters

A child may not be picky, sometimes parents have to remember that children have tiny tummies and a fistful of food is sufficient portion meal size. So, instead of feeding 3 meals a day, ‘grazing’ ie giving foods for the child to nibble throughout the day is increasingly studied to improve their growth and helps with even sugar level. Dr Sears suggested leaving foods in a tray and let the ‘picky’ eater pick at it instead of insisting that they be eaten at one go.

When to Feed Your Baby

On-demand feeding is increasingly recommended versus feeding babies on four-hour schedule, which had been associated with a failure to thrive. Breast milk gets out of baby’s stomach in about 45 minutes, much shorter time than formula milk as casein takes a longer time to digest. Mothers who breastfeed will not need to worry about under or over feeding their babies.

How to Prevent Childhood Illness

Dr Sears recommended breastfeeding, feeding the child with real food (not processed, junk food), immune-boosting foods (see this Dr Sears Lean Series: Raising Healthy Kids by Boosting Immune System) and get the recommended vaccinations.

A word on Childhood Vaccinations

Dr Sears shared that vaccinations are good for the child, family and society. About 2.5 million life are saved per year but sadly, 1.5 million children die each year from vaccine-preventable disease. It is a myth that vaccinations should be put on hold till the child is holder, as the whole point of vaccination is to protect the infant who is the most vulnerable. MMR (measles) vaccine has also been disproven to cause autism through a study involving 500,000 children.

What to do with Colic Baby

Colic is mostly due to Gastroesophageal reflux which should not be ignored because continued severe reflux can damage the lining of the esophagus. Sleeping in inclined upright position, sipping rather than drinking too much at a go, antacid prescriptions can help relieve the reflux.

What to do with Fussy Baby

Again, similar to colic baby that is better termed ‘hurting baby’, fussy baby is better termed ‘high need baby’. These babies have a higher need to be touched, held, more intense, more active, therefore demanding and draining their parents more. As they can be more sensitive to separation, it is best to hold these babies in arms, closer to breast.

I didn’t get to have Dr Sears vet through this post before publishing, any and all mistakes mine. Next week, we will cover more on parenting.

Doctor Q&A

Rise and Shine Feature – Attachment Parenting with Dr Sears

Dr. Bill Sears is one of America’s most renowned pediatricians, father of eight children, and author of over 40 books on childcare. He is the Associate Clinical Professor of Pediatrics at the University of California, Irvine, School of Medicine. Dr Sears Lean has a series on this blog that covers many aspects of raising healthy kids. Dr Sears shared many tips in this Singapore workshop ‘Keeping Your Child Healthy’.

Raising healthy babies and successful children with Dr Bill Sears
Attachment Parenting & Handling Gassy and High-Need Babies

Dr Sears shared in the workshop at Rise and Shine Expo ‘Attachment Parenting and Handling Gassy and High-Need Babies’ that during his first venture into parenthood, he decided to make a checklist of desired qualities in children who he helped in his practice and asked what the parents do. It turned out that the parents were practising attachment parenting!

To help us all understand what attachment parenting is, especially important given all the misinformation on what it is, Dr Sears shared the Baby B’s of Attachment Parenting:

Birth bonding – keep baby with the mother after birth

Breastfeeding – breast milk recommended for baby’s nutrition

Baby wearing – sling is preferred so that baby can be close to the parent (either dad or mom can baby wear)

Bed sharing – sleeping beside the baby has been studied to lead to better physiology, and the baby experienced more even breathing, better growth, less stress hormones, lower glucocorticoids neurotoxicity.

Believe Baby’s Cries – leaving the baby to cry it out alone leads to prolonged stress, which can damage the hippocampus. It risks neonatal glucocorticoid neurotoxicity which can carry over into adulthood. During infancy, a baby who is carried by parents cries less and has lower risk of this toxicity. Interestingly, babies who cry but do so in the arms of others do not suffer from this effect.

Beware of Baby Trainers – for the same reason above, methods that sought to train babies are to be wary of.

Balance – Dr Sears shared that babies whose parents practiced the above (as much as they can, need not be all if not possible), have been observed to have the Childhood Cs.

