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Guest Interview

MooGoo… Learning about a Natural Skin Care brand

Interview with founder of Moogoo Skincare Craig Jones on EczemaBlues

I heard from a mom in Malaysia of how well received MooGoo is among moms with eczema children. MooGoo is an Australian company that makes a range of skincare products, founded by adapting the ‘diary’ version of udder cream for a family member. This is an interview with Craig Jones, founder of Moogoo.com.au

This was originally a 2-part series, combined into a single post. This is not a sponsored post; I reached out to Craig as I wanted to find out more about the company and its eczema skincare products, and ask the questions which other parents with eczema children may be interested in finding out.

What Natural Skincare Mean

Marcie Mom: Thank you Craig for taking time for this interview. I haven’t used MooGoo but like to ask questions that another ‘self-educated!’ mom with eczema child would likely ask reading your website. I’m very pleased to see that you do highlight on your website that natural doesn’t mean not allergenic and you encourage testing on a small skin patch before using. Now, we know there is no certification for natural and ingredients extracted from nature will need to be processed to fit into the packaging and be of a form that can be used. For instance, olive oil needs to be preserved and the preservatives can irritate.

Is there a certification for organic in Australia and if there is, do you think it’d be more objective to brand MooGoo as such? And if not, how do you think you can help explain to your customers how to assess the extent of ‘natural-ness’ of MooGoo or another brand?

Craig Jones: Very good question. In fact, a pure oil like Olive Oil doesn’t need a preservative. When we buy Olive Oil, or Sweet Almond Oil or any other natural ingredient, it is already pure. A preservative is only needed when an oil is mixed with water as bacteria and mould need water. (That is why, if you ever see on a website an ingredient list that contains water, but they don’t show a preservative, you know there is something missing from the preservative list.) If an ingredient came blended with a preservative, this should be put on the finished label of the product.

Certified ORGANIC Skincare

There are lots of organic certification system in Australia. For food, organic certification can be important for many people. For skin care, because the ingredients we buy are already pure and cosmetic grade, I know it doesn’t really make any difference. They do not come contaminated with pesticides or preservative.

It would certainly help from a marketing perspective to have “organic” splashed across the label. It would also be a simple process for us to become “Organic” certified. I think all of our products would already qualify. All we have to do is to pay the license fee to whichever certification body we choose and a bit more record keeping concerning ingredient supply chain. But I personally feel “organic” in skin care is more of a marketing tool than anything else and I would feel insincere using it. That is why we choose not to. Perhaps we should.

Mineral Oil or Paraffin Oil

Marcie Mom: Your website gives a very homely and cosy feel and I noticed that a message that seems to be emphasized is to not use products containing mineral oil or paraffin oil. From what I know, though these oils do get mention as being potential irritants, they are not the top allergens and not cancer causing when applied to the skin as moisturizer.

Why have MooGoo chosen to emphasize on paraffin and mineral oil?

Craig Jones: Although everyone has different preferences and some people may choose paraffin oil, I think mostly it sneaks into products because it is poorly understood exactly what it is. I personally think Paraffin Oil is a very poor quality oil to be used in skin care and would not use a product with Paraffin on my skin. Nor would I put it in a product that we make. Labelled as “soft white paraffin oil/mineral oil/baby oil/paraffin liquidatum” it doesn’t sound particularly offensive. But people probably don’t comprehend that this is a flammable petroleum oil that in its raw form, they probably wouldn’t put on their skin.  Properly refined petroleum oil for skin care does have the carcinogenic hydrocarbons removed, that is true. However, in the need to keep the price down (paraffin oil is usually used in cheaper products) I wonder sometimes if there might be a temptation for companies to use cheaper grades of paraffin.

But people probably don’t comprehend that this is a flammable petroleum oil that in its raw form, they probably wouldn’t put on their skin. 

Also, the study below here has always concerned me. It has shown tumour growth in UV treated mice that have first had paraffin based moisturisers applied, as compared to no tumour growth in the control cream which was non-paraffin based. It doesn’t prove that paraffin oil can cause tumour growth in humans exposed to UV, but it would concern me. (Study here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2630214/?tool=pubmed)

Here is story about a study done on paraffin oils and childhood eczema using a paraffin based cream where is generally made eczema worse for kids. (http://www.sciencedaily.com/releases/2010/10/101018074536.htm)

So we didn’t make any claims that paraffin is a cancer risk as is claimed by a few other websites. All we wanted to do was show people exactly what it was. Paraffin is the base oil for so many pharmacy products because it is so cheap. We get a feedback all the time comparing the price of our products to something like Sorbolene. So we need to explain that although both may look the same, they aren’t the same.

Diaper Cream & Baby Safety

Marcie Mom: I also see that you have a MooGoo Nappy Balm and that they are first tried and tested on your own babies, and friends, staff and even facebook customers! Good to know but I’d like to ask if you send or intend to send your product for clinical trials for independent reporting.

I also noted that there are quite a number of oils that you use, can you share a little more about which oil needs to be preserved and processed to the form of a balm and how MooGoo has ensured that you keep the end product safe for use in babies? Do you manufacture all your products in-house?

Craig Jones: All the products we make for ourselves first. The Nappy Balm will soon be registered as a medical device in Australia which includes the evidence for ingredient efficacy.

For the oils we simply chose a list of soothing edible oils. Although people with nut allergies are generally not allergic to nut oils (because the allergy causing protein is removed) we chose to not use Nut Oils in this case so that new mothers weren’t concerned.

This is not a miracle product either. The main thing is that we use edible oils so that the product can be ingested. Most commercial nappy balms are paraffin based. Paraffin Oil can be fatal for children if ingested. It simply works as an edible barrier balm that is also anti-bacterial. A very simple product.

Product Testing

Marcie Mom: I noted also on your website that ‘MooGoo creams have been independently tested to ensure they remain pure and uncontaminated for at least two years, when stored below 30 Degrees Celsius. This is a called a “Challenge Test. It is not a compulsory test in Australia.’ 

Could you give further details as to who conducted this test, how the test is conducted and what is your definition of ‘pure’ and ‘uncontaminated’?

Craig Jones: Preservatives is one area of our formulation that we are very proud. A product that is often used on broken skin, or babies, needs to be properly preserved so it is sterile. Everyone would be aware of ingredients like Parabens, Benzoates, Formaldehyde Donors and other ingredients often used to keep skin care products sterile. It doesn’t take too much research to see that if we had the choice, we probably wouldn’t put these chemicals on our skin. (It is also interesting to see how often they aren’t on the list of ingredients published on websites, but are on the label of products). These ingredients are used as they are inexpensive ways of preserving a cream.