Childhood Cs

Caring kids – play better with other children




Comfortable with intimacy – better lovers

Confident kids – as well as better behaved and more resilient, resourceful, respectiful and thoughtful

Confident parents – these children become confident parents who connect better to their children

Q&A on Co-Sleeping

I raised a question on how long the Baby Bs can be practised, in particular sleeping with the baby. Case in point – I’ve been sleeping with mine ever since she can’t be swaddled just to watch over the scratching of eczema at night. Marcie is now 4, and we are still sleeping together. Will there be any developmental issues associated with sleeping with a child, who is no longer a baby?

Dr Sears and Martha: Dr Sears and his wife Martha shared that they do not purposely shift their children (they have eight!) out of their bed or bedroom but let the transition comes naturally as an older child start to want to have their own bed/room. This has not been studied and the best arrangement is the one that works for the whole family.

Dr Sears also shared that given that working mothers had less time with their children, practising attachment parenting is even more important. And as an ending comment, Parenting is Giving our Children the Tools to Succeed in Life.

I didn’t get to have Dr Sears vet through this post before publishing, any and all mistakes mine; next week we will tackle more health issues, such as nutrition, colic and vaccinations.

Doctor Q&A

Rise and Shine Feature – Healthy Child with Dr Sears

Dr. Bill Sears is one of America’s most renowned pediatricians, father of eight children, and author of over 40 books on childcare. He is the Associate Clinical Professor of Pediatrics at the University of California, Irvine, School of Medicine. Dr Sears Lean has a series on this blog that covers many aspects of raising healthy kids. Dr Sears shared many tips in this Singapore workshop ‘Keeping Your Child Healthy’.

Raising healthy babies and successful children with Dr Bill Sears

Baby Colic

Dr Sears explained that for many years, colic had not been understood by physicians and parents although recently, more causes had been known. Dr Sears also suggested replacing the term ‘colic’ which has taken on a negative connotation to the ‘hurting baby’.

Gastroesophageal reflux (also known as ‘heart burn’) – This condition is due to the lower esophageal sphincter not being closed tightly, allowing reflux and leading to colic. Symptoms include sudden crying outbursts, irritable child, sour burps and throaty noises of the baby which worsens when the baby is lying down. The reflux may be a reaction to (i) eating too fast or (ii) incorrect formula choice, including being allergic to food allergens in the breast milk or the formula, or being intolerant to cow’s milk protein. A leaky latch-on for a breast-fed baby is also a hint of intolerances to the breast milk.

Parents can help by gathering information for the doctor’s diagnosis, such as journaling the baby cries, tracking possible triggers and what works/does not. Recording videos of the baby having a reflux can also aid the doctor in his/her diagnosis.

The gastroesophageal reflux can be relieved through prescription antacids, avoidance of fuss foods (common ones are diary, wheat, caffeine and gassy foods like broccoli and onions) and having the baby eat and sleep in a more upright position. Feeding twice as often can also relieve the reflux symptoms for these babies.

Attachment parenting

Dr Sears shared that attachment parenting is simple as in it is the mother (and father) doing what they would naturally do, without wrong advice or pressures relating to ‘letting the baby cry it out’. First, let’s explore what’s wrong with the ‘let baby cry it out’ advice:

Should Baby be left to Cry it out?

NO – Dr Sears shared that training the baby to sleep, despite crying is the wrong advice. The newborn baby would naturally want to be near to the mother and intentionally leaving the baby alone and forcing the mother not to carry the crying baby has been studied to have negative effects. For one, a mother who implements this incorrect advice will overtime lose the natural sensitivity to the baby. On the other hand, the baby who has cried it out experiences slower growth, partly due to the body ‘shutting down’ due to lose of trust that care will be provided. A simple guideline for parents to know what to do or not do is ask

‘If I were my child, how would I want my parents to respond?’

Next week, we will learn more in-depth from Dr Sears on attachment parenting – what to do and its benefits. I didn’t get to have Dr Sears vet through this post before publishing, any and all mistakes mine.

Doctor Q&A

Rise and Shine Feature – Healthy Child with Dr Sears

Dr. Bill Sears is one of America’s most renowned pediatricians, father of eight children, and author of over 40 books on childcare. He is the Associate Clinical Professor of Pediatrics at the University of California, Irvine, School of Medicine. Dr Sears Lean has a series on this blog that covers many aspects of raising healthy kids. Dr Sears shared many tips in this Singapore workshop ‘Keeping Your Child Healthy’.