Obviously most natural companies want to avoid being seen in the company of these type of ingredients. The temptation can be to try and cut corners in preserving a cream and use fairly ineffective preservatives like Grapefruit Seed Extract. Not all companies do this at all, but it can be a temptation, especially as nobody checks for preservative efficacy in Australia.

Preservatives Test

We accidentally discovered a new way of preserving our creams based on Hops. I stumbled across i when talking to a food ingredient supplier who used it for Apple Juice. We tried it in the creams and after a bit of tinkering (at first some people found it changed the smell of the cream so we had to cut the percentage down) we now use that as a total edible preservative.

We have our creams tested by Conmac labs. The BP Preservative Efficacy Test is a program of deliberately contaminating the cream sample with a range of bacteria and mould, and then tracking the growth of the bacteria and mould over a 30 day period. To pass, the preservation system must kill all the bacteria and mould. I have included a sample report so you can see.

Because we have so many infants using our products, and because we are using a novel edible preservation system, we make sure our products pass this test.

Selection of Ingredients

Marcie Mom: You have some products suited for eczema and one of them is the ‘Eczema and Psoriasis Balm’. It is AUD18.50 for 120g which translates to about SGD24. I would say the price is about mid-range. Aloe vera, matricaria chamomilla extract, centella asiatica and sage oil are listed as active ingredients (and very good that you list amount of mg of ingredient per gram, which in aggregate is 30.5mg/g). 

Why did you choose these ingredients and what research can you point us to that concludes these ingredients applied on skin are beneficial for eczema? Also, are these ingredients listed as allergens by any national dermatitis group, e.g. NACDG?

Craig Jones: This is a complicated question. Before we created the Eczema Balm, a lot of people were already using our Udder Cream for skin problems. In fact, the Udder Cream was first made for my mother who had psoriasis. At that time I had no intention of starting a skin care company, and if that cream hadn’t worked as well as it did, I am sure I would still be enjoying my previous profession of being a pilot and MooGoo would have gone no further than our kitchen and my mother’s skin.

The original Udder Cream we made  probably worked quite well due to the oils such as Sweet Almond Oil that we used, combined with the Aloe and Allantoin. I am the first to admit it is not a “miracle” formula. I think the reason it helped so many people is that they had been using poorer quality creams (often sorbolene type creams) for years and so when they switched to a repair moisturiser of better quality, some found a huge improvement. But it was probably the choice of oils, the fact it didn’t contain some certain preservatives that helped the most.

However, to register a product for Eczema with the Therapeutic Goods Administration, we needed to add some approved “Actives”. So we looked for those with the best evidence we could find as natural anti-inflammatories and wound healing, and added those. But I don’t think it is just the actives that help. I personally think the natural oils and Allantoin also assist.

Incidentally, over the last 4 years i have kept researching lots of different natural actives. In a few months we are releasing a second Eczema Balm. On paper it should work even better. We are keeping the original as it is so popular and still a very good product. However it doesn’t work for everybody, and so this is another option. It was also the result of my personal belief that the combination of ingredients should result in the best possible natural anti-inflammatory cream it is possible to make. So we will see how it goes.

Sensitivity to Skincare Ingredients

As for allergies, even the best ingredients can have people that are allergic to them. As you know, we compare it to food. People can be allergic to nuts or dairy or shellfish. However, for the vast majority of the population, these foods are very healthy. Nobody is allergic to Cola. This doesn’t make Cola a superior food to shellfish.

It is the same in skin care. Typical examples of allergies can be to Aloe Vera and Vitamin E. For most people however, these are excellent ingredients for the skin. It would be detrimental to most people if they were taken out because a very small number of people have allergies.

We do however avoid Essential Oils as much as possible due to allergies. We used to use them in a lot of our products, including the Milk Shampoo, Wash and Conditioner. People would sometimes react to these. So we instead worked with a company that specialized in phthalate free fragrant oils that didn’t cause allergic reactions and now use these. The number of people with reactions in the products without essential oils is almost nil.

Anti-ageing products though do have more potential for allergies with some people if they are genuinely effective. This is because genuine anti-ageing actives need to penetrate and work with the skin metabolism, so they need to be reasonably concentrated and fairly bio-active. So they are more powerful. An inert ingredient or an ingredient that was in the product at a tiny concentration would not be an allergy risk for anyone, but nor would it do what people hoped.

Patch Testing – Encouraged

So what we do it put the best ingredients in the product we can at the concentration we think we need, and then encourage everyone to patch test all natural products before use.  This is much better for most people we think than not using any ingredient that may end up causing an allergy. Paraffin and Water (Sorbolene) may not cause many allergies, but it won’t do a lot of good either.

Marcie Mom: Thanks Craig for being open and sharing insights to your products and the decisions behind them. p.s. to readers of eczemablues.com, I didn’t receive any money from MooGoo for this interview.

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Last updated on 23 November, 2024 8:29 am
Categories
Support Group

Don’t Miss Inaugural Eczema Support Group Meeting at National Skin Centre

To all you wonderful parents in Singapore who has been supporting my blog or joined my support group, do turn up for this Saturday’s (14th July) inaugural meeting of the Eczema Support Group, a peer support network for eczema patients in Singapore supported by the National Skin Centre’s Health Endowment Fund.

I’m the co-chairperson for this group, and I look forward to meeting everyone because I know you will make it a meaningful session where we ‘band’ together with the benefit of esteemed doctors sharing eczema information and a supportive NSC team (nurses, medical social worker, HR, communications/publicity). Registration starts at 1.30pm and run from 2 to 4pm.

See further details below as RSVP is required!

Come for the Inaugural meeting of the Eczema Support Group!

Categories
101 things that Mothers with Eczema Child do Differently

49 of the 101 things that Moms with Eczema Child do Differently – Keeping an Eye and Ear out

Keeping an Eye and Ear out while washing dishes! (Got to hear if there's scratching sound!)

This is the 49th of my “101 Things that Moms with Eczema Child Do Differently“, a tongue-in-cheek look at the many unique situations that we face. For more cartoons, click here to view.

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Doctor Q&A

Friday Dr Q&A with Dr Liew – Managing Allergy & Eczema at Childcare

Dr Liew is a pediatrician who practices at the SBCC Baby & Child Clinic, Gleneagles Hospital Singapore and is also a visiting consultant to KK Hospital. He subspecialises in allergy, immunology and rheumatology. He was also awarded several research grants to pursue clinical research in paediatric anaphylaxis, drug allergy, primary immunodeficiencies and Kawasaki disease.

Managing Allergy for Eczema Kids Dr Liew Woei Kang

This was an original four posts of Friday Q&A, combined into one more informative post. MarcieMom contacted Dr Liew on setting up an eczema fund in Singapore and subsequently collaborated on this Q&A.

Childcare for Allergy Kids

MarcieMom: Suppose a child who has an allergy has to have alternative care-giver, say at child care centre.

What would you recommend a parent to share with the childcare?

Dr Liew: Your allergist should be able to advice what the caregivers be taught. Written action plans for eczema are useful for daily skin care instructions, whilst food allergy/anaphylaxis action plans provide information on treatment in emergencies. There is continued public education regarding allergic conditions via hospitals and societies like AAA.

Food Allergy in Childcare

How should a parent besides obviously telling the teachers/ care-givers of the allergy, help to make it easier for the school to prevent contact with the food? 

For instance, is there a need to warrant 0% contact, for instance, the whole school shouldn’t even bring the food in?

Dr Liew: After a diagnosis of food allergy, it would be important to relay the importance of food avoidance and emergency care plans with the care-givers. Written food allergy/anaphylaxis plans are useful. The degree of strict avoidance varies accordingly to the food allergen and severity of allergic reaction. It would be better to discuss specific advice with your allergist.

Non-Food Allergens

What are the common non-food allergens?

And if it’s dust mite, how can a parent tell the school to keep the dust mite level low since house dust mite is something that can’t be totally eliminated? And if it’s dog droppings allergy, should a parent not even sign up a child care centre where teachers or even classmates have dogs at home? For common skin allergen like soaps and detergents, should a parent go as far as to monitor what detergent the child care centre or caregiver is using? (And the bigger question is – how can a child care centre with 70+ kids cope with so ‘many requests’ of a parent?)

Dr Liew: The most common environmental allergen is house dust mites in Singapore. House dust mite avoidance measures are useful to reduce the levels of protein, but results variable. I would not recommend schools to implement house dust mite avoidance measures as they are time-consuming and difficult to implement in the long term. Dog sensitisation is usually to the hair epithelia, rather than poo, and is not common in Singapore. Irritants like harsh soaps and detergents should be avoided in children with eczema and dry skin. It may be helpful to provide the school with your child’s soap substitute and moisturisers, and get the teachers assistance for application.

Allergic Reactions in Kids

How can a parent recognize an allergic reaction and more importantly, which are the symptoms that are signs of serious reaction such as anaphylaxis?

Mild to moderate allergic reaction include:

• Swelling of lips, face, eyes

• Hives or welts

• Tingling mouth

• Abdominal pain, vomiting

Antihistamines usually suffice.

Severe allergic reaction (anaphylaxis) include:

• Difficult/noisy breathing

• Swelling of tongue

• Swelling/tightness in throat

• Difficulty talking and/or hoarse voice

• Wheeze or persistent cough

• Persistent dizziness or collapse

• Pale and floppy (young children)

Epi-pens at Childcare

When should a parent prepare an epi-pen and how can the parent teach the child and the alternative care-giver on when an epi-pen is to be used?

Epipen should be administered for severe reactions. A written anaphylaxis plan should be provided with pictorial reminders on how to administer an epipen.

Outdoor Allergens

What are some common outdoor allergens in Singapore?

For instance, to certain type of trees or to certain pollen? Pollen counts are usually higher in the morning and on a warm, windy day versus just after a rain. Many places in Singapore are air-conditioned, is this better or worse off for a child with dust mite, pollen or certain allergy?

Dr Liew: Outdoor aeroallergens include tree pollen (Oil palm tree pollen is commonest), grass pollen are common in temperate countries with seasons, but is uncommon in Singapore. Air-conditioning is better tolerated for eczema patients but can worsen an allergic rhinitis. The impact on specific allergens are not great except moulds, as they may grow in poorly maintained air-conditioning units.

Air-conditioning is better tolerated for eczema patients but can worsen an allergic rhinitis.

Mold & Indoor Allergens

MarcieMom: Mold is another allergen and lots seem to be growing in my home!

If a child is allergic to mold, what steps should a parent take?

Also, for allergies like cockroach droppings, does it mean that the parent must diligently hunt for all droppings in corners of the home and remove them?

Dr Liew: Steps to reduce mould in the environment include a well-ventilated room, and if air-conditioning is used, frequent maintenance of the AC unit. Pest control measures are best for cockcroach sensitisation, as cockroaches often “roam” around and leave traces of protein.

Vaccines and Allergy

MarcieMom: On vaccines, there is so much discussion out there where even doctors are coming out to say that vaccines are unnecessary and pharmaceutical companies are coming up with more and more vaccines that are unnecessary and even harmful for our children. Some parents may be opting their child out of vaccines due to egg protein included in some of the vaccines.

What’s your recommendation on this and when should a parent seriously questions a vaccine before letting his/her child have it?

Dr Liew: Vaccines are the one of the proven public health measures to reduce mortality from infectious diseases. Vaccines are produced for significant infectious diseases. There is no link between vaccination and allergies. Traces of egg proteins can be found in influenza vaccines and specialised vaccines like yellow fever. Egg allergic patients should discuss the risk benefit ratios of receiving these vaccines. MMR vaccines are safe for egg allergic patients.

Antibiotics

MarcieMom: On antibiotics, I’ve read online that antibiotics are mostly unnecessary since they are only effective against bacteria yet it is so common for general practitioners to prescribe antibiotics! (in fact, I always have to refuse the prescription because it’s just a common flu!) Antibiotics are also known to cause allergic reaction, what would be your recommendation?

Dr Liew: Antibiotics should only be prescribed for bacterial infections.

Cross-Reactions

MarcieMom: On cross-reaction, it’s commonly heard of when a child is allergic to birch pollen, he/she is also allergic to apple. Or a child who is allergic to latex is also allergic to kiwi.

Can such allergy be identified by allergy tests?

Also, what are some of the common allergies that you can point our parents to, so that they are aware if their child is allergic to one thing, they should probably avoid something else.

Dr Liew: Cross-reactive allergens occur due to the similarity of one protein to another, usually within the same botany taxonomy. They can be easily tested by skin prick test or blood IgE testing. A good example would be most cow’s milk allergic patients are allergic to goat’s milk as there is an approximately 95% similarity between the two.

MarcieMom: Thank you Dr Liew, it’s such a great pleasure to have you explaining all these allergy questions that many parents have, we are all so grateful!