Raising healthy babies and successful children with Dr Bill Sears

Diabetes in Children

Listening to the esteemed Dr Sears speak on healthy child is a privilege!

Diabetes is an increasing and worrying condition among children. The risk of diabetes decrease with healthy choices and conversely, increase with unhealthy ones. Although genes play a role, recent studies show that whether that gene is expressed is determined by healthy choices, including those at pregnancy. Eating too much junk food and lack of exercise contributes to the rising diabetes problem in children in the US.

Exercise for Children

Exercise can help the baby to be healthier as recent studies found that the body’s internal ‘medicine’ is released from the endothelium, the inside lining of blood vessels. Exercise creates an energy field and the glands along the endothelium open up, releasing ‘medicines’ for growth and regulating mood into the blood vessels, which in turn are circulated. An unhealthy diet and lack of exercise clogs the endothelium, preventing these ‘medicines’ from being released.

Effect of Omega 3 in Children

Increase intake of omega 3, such as fish oil with EPA and DHA during pregnancy has been associated with reduced post-partum depression, less premature births, fewer incidences of pre-eclampsia and less gestational diabetes. Numerous times during the talk, Dr Sears recommended that we stick to the Asian diet which is typically higher in fish and other safe seafood.

Stick to the Asian diet which is typically higher in fish and other safe seafood

Dr Sears also shared the theory that post-partum depression is linked to Omega 3 deficiency – the theory is that the baby drains the mother as their brain grows most during pregnancy and the first year. A baby’s brain is 60% fat and uses glucose and oxygen. Therefore, appropriate intake of omega 3, carbohydrates and antioxidants are required. Dr Sears illustrated that omega 3 is to brain like calcium is to bone, responsible for brain cell membrane fluidity and myelin development. Omega 3 has also been associated with improved cognitive abilities of children and improved visual acuity.

Smoking – Smoking is not recommended and linked to many risks for the baby, including sudden infant death syndrome, affecting the breathing of babies via the paralysis of cilia (found in windpipes for sweeping dirt from lungs), doubling the risk of respiratory infection and causes higher nicotine levels in breast milk. Moreover, smoking also lowers prolactin, which stimulates mammary glands in preparation for milk production.

Dr Sears’ Eating Tips for Pregnant Moms

  • Eat twice as often
  • Eat half as much
  • Chew twice as long
  • Take twice the time to dine

I didn’t get to have Dr Sears vet through this post before publishing, any and all mistakes mine. Next week, we will cover more of Dr Sears’ talk, including on attachment parenting and (the mysterious) colic.

Guest Interview

Dr SEARS L.E.A.N. Series: Raising Healthy Kids

This original 9-part series published every fortnight has been condensed to one longer informative post. This series examine the DrSearsLEAN (Lifestyle-Exercise-Attitude-Nutrition) tips and privileged to have DrSears’ team to help with the tips for parents with eczema children.

Healthy Kid’s Diet

Tip #1: Pick Your Salad

It is a fun way to learn about fruits and vegetables in a farm, by picking them and making your own salad. Most of the farms listed on are in the US, but you can also find vegetable farms in Singapore! Parents of eczema children may think that their child is allergic or hypersensitive to certain foods, particularly when there’s an eczema flare after consumption of a new food. But is the food really a trigger?

How do Parents know if it’s the Food that’s Triggering an Itch?

There are certain foods that are more common in triggering an allergic reaction, but food in itself is not a common eczema trigger. The nature of eczema is that it comes and goes and it’s best to have the suspected food be confirmed in a skin prick test or if need to, an oral food challenge before excluding it. Should food be a trigger, usually it’s a few food rather than many foods. Even food that shows up positive in a skin prick test may not trigger itch and thus need not be excluded from your child’s diet.

You may start suspecting a food allergy when:

1.             Your child shows immediate rashes or swelling around the mouth (oral allergy syndrome). This is less common in young children but some foods such as banana, kiwi, avocado, and potato have triggered such reactions. Other reactions could be itchy bumps or abdominal pain, vomiting, itchy eyes, sneezing or wheezing.