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Last updated on 23 November, 2024 4:11 am
Categories
Eczema Tips Guest Interview

Reducing Stress for Children

Reducing Stress for Eczema Children

Eczema families face higher stress due to the constant attention required to manage our child’s skin, including the itch and the scratching. Marcie Mom interviews Lori Lite, founder of Stress Free Kids®, who has a line of books and CDs to help children reduce stress, anxiety and anger.

Lori started her business when trying to settle her young son to sleep and reduce night terrors of her daughter. Her Indigo Dreams® audio book/CD series has been awarded the CNE Award of Excellence. Lori has been interviewed and/or featured in NY Times, MSNBC, ABC Radio, CBS News, USA Today, Web MD and Prevention Magazine. She is a certified children’s meditation facilitator and parenting stress expert and gained national attention when she appeared on Shark Tank.

What is Stress?

Stress is a reaction that affects our mind and/or body when we are confronted by a ‘stressor’ – something that angers, scares or worries us. For the child, stress can trigger or worsen the eczema – Dr Christopher Bridgett and Dr Claudia Aguirre shared about stress brain and skin connection.

Apart from impact on skin, stress can affect a child’s learning, sleep, emotions and ability to handle stressful situations. Not all stress is bad, as some normal stress encountered prior to a test may help the child to prepare for it. Unfortunately, with eczema, the stress can be chronic (just like eczema) as persistent eczema flares, scratching, lack of sleep and self-esteem can build up in a child.

How to Know if Your Child is Stressed?

MarcieMom: Lori, can you share with parents how we can identify that our child is stressed, in particular, for an infant or toddler? Can a new-born be stressed? (I’m thinking of all the writhing and fidgeting of my baby when her eczema already affected her at two weeks old!)

Lori:  Recognizing stress in new-borns and toddlers is difficult. As you noted, you felt your baby’s body language was telling you something was out of balance at only two weeks old. Babies that stiffen their bodies, arch their backs, grimace, and cry frequently can be exhibiting signs of stress. I always tell parents to trust their instincts. Parents, especially moms, know when something is wrong with their children. Keep an eye out for a change in your child’s behavior.  For example: clingy behavior is a sign of stress in toddlers. However, some toddlers are clingy. So if your child is usually not the clingy type and they are suddenly attached to your leg, then that would be a change in behavior.

Babies that stiffen their bodies, arch their backs, grimace, and cry frequently can be exhibiting signs of stress.

Some of the signs in children also include: no longer wanting to go to school, an increase in nightmares or night terrors, difficulty falling and staying asleep. Physical symptoms can present themselves as unexplained stomachaches, headaches, or other ailments. Sometimes the child will withdraw from friends and family members, or have frequent meltdowns, which is a common sign of stress for toddlers. It is important for moms or parents dealing with the additional challenges of eczema to be aware of and manage their own stress. Babies, children, and teens pick up on our stress. It is contagious and we must find healthy ways to manage stress and anxiety. We can set a great example to our family and send  a ripple of calm throughout the house.

Causes and How to Cope with Stress

In a survey of 1,206 young people, 44% are stressed over performance in school and 30% are stressed over family’s finances. In an article on StressFreeKids.com, it is mentioned by David Code, author of “Kids Pick Up on Everything” that “Parental stress can weaken the development of a child’s brain or immune system, increasing the risk of allergies, obesity, or mental disorders.”

In other words, “Stress is highly contagious between parent and child, even if the parent is unaware of his or her own anxiety.”

Children cope with the stress they face, usually by doing activities that relax them, such as exercise, music, TV or talking to a friend. As a parent, we can try to help our child cope in a healthy manner, ways that help their mind and body and won’t cause harm such as hitting themselves or others.

Reduce Stress Techniques for Kids

MarcieMom: Lori, your books and CDs focus on a few techniques, namely breathing, muscle relaxation, affirmative statements and visualization. For breathing, you mentioned

(i)         Have your child lie on their back and put their hand on their belly.

(ii)        Take a slow deep breath in through their nose and let it out through their mouth with a gentle ah-h-h-h-h-h-h sound. (They should feel their belly rise and fall).

(iii)       Breathe in slowly through their nose and out through their mouth like they are trying to move a feather up in the air.

(iv)       Breathe in slowly to the count 2, 3, 4 and out 2, 3, 4.

(v)        In 2, 3, 4 and out 2, 3, 4.

For breathing and muscle relaxation exercises, which age is appropriate to start?

Lori: It is never too soon for a child to reap the benefits of relaxation and meditation. There are reports that state that stress levels during pregnancy can affect an unborn child. I used deep breathing throughout my last pregnancy and I believe that because of this my newborn was easier to soothe when I focused on my breathing. In general the age of 4 is when a child can start to participate in relaxation exercises, but I have seen children as young as 18 months copy breathing and positive statements. Self-care, relaxation and stress management can begin at any age and should be part of daily living. When you feel stressed, tell your children that you are takeing a minute to focus on your breathing. Add visualizing breathing in happy, calm air…Throw an affirmation in like, “I am calm.” Children will copy what they see. Don’t be surprised if they climb up on you lap and breathe with you.

MarcieMom: You also recommended using affirmative statements, and also asking ‘What-If’ positive scenario questions. What age is suitable for this, and can you recommend a few ‘what-if’ questions and affirmative statements that parents with eczema children can use? (I was thinking ‘What if you don’t feel itchy?’ but then I’m WORRIED that will get the child to think about the itch!)

Lori: As soon as children start asking “what-if” and inserting their own fear-filled or negative outcomes, this is the time to implement repeating their “what-if” question and finishing with a positive outcome. For example, the child says, “What if my eczema gets worse?” and the parent says, “What if your eczema gets better?” Another example would be if the child asks, “What if the kids laugh at me?” In turn, the parent should suggest, “What if you find friends that accept you?”  Many children with eczema have food based allergies and might say, “What if I can’t eat anything yummy ever again?” We can empower children by answering, “What if we find new foods together that we can have a picnic with?”

The important aspect in affirmative statements is helping the child see a positive side, and have them focus on a positive outcome that rather than negative. You intuitively knew not to use the word itch in an effort to avoid bringing attention to it. We also want to avoid saying “not.”

MarcieMom: Thank you Lori so much for giving us a few techniques to relieve the daily stress. p.s. to readers of eczemablues.com, I did not receive any money from Lori or StressFreeKids for this interview

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Last updated on 21 November, 2024 10:53 am
Categories
101 things that Mothers with Eczema Child do Differently

48 of the 101 things that Moms with Eczema Child do Differently – Bath Oily Floor

We use bath oil, instead of soap for shower; A few times, we slipped cos the floor is really bath oily!