2.             Your child shows delayed reactions, more than 24 hours, after consuming the food. However, such foods are harder to detect through skin prick test or by observation as abdominal pain, itchiness or diarrhea could also be due to other reasons.

For a start, you can keep a food diary for your child, logging everything he/she eats for 4 to 6 weeks. I actually recorded from my baby’s first bite all the way to 9 month old but there’s no discernible pattern because my baby turned out to be not allergic to anything! I was a paranoid mom for so long until the negative results from the skin prick test, which is why I recommend it to every parent to save themselves the agony of second-guessing.

DrSearsLEAN’s recommendation

Eczema is a condition caused by two factors: first, a genetic tendency toward dry, irritated skin; and second, skin allergies to a variety of irritants and foods. The cause is mainly genetic – an inborn tendency toward dry skin and allergies. There is no way to change this genetics. The important issue is not what causes eczema in the first place, but what allergies and skin irritants is your child exposed to that is triggering the flare-ups.

If your child has any food allergies, then they will play a major role in causing eczema. The problem is, you may not know if your child has any food allergies, and if he does, which foods is he allergic to? Thankfully, there are six common foods that make up nearly 90% of possible allergic foods. These are milk, egg, soy, peanuts, fish and wheat.

What Foods for Eczema Child?

Before we discuss the common food allergens that may trigger your child’s eczema, let’s have some fun looking at DrSearsLEAN  – Traffic Light Eating for healthy diet:

GREEN Light foods are “Go” foods. They are all high in nutrients and are all fruits & vegetables.

Yellow Light foods are “Slowdown” foods. These are foods that are ok to eat every day, but you need to use portion control. Examples of yellow light foods include whole grain bread, pasta, eggs, lean meat, fish, and olive oil.

Red Light foods are “Stop and Think!” about making a better choice. These are foods that are highly processed and contain high amounts of sugar and trans-fat. Red Light foods are foods such as cookies, candies, fast food, doughnuts, etc.

What are the Common Food Allergens?

Food is not a common eczema trigger, but certain foods that children are more commonly allergic to include cow’s milk, eggs, soya, wheat, fish, nuts and gluten (this is different from celiac disease). Cow’s milk should not be excluded unless it’s proven intolerant or to trigger a reaction. Salicylates, usually present in concentrated juice/sauce, unripe fruits and areas around the skin, can also trigger itchiness and redness. Salicylates increase the release of histamine but cooking the food can reduce the chance of allergy.

Should Elimination Diets be carried out?

Food should not be excluded until proven allergic to. A dietian should always be consulted and advice followed. Parents need to be educated in nutrition and be able to read food labels. A restricted diet, usually consisting of meat, vegetables, fruits, water and rice milk, should not be continued if there is no improvement after 6 weeks. There are cases when food removed from a diet added back later in childhood causes a more severe allergic reaction than before.

AskDrSears also has an article on eczema, which shares allergic triggers such as milk, egg, soy, peanuts, fish and wheat. The advice was to eliminate all six foods for 2 to 3 weeks, then re-introduce each food one at a time to determine which is causing the allergy.

DrSearsLEAN’s recommendation

As mentioned last week, there are six common foods (milk, egg, soy, peanuts, fish and wheat) that make up nearly 90% of possible allergic foods. Eliminate all 6 foods for 2 to 3 weeks. If you see dramatic improvement, then re-introduce each food one at a time to determine which is causing the allergy. It is important to note that fruits and vegetables are not common allergens and are very important in boosting your child’s immune system and the phytonutrients and antioxidants they contain are powerful anti-inflammatories. Try incorporating fruits and vegetables into every meal – even breakfast!

Healthy Kid’s Lifestyle

Tip #2: Make a Rule – Less TV, More Exercise!

Make a rule’ – which is no TV or video games on weekdays or before 30 minutes of play outside. Ideally, instead of watching TV, children can spend time exercising and do a range of activities from inviting their friends over to play to playing sports as a family. TV (and IPad) is becoming a ‘baby-sitter’, offering some relief for parents to finish up the chores or tidy the house (my own favorite phrase is ‘Order Has Been Restored!’). I have to confess that I let my baby watch TV since 3 month old, but only baby sign language dvd which has distracted her from scratching. As parents of eczema child would appreciate, it’s immensely stressful and difficult to keep the child from scratching and if TV can help, is that ok?

TV and Eczema and ADHD

The American Academy of Pediatrics recommends no TV for children below two years old. A study by Dr. Dimitri Christakis, Director of Child Health Institute at Children’s Hospital and Regional Medical Center (Seattle, Washington) showed that for every hour of TV watched, the toddler has a 10% higher chance of developing attention problems by age 7. The study is not without its limitations, which include data collected based on parents’ recollection, no data on content of TV programs and attention problems do not necessarily equal ADHD (‘Attention Deficit Hyperactivity Disorder’). Another study done by Carl Landhuis of University of Otago in Dunedin similarly concluded that children aged 5 to 7 who watched more than two hours of TV are more likely to develop symptoms of ADHD. Common reasons why TV is not good for children are that the fast-paced screens are not natural and replaces other activities like reading that require attention development. The noise of the TV also interferes with the brain’s ‘inner speech’, especially if TV is left on all the time when no one’s watching.

The bad news for parents with eczema children is that study has suggested an association between eczema and ADHD in children. 5.2% of 1,436 children with eczema also have ADHD versus 3.4% of children without eczema. Also the younger the child has eczema, the increased likelihood of ADHD. Thus, it would appear that even though TV may help distract a child from scratching, it is even more critical not to let eczema children watch TV given the higher correlation with ADHD.

DrSearsLEAN’s recommendation

Television plays a big role in childhood obesity because watching TV is a non-active activity that often leads to boredom (believe it or not!) and a tendency to over consume junky foods. Be a role model for your children and don’t eat while watching TV. Encourage them to participate in another activity such as reading or imaginative play. Your children will imitate your actions so always remember that how much time you spend watching TV and what other behaviors you practice while watching TV is a choice. Taking the time to invest in your child by playing with them is always a worthwhile investment for both your and their health!

Tip #3: ‘Set an Example’ – It’s easier to Exercise as a family

Exercise as a family such as ‘develop a routine’, ‘play sports together as a family’ and ‘have each person pick a different family exercise or activity to learn together’. It’s even more important to encourage each family member to keep fit because obesity is contagious! As written in the ‘The New England Journal of Medicine recently published a study that showed that if one spouse is obese, the other is 37 percent more likely to become obese, too’. For families with children with eczema, it is even more important because there appears to be a link between obesity and eczema.

Obesity is Contagious

Obesity and Eczema

In a study conducted by Dr. Jonathan Silverberg, dermatologist at St Luke’s Roosevelt Hospital (New York), there’s increased risk of developing severe eczema for children who are obese. Particularly, for children who became obese between age 2 to 5, the risk is three times higher than non-obese children. A later study focusing on adults gave similar results but the good thing is in both studies, eczema symptoms improved when weight is reduced.

Another study in Sweden also showed that hand eczema co-relates with individuals who are obese, have higher stress and smokes. The reason for obesity affecting eczema could be due to obesity resulting in inflammation in fat tissue, which overtime, can affect the skin.

DrSearsLEAN’s recommendation

Moving around and being active is one habit kids can learn easily, especially if their parents set a good example. Rather than thinking of movement as “exercise”, think of it as “play”! Running, hopping, skipping, jumping, riding a bike, etc, – These are all things kids (and parent) naturally enjoy. Movement does far more than just help control obesity. Moving more improves mood, helps you to feel better, improves sleep, helps digestion, encourages self-confidence, and more! Take some time to play with your child everyday. It will benefit both of you immensely!

Tip #4: ‘Reduce Stress in Your Life’ – Laugh More and Be Grateful

Leading a healthier and happier life comes from having the right attitude to life, and that includes taking steps to reduce stress, increase laughter and be grateful. There are many practical tips to follow but as parents of eczema children, it may be hard to do so; for instance, it’s hard to think positively when the eczema flares yet again for no reason. Or it can be difficult to enjoy a dvd when your child keeps scratching during the movie. Worse, repeated failed attempts to keep the eczema under control could demoralize the parent so much that it’s hard to appreciate the good even in our spouse, not to mention someone we don’t like.  The stress that families with eczema faces is considerable and a study has shown that stress levels in mothers caring for young children with eczema are equivalent to those mothers of children with severe disabilities.