This is the 48th of my “101 Things that Moms with Eczema Child Do Differently“, a tongue-in-cheek look at the many unique situations that we face. For more cartoons, click here to view.

Read more: How to Shower Your Eczema Child

Categories
Doctor Q&A Other treatments

Combined Approach Series – Stress, Attitude and Habit Reversal

Dr. Christopher Bridgett is Hon. Clinical Senior Lecturer Imperial College at Chelsea & Westminster Hospital London. He is a psychiatrist with a special interest of using behavioural interventions to help people with atopic eczema, co-author of The Combined Approach at AtopicSkinDisease.com

Habitual Scratching and Eczema with Dr Christopher Bridgett

3 Levels of Eczema Treatment

In the manual ‘Atopic Skin Disease’, three levels of treatment are stated, namely:

1. Emollient Therapy

2. Steroid

3. Habit reversal

It is advised in your manual that steroid should not be used without follow-up moisturizer but moisturizer can be without steroid application. In the course of recovery, level 3 can be stopped first, followed by 2 and 1. We’ve covered the basics of all three levels in previous posts. There are some further dimensions in the management of eczema as follow:

Stress for Eczema Child

1. Stress – Stress is one of the possible triggers for eczema.

Can you help a parent to identify when a child is stressed and how to see if the child is stressed because of the eczema or because of something else?

Stress can cause emotional upset – unhappiness and apprehensiveness for example – in anyone, young or old. In a child this may include tearfulness, and avoidance behaviour, just as in an adult. Certainly having eczema itself is stressful, for both the child and the parents. Careful observation may clarify if something else is the source of stress: stress comes from common causes, even for the youngest child, and family upsets may be especially important to think about. If there are no other causes and the eczema is troublesome, then adequate treatment of the eczema will be stress relieving – for everyone.

How can a parent help a child to relax?

Helping a child to relax usually involves simple acts – giving attention, and comfort, with suitable play, and amusing distraction. Reading a favourite story is a tried and tested bedtime means of inducing relaxation and sleep. But when a child is stressed, enabling relaxation is more difficult, especially if the causes of stress are not identified and dealt with.

Positive Attitude

2. Attitudes – Positive attitudes are suggested in your manual, such as ‘Manage, Don’t be Managed’ and to be careful so the doctor/nurse does not to ‘spread’ helplessness during a consultation.

Should a patient comes across a doctor who is passive about managing the eczema, what can he/she do to change the doctor’s attitude?

(Obviously, the other choice is simply switch doctor! But as a service to other patients, someone ought to say something!)

I find myself saying something about this all the time! Of course the responsibility for a successful visit to a doctor rests with all those involved. Each person should consider first what they themselves can do, rather than seeing any problem as caused by someone else. Some really useful ideas about this were covered when Jennifer talked to me: see http://atopicskindisease.com/articles/20111216 This might make a good topic for people reading this post to comment on here: I suggest your readers share their thoughts and experiences with you.

At some health centres and doctors surgeries there are patient discussion groups to allow people to share ideas on how things can be improved. Has anyone had experience of such a group? Does your doctor ever conduct a patient satisfaction survey?

Each person should consider first what they themselves can do, rather than seeing any problem as caused by someone else. 

Review of Habit Reversal

In The Combined Approach, follow-up visits include asking the patient or parent their (i) scratching frequency (ii) when there’s most scratching (iii) % of scratching from itch (iv) severity of eczema (v) % new eczema vs old and (vi) where most eczema.

If a parent cannot find a doctor or convince their current doctor to implement the Combined Approach, can the parents implement this on their own without a doctor doing the follow-up (i.e. monitoring scratching on their own)?

The questions that you detail are in the first stages of The Combined Approach, during the first 4 to 6 weeks when habit reversal is important. The later part of the programme we call follow-up, and then vigilance for acute flare-up is the important emphasis, with early and energetic treatment with topical treatment being the order of the day. Habit reversal is not important long term. It is optimal topical treatment that is essential to maintain the progress that The Combined Approach achieves.

How to use The Combined Approach depends on the resources available. The clinic-based format is very effective, but if it is not feasible a self-help format is a good alternative, as discussed at http://atopicskindisease.com

Hopefully blogs like this, and websites like www.AtopicSkinDisease.com will now gradually help everyone everywhere to discover how to treat atopic eczema successfully. There is no need now for anyone to necessarily Live With Eczema: there is now a possibility to learn how to Live Without Eczema.

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Last updated on 22 November, 2024 7:06 pm
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101 things that Mothers with Eczema Child do Differently

47 of the 101 things that Moms with Eczema Child do Differently – Ice Water for Baby

Ice water helps cool Marcie down and drinking like an adult keeps her happy

This is the 47th of my “101 Things that Moms with Eczema Child Do Differently“, a tongue-in-cheek look at the many unique situations that we face. For more cartoons, click here to view.

Read also: Giving my Eczema Baby Cold Water and Getting a Backlash

Read also: Does Taking Fluids Rehydrate your Child’s Skin?

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Doctor Q&A Other treatments

Combined Approach Series – Eliminate Habitual Scratching

Dr. Christopher Bridgett is Hon. Clinical Senior Lecturer Imperial College at Chelsea & Westminster Hospital London. He is a psychiatrist with a special interest of using behavioural interventions to help people with atopic eczema, co-author of The Combined Approach at AtopicSkinDisease.com

Habitual Scratching and Eczema with Dr Christopher Bridgett

Development of a Nervous Habit

I read in your manual ‘Atopic Skin Disease’ of how a nervous habit develops, namely:

1. Normal initial specific response to an injury (or itch)

2. Increased frequency by positive reinforcement that leads to

3. Behavior (or scratching) becomes automatic

4. The habit generalizes to cause more situations precipitating the behavior

5. Decreased personal and social awareness

Introduction of Replacement Habit

Also illustrated in your manual, another habit is introduced to reverse the scratching:

1. New habit is opposite to the old habit

2. Can be maintained for several minutes

3. Socially acceptable and compatible with normal activities

4. Strengthen muscles antagonistic to those of old habit

The techniques used in Noren and Melin, 1989 study mentioned in Atopic Skin Disease are:

1. Clenching fists and counting to 30 as an alternative to habit of scratching

2. Pinching the skin where it was itching as an alternative to itch-provoked scratching

Can you explain to our parents how to tell their child to clench fist and pinch skin? Is this something that can be understood by young children? And will pinching skin lead to the child using painful techniques to get rid of scratching? (I read in your manual not to say ‘Stop Scratching’, just as I’ve posted!)