Stress Triggers Eczema

While it may be more difficult to keep the stress level low in families with eczema children, it is important to do so should stress be one of the triggers of the eczema. As stated in Adnan Nasir’s book Eczema Free for Life, stress is the number three trigger and can worsen eczema by:

(i)         Stimulating hormones to be released which result in an increase in inflammatory substances the skin is allergic to

(ii)        Suppressing the immune system which results in a decrease in defense proteins to protect the skin

(iii)       Weakening the lipid skin barrier which results in dry skin that is vulnerable to irritants

Museums, Factory Tours, Animal Farms but Swimming?

Swimming is a fun activity such as having fun with balls and slides in water parks or leisure pools.  But many parents are worried about bringing their child with eczema to the pool, fearing that the chlorine in the swimming pool water may worsen the eczema. On the contrary, my baby’s doctor actually advised swimming three times a week but not more than 10 minutes each time. Be sure to shower them immediately and apply generous amount of moisturizer.

According to a factsheet from the National Eczema Society, chlorine is generally the least likely to cause skin irritation. In another of their fact sheet, it is suggested that re-creating chlorinated swimming pool with a bleach bath can have positive anti-septic effects on the skin. In particular, eczema skin is susceptible to colonization of staphylococcus aureus bacteria that can cause infection if it penetrates the skin. More than 90% of the people with eczema have staph versus less than 10% of people without eczema. Swimming is therefore a fun way to reduce this bacteria and applying steroid will then be more effective.

DrSearsLEAN’s recommendation

Chlorine and other chemicals in water can sometimes be the cause of skin irritation and contribute to eczema in a small percentage of kids. Always bathe your child in clean fresh water after swimming and avoid using regular soap. Most regular soap, whether liquid or bar soap can cause dryness. A natural soap mixed with moisturizing lotion and free of perfumes will enhance skin moisture. These can be found in any drugstore or supermarket. Also avoid scented lotions and use PABA-free suntan lotion to protect their skin. Be sure to use a generous amount of moisturizer after bathing your child.The lotion helps seal in all the moisture gained from the bath to help control your child’s eczema.

Overall, swimming is a fun way to get your kids moving more! Plus, they are learning a life-long tool. It’s much easier to learn to swim when your child is young. Getting them used to the water helps them overcome fears and could be a life-saving tool  someday!

Indoors Fun versus Sweating it Outdoors

There are many fun activities to do indoors and some are ‘put together a PLAY basket’ and ‘get a pedometer’. One of the tips is ‘plan your family vacation around an outdoor activity’, such as camping which is an opportunity to get away from technology and instead, do some biking and hiking. However, outdoor exercise inadvertently comes with sun and sweat. Heat and perspiration is the number one trigger for eczema and is also the only trigger I’ve identified for my baby. The combination of heat and perspiration may set off a ‘heat rash’ as an eczema child’s skin is more vulnerable to chemicals in sweat which may irritate the skin.

Sunlight – To Block or Not?

According to a factsheet from the National Eczema Society, sun exposure is drying to the skin and may aggravate eczema for some people. Ron Sweren, M.D., a dermatologist and director of the photo-medicine unit at Johns Hopkins also said that sunlight can serve as a trigger that worsens eczema. To prevent sunburn, sunscreen lotion is a must but again, you can read here that some of the ingredients may also irritate your child’s skin. Moreover, according to Sewon Kang, M.D., director of department of dermatology at John Hopkins, increased sweating will lead to more showers taken, which again could worsen the eczema. In less common cases, there may be sunlight allergy or photosensitive eczema which further restricts exposure to sun.

However, there are also cases of eczema that improve with sunlight exposure and there’s a treatment known as phototherapy that exposes the skin to UVA1 rays that can soothe the skin without causing sunburn. Moreover, vitamin D that comes from sunlight has been shown to increase the production of skin proteins (cathelicidin) which protects against skin infection.

Dr Sears L.E.A.N.’s recommendation

Eczema results from the combination of a genetic tendency toward dry, sensitive skin and a susceptibility to allergies. Although most children aren’t bothered by the day-to-day wear and tear of soaps, dirt, sweat, heat, clothing, and everything else we come into contact with, the skin of a child with eczema is hypersensitive to everyday life. It is important for you to monitor your child and identify the main trigger for developing eczema flare-ups. For some it could be heat and sweat, others are triggered by what they eat (or what mom eats if they are breastfeeding), grass, dirt, or chemicals in the environment around them. Although there is nothing you can do to change your child’s genetic susceptibility to dry, sensitive skin, there are many steps you can take to improve skin health, reduce exposure to irritants, track own allergic triggers, and minimize the impact the eczema has on your child’s day-to-day life

Healthy Kid’s Nutrition

Boosting our immune system is important, particularly for both parents and children with eczema because the lack of sleep can lower our immunity. As recommended on, we should choose healthy food that contain the following eight immune system boosters, namely vitamin C, vitamin E, carotenoids, bioflavonoids, zinc, garlic, selenium and omega-3 fatty acids. Out of these eight immunity boosters, parents may find that zinc and essential fatty acids are often recommended for children with eczema.

Tip #5: Get Healthy Eating Food, not Supplement

There’s some research that points to zinc and omega-3 fatty acids can help to reduce skin rashes in adults and also that eczema children appear to be deficient in essential fatty acids which results in a lower production of anti-inflammatory prostaglandins that can help fight skin infection. However, research is not conclusive as clinical trials have also been conducted with no significant impact on eczema. Parents should incorporate the immune system booster food into the child’s diet rather than in supplement as excessive intake of say, zinc can inhibit immune function. The RNI (reference nutrient intake) for zinc is 4mg per day for a six month-old and 5mg for a toddler. Zinc-rich foods include beans, chickpeas, beef, turkey and spinach while omega-3 rich foods are salmon, tuna and sardines.

DrSearsLEAN’s recommendation

To improve your child’s skin from the inside out, add these nutrients to his or her diet:

  • Fruits and vegetables can help improve allergic and inflammatory diseases like eczema. If you have a picky eater who avoids fruits and veggies, you may consider giving them a whole food supplement to help boost their immune system.
  • An omega-3 supplement provides beneficial fats to help the skin stay healthy. Good sources of Omega-3s are avocados, salmon, tuna, flax seeds, pumpkin seeds.
  • Probiotics taken in liquid, powder, or pill form can help decrease food allergies.

Choosing A Healthy Drink for Kids

Parents beware that not all drinks packaged for children and have ‘vitamins’ listed on the packaging are healthy. As stated on, drinks with the main ingredient ‘high fructose corn syrup’ may result in overeating because it does not trigger a hormone, leptin, that creates fullness. Moreover, children who drink more than 12 ounces per day of concentrated juice are more likely to be overweight. For eczema children, it’s also best to avoid sugary drinks which contain caffeine (may trigger eczema), increase tooth decay while artificially flavored drinks have been linked to ADHD. For a healthy choice, plain water with lots of fruits and vegetables is best

Does Softening Water Help?

Water makes up 60% of our body and is useful for flushing out waste and toxins. There are some observations that eczema is more prevalent in areas where water is hard as the higher calcium and magnesium content may be a skin irritant. However, from a clinical trial conducted by Professor Hywel Williams and Dr Kim Thomas of the Centre of Evidence Based Dermatology at University of Nottingham, there is no impact of using softened water on eczema. However for parents who have found water softeners to improve their children’s eczema, they certainly can continue to do so. Skincare routine like moisturizing, showering without using harsh soap and appropriate treatment is still required.

DrSearsLEAN’s recommendation

Water is an essential nutrient. Water is to our body what oil is to a car; we can’t function without it. Like growing plants, growing kids need lots of water. Our bodies are 50 to 70 percent water, and much of that water has to be replaced every day. Water helps prevent constipation, eliminate toxins from the body, hydrate the brain, and keeps breathing passages moist and clear of mucus. As a general rule, children need around one ounce of fluid per pound of body weight per day. The majority of your fluids should be from plain water, but a small amount of fluids can also be from milk or 100% fruit juice. Drinking soda should be discouraged. Many juice drinks and all sodas are high in calories, provide no nutrients, and are usually sweetened with high fructose corn syrup (HFCS), which you should always avoid.

MarcieMom: Thank you Dr. Sears for being with us throughout the whole series. I’ve been so glad and delighted to hear your advice which definitely gives me the confidence to raise a healthy child, despite her eczema.