The method of clenching a fist, then pinching the skin, is only suitable for older children, who are able to understand the instruction, and can accept responsibility for following the recommendations. The younger child requires a different approach which sees the parents as responsible for the treatment, with an adapted programme in between: see http://www.atopicskindisease.com/articles/20120115

So, no pinching small children please!

And yes – it is important to avoid saying “Stop Scratching” – you are quite right, of course!

Parents noting child is scratching
Parents noting child is scratching (picture credit atopicskindisease.com)

Register Scratching Frequency

In The Combined Approach, the first homework assignment to patients is to register the scratch frequency. This aids in the analysis of the scratching habit, following an ABC format of understanding the antecedents, behavior and consequences. Do you normally explain the ABC to patients before requesting them to register their scratching frequency? How can a parent help explain this to a young child? How can a parent help a child to count the scratching?

Dr Bridgett: The explanation of the ABC normally comes after registration, as part of the instruction of how habit reversal works. See the patient handbook for Older Children: http://atopicskindisease.com/categories/20110503_1

The younger child has a different treatment programme, without any counting of scratching: for the younger child it is the parents who are responsible. They can achieve awareness of the childs behaviour without using a counter.

See http://atopicskindisease.com/articles/Mark

MarcieMom: Thank you Dr Christopher Bridgett for explaining habit reversal that is part of The Combined Approach. In our next post, we will understand the three levels of treatment and conclude the series.

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Last updated on 20 November, 2024 9:05 pm
Categories
101 things that Mothers with Eczema Child do Differently

46 of the 101 things that Moms with Eczema Child do Differently – Busy Fingers

Which one is better than scratching? Moms with eczema child parent with compromises?!

This is the 46th of my “101 Things that Moms with Eczema Child Do Differently“, a tongue-in-cheek look at the many unique situations that we face. For more cartoons, click here to view.

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Doctor Q&A Other treatments

Combined Approach Series – Topical Treatment

Dr. Christopher Bridgett is Hon. Clinical Senior Lecturer Imperial College at Chelsea & Westminster Hospital London. He is a psychiatrist with a special interest of using behavioural interventions to help people with atopic eczema, co-author of The Combined Approach at AtopicSkinDisease.com

Habitual Scratching and Eczema with Dr Christopher Bridgett

Explaining Topical Treatment – Moisturizer

The Combined Approach includes topical treatment using emollient and steroid. Moisturizing is a HUGE part of topical treatment, as emollients both lubricate and moisturize. Dr Bridgett’s advice on moisturizing is Thinly, Gently, Quickly and Often. There are a few other points mentioned in the ‘Atopic Skin Disease’:

  1. Thinnest possible application without ‘rubbing it in’
  2. More on exposed areas such as the head, neck and hands
  3. Pump dispensers preferable to open tubs due to bacteria infection
  4. Applying topical steroid first, then emollient over both the skin and the steroid
  5. Cream preferred over lotion

Can you explain why thinnest possible application is preferable for emollient?

(I’d usually slather on my child as I find applying a thin layer leads to more rubbing to spread the emollient)

Also, can you explain why topical steroid first?

(I’d written on this here and it does generate some discussion!)

Can you explain why cream is preferable over lotion?

Dr Bridgett: Your three questions answered:

  • Thin applications of moisturizer allows heat to escape, but insulates against water loss.
  • If moisturizer is applied often enough, when the steroid is applied directly onto the eczema, it is applied to skin that has been recently moisturized. We get then the best results by putting moisturizer on over topical steroid, and moisturizing all the skin, not just that which has the eczema.
  • The thicker the moisturizer, the better the moisturizing effect. Also, often there are less additives in thicker moisturizers, as thicker moisturizers “keep” longer. There is less chance that a sensitivity reaction will occur with an ointment, compared with a cream. See http://atopicskindisease.com/articles/20110801

Explaining Topical Treatment – Steroid

It is stated in ‘Atopic Skin Disease’ manual that steroid cream work by inhibiting protein synthesis, secretion of products, cell division and migration of cells. The epidermis can benefit from reduced cell division, and the dermis from reduced cellular and lymphokine activity. Can you explain what this means, and

why it is important to continue steroid treatment after epidermis healing (‘2-stage in steroid effect’)?

Dr Bridgett: It seems the steroid anti-inflammatory effect is partly achieved by reducing over-activity in the skin, allowing natural healing then to lay down healthy skin again. By the time the seems good to look at, the healing is not complete through and through – there is more that is needed under the surface, so we recommend continuing with the topical steroid, beyond The Look Good Point: do not stop too soon. See http://atopicskindisease.com/articles/TT7

Many parents are very concerned with the skin-thinning side effects of steroid and also the ‘withdrawal’ symptoms once steroid treatment is discontinued. I read in your manual that side-effects are associated with inappropriate use of topical steroid and the risk is usually inadequate treatment (i.e. stopping steroid cream too early or using one of too low strength).

How do you normally convince parents that steroid cream is safe? And what guidelines would you give them to gauge if the steroid cream of correct potency, frequency and amount is used?

Dr Bridgett: Steroid side-effects come especially from using topical steroids long-term and in an unsupervised way. The method we use in The Combined Approach includes more supervision than is usually given, with a programme of several clinic visits, involving careful discussion of all anxieties and concerns. Using The Combined Approach, including therefore habit reversal, which allows natural healing alongside the good steroid effect. Then less topical steroid is used overall, for good effects, not side effects!

We offer information about the potency groups of the topical steroids, and how they are usually used. The thicker the skin, the stronger the topical steroid to be used. See http://atopicskindisease.com/categories/20110423_11

Each application of any cream needs to be sparingly applied – whether it is an emollient or a topical steroid: only a shine is required.

MarcieMom: Thank you Dr Christopher Bridgett for explaining the topical treatment that is part of The Combined Approach. In our next post, we will understand more on habit reversal techniques.

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101 things that Mothers with Eczema Child do Differently

45 of the 101 things that Moms with Eczema Child do Differently – STOP Scratching

I may not be shouting so loud, but I am SCREAMING inside..

This is the 45th of my “101 Things that Moms with Eczema Child Do Differently“, a tongue-in-cheek look at the many unique situations that we face. For more cartoons, click here to view.

Btw, here’s a post I’ve written ‘Saying (or Shouting!) Stop Scratching to Your Eczema Child‘; basically, doesn’t help..read and comment your experience!

 

Categories
Doctor Q&A Other treatments

Combined Approach Series – Habit Reversal

Dr. Christopher Bridgett is Hon. Clinical Senior Lecturer Imperial College at Chelsea & Westminster Hospital London. He is a psychiatrist with a special interest of using behavioural interventions to help people with atopic eczema, co-author of The Combined Approach at AtopicSkinDisease.com

Habitual Scratching and Eczema with Dr Christopher Bridgett

What is Combined Approach?

The Combined Approach is about using conventional topical treatment (steroids and moisturizers) together with the elimination of self-damaging behavior using habit reversal techniques. ‘Atopic Skin Disease’ was published in 1996 as there was much success using The Combined Approach, which was reported at the European Congresses on Dermatology and Psychiatry in 1991 and 1995.

Patient Improvised Distraction vs Combined Approach

MarcieMom: Dr Bridgett, can you briefly explain the difference between The Combined Approach versus an eczema patient using his/her own ways to divert attention from scratching?

Dr Bridgett: The Combined Approach is an exercise in behavioral medicine, and has two elements combined:

1. Optimized conventional treatment (emollients and topical steroids usually) : this is an important part of the approach, and cannot be overlooked!

2. Habit reversal: a formal behaviour modification technique: it requires, when offered to Adults and Older Children, first a period of registration using a hand tally counter – this is continued, as habit reversal is introduced. The inventiveness of the eczema patient is very useful in introducing new successful habit reversal behaviours, but some structure, discipline and supervision is linked to the success reported by many patients, and this requires reference to written material, and is often usefully supported by contact with others.

Also, if an eczema patient or parent of eczema child comes to know of your approach, can he/she simply pass your manual to a dermatologist that he/she is seeing?

The manual is available for anyone to consult and follow if they wish, and both nurse practitioners and medical practitioners are successfully using The Combined Approach. An important alternative is to use the self help format set out in the book The Eczema Solution by Sue Armstrong-Brown.

When is Habit Reversal Most Effective?

The main idea is that scratching can often become a habit – that is, the adult or child with eczema then scratches not only because of itch. It is mentioned that adults with severe eczema can benefit most from The Combined Approach. Why is this so?

Can you share with us pictures of before and after eczema and what was the habit that was eliminated that led to an improvement?

Dr Bridgett: Habit reversal is most effective

  • in combination with optimized conventional treatment, and
  • when there is evidence of chronic eczema – in adults or children – that is to say, the thickened skin called lichenification, which is due to regular rubbing and scratching that has become a habit, complicating atopic eczema. Any rubbing and scratching of the skin can become a habit, but each person can have their own particular problem. 

Habitual Picking during TV

In the first pictures below the patient was habitually picking the skin of her forehead when watching TV, resulting in chronic eczema. When habit reversal was added to optimized topical treatment the skin healed very quickly.

Before & After Pictures of Forehead, contributed by Dr B scratching habit associated with TV
Before & After Pics of Forehead, contributed by Dr B

In the next pictures, the patient had developed a habit of using the rivets on her jeans to scratch against:

Hand Eczema worsened by rubbing against jeans before habit reversal
Before The Combined Approach
Rubbing of hands against jeans rivets
Before The Combined Approach
After Hand Eczema
After The Combined Approach

Combined Habit Reversal with Topical Treatment

I note that The Combined Approach does start with understanding and explaining the importance of topical treatment, as eliminating scratching is not a stand-alone treatment. Would explaining the structure of the skin and how a weak skin barrier is prone to water loss be important in the first visit? If yes, could you do a quick introduction for our parents to understand?

Dr Bridgett: Yes, The Combined Approach always covers the importance of skin as a barrier, and the importance of optimal topical treatment.

The skin has two layers, epidermis and dermis. The outer epidermis, which carefully replaces itself every four weeks, is important in preventing water getting out from inside, and irritation and infection getting in from outside.

Acute eczema involves inflammation of the epidermis. It’s structure then becomes weakened, allowing excessive water to escape. Extra moisturizers are then needed to stop excessive water loss, and anti-inflammatory topical steroids are also needed. And that’s not the whole story: the inflammation releases itchy substances that cause scratching – and this scratching stimulates over-activity of the epidermal cells. If the emollients and topical steroids are used correctly the situation quickly returns to normal. If not, the scratching continues, becomes a habit and the damaged and sensitive skin of chronic eczema is the result.

For more on skin structure, acute and chronic eczema see http://atopicskindisease.com/articles/FF3

MarcieMom: Thank you Dr Christopher Bridgett for giving us an understanding of the Combined Approach and showed us some of the successful cases. In our next post, we will understand more on the use of moisturizers and steroids as explained in the manual ‘Atopic Skin Disease’.

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101 things that Mothers with Eczema Child do Differently

44 of the 101 things that Moms with Eczema Child do Differently – Zz on the Bus

With a scratchy night of poor intermittent sleep, it's no wonder Marcie's sleepy!

This is the 44th of my “101 Things that Moms with Eczema Child Do Differently“, a tongue-in-cheek look at the many unique situations that we face. For more cartoons, click here to view.

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Guest Interview

Bamboo Bubby – Sleeping Bag for a Good Night for Sensitive Skin

Bamboo Bubby interview with EczemaBlues Eczema children sleeping bag and clothing

Kelly Northey, owner of Australian company Bamboo Bubby, came to know of EczemaBlues.com and introduced MarcieMom to its Bamboo Bubby Bag – a sleeping bag that is made from a blend of cotton and bamboo with an Adjust-a-Sleeve design. It is created to reduce damage from scratching at night, so that the whole family can have a good night’s sleep.

Marcie Mom: Thank you Kelly for taking time for this interview. I’m happy to know you, a mom who has built a business from finding a solution to your son’s eczema. I read from your site that you have designed Bamboo Bubby Bag at a time when your son has outgrown sleepsuits with handcovers. This, I’m sure many parents, myself included, can relate. It’s indeed the toughest period because the child can’t be swaddled safely but can roll and scratch. Can you share a little about your background? For instance, did your healthcare industry background help or do you like sewing and why have you decided to make your own sleeping bag?

How Bamboo Bubby Started

Kelly: I think both of these things have helped in the conception of the Bamboo Bubby Bag. I work in the healthcare industry but with a focus on research and information technology roles, so when I noticed a real gap in the market here for a product to solve my baby’s problems, I definitely utilised my research skills when trying to find a solution to our problem and while I do have some sewing skills, I haven’t actually practiced them properly for a long time, so I am grateful for the assistance of my sister-in-law for her expertise when it came to sewing the first lot of prototype Bamboo Bubby Bags.

Bamboo Bubby for eczema kids

However deciding to launch my business as a predominantly online one has definitely been the best use of my previous skills in information technology systems and website design and I love everything about the world of online marketing and social media as a means of sharing information and helping each other and when I realised there was no other product quite like it on the market, I knew I had to get Bamboo Bubby Bags out there in the world to help as many others who are struggling with sleeplessness caused by eczema.

Bamboo for Anti-Bacterial

Marcie Mom: Your Bamboo Bubby Bag is made from 70% bamboo and 30% organic cotton interlock fabric. From your site, I understand the bamboo has anti-bacterial properties, not likely to irritate baby’s skin and able to expand when warm (for baby to be kept cool) and contract when cold (for additional warmth).

Do all bamboo have the same anti-bacterial properties and texture and which type of bamboo is used in your Bamboo Bubby Bag?

Kelly: Bamboo naturally contains anti-bacterial and bacteriostatic bio-agent called “Bamboo Kun”, which allows it to naturally flourish and grow in the wild without the use of pesticides or fertilizers. There have been some studies undertaken in whether or not this anti-bacterial benefit remains when bamboo is manufactured into fabric. The Japan Textile Inspection Association (JTIA) completed a study that claims that even after 50 industrial washes, bamboo sheets showed a 70% effectiveness of antibacterial properties.

The China Industrial Testing Center completed a similar study, where bamboo fabric was tested over a 24 hour incubation period with the bacterial strain Staphylococcus aureous. Their results showed after a 24 hour period, the 100% bamboo fabric showed a 99.8% kill rate. These reports suggest bamboo may be an ideal fabric to use on eczema skin which is often inflamed and even infected.

The bamboo fabric used by Bamboo Bubby has passed Oeko-Tex 100 Class 1 testing which means that it is free from harmful substances, manufactured to cause the least possible harm to the environment and safe to use for baby products.

Bamboo For Wicking Effect

MarcieMom: It is mentioned on your site that bamboo has the property to remove excessive moisture. Can you explain to us how this works? Also, why is the decision to have it 70% bamboo, in other words, is 70% proven to give the optimal properties – thermal regulating, anti-bacterial, softness, durability?

Kelly: The scientific term for the ability to remove excessive moisture is the capillary effect or wicking effect and research shows that of the five leading fabrics available on the market, bamboo has the highest capillary effect, absorbing more moisture and drawing it away from the body than other fabrics and also decreasing the level of abrasion and damage to sensitive skin.

When skin becomes sweaty, fabric used to cover it causes the level of abrasion to increase, which then worsens skin conditions like eczema and is especially harsh on the delicate skin of babies with eczema. This is why synthetic fabrics which do not let the skin ‘breathe’ are notoriously bad for eczema skin.

It is a fact that if a baby sweats under their clothing then the level of abrasion caused to the skin is almost doubled.


So therefore, Bamboo fabric is the softest and least abrasive fabric to delicate skin, due to its ability to pull moisture away from the body. When compared to other ‘breathable’ fabrics such as cotton and viscose rayon, bamboo is superior due to the spaces between the individual fabric fibres, allowing greater moisture absorption while at the same time allowing more air ventilation through the fabric.

Deciding upon the best type of bamboo fabric to manufacture the Bamboo Bubby Bags from was difficult. 100% bamboo fabrics are beautifully soft and silky, but this softness also seemed to wear quicker and for a sleeping bag that will last throughout a baby’s entire first 2 or more years we needed an element of durability to the fabric. So a 70% bamboo/30% organic cotton mix interlock fabric was the best option. Still plenty of softness, but with added strength of organic cotton to help maintain its shape and be able to outlast a baby’s first couple of years.

Adjust Sleeve Design

Marcie Mom: Your Bamboo Bubby Bag has unique design features, such as Adjust-a-Sleeve design and double-ended zipper. Apart from allowing the baby to use up till 2 year-old, it can also help to make night changes easier. Given that the design is meant for the sleeping bag to ‘grow’ with the baby, how many machine washes can it withstand? Can it be washed in 600C cycle to remove dust mites?

Kelly: Bamboo fabrics will maintain their special qualities when washed in cold to warm water (up to 60 degrees Celsius) on a gentle-normal cycle with a gentle detergent, free of bleach. Line dying is best, however when necessary they can also be dried in clothes dryer on the cool setting. I have Bamboo Bubby Bags here that have been washed regularly like this for more than 18 months now!

Bamboo Bubby Sleeve Eczema Kids

Selecting Bamboo Fabric

Marcie Mom: One last question – for parents who want to try out bamboo clothing or sleeping bags, what would you recommend them to look out for before making the purchase? For instance, the source of bamboo or any certification?

Kelly:  Yes, definitely check that any bamboo fabric products you purchase meet the Oeko-Tex 100 Class 1 testing standard which means that it is free from harmful substances, manufactured to cause the least possible harm to the environment and safe to use for baby products.

And we always to recommend following the SIDS & Kids Safe Sleeping Guidelines to ensure your baby sleeps safely. Recommendations from these are that baby sleeping bags have a fitted neckline, armholes and sleeves and no hoods. Baby sleeping bags also help to encourage babies to sleep on their backs. And when sleeping babies with their feet to the foot of the cot (as recommended in the guidelines), you can also tuck excess fabric from one size sleeping bags into the end of the cot mattress just like you would a sheet or blanket.

Eczema Kid, Family, Business

MarcieMom: On a personal note, how did you juggle your business, family and childcare?

Kelly: We had to change a lot of things about our working life to make it more flexible and to suit our particular family needs. We have both in the past year changed jobs and I’m now more easily able to also juggle the Bamboo Bubby business I have built steadily over this time as well alongside everything else.

I am now quite proud of the fact that I started the entire Bamboo Bubby business as a way to give my mind something positive to focus on in the few hours every evening when we would anxiously await the next midnight wake up, knowing that our baby just never really slept until after this time. I hope it can now help others and give them also a place of support during a really distressing time.

On hindsight now too, I’m also very glad that my now toddler has had such great experiences at childcare. It has been great for him in every possible way and he’s made some wonderful little friends. Much as I have struggled with the ‘return to work juggle’, I would say to anyone who is contemplating childcare that just because your child may have some special needs, if you feel in your gut that the place is right and that they can look after your child according to management plans then the benefits for your child overall do outweigh any of the mummy-guilt that we naturally place on ourselves!

Marcie Mom: Thank you Kelly so much for answering my questions. It’s great to see your business flourishing and being awarded to be part of the Young Australian Entrepreneur scheme. p.s. to readers of eczemablues.com, I didn’t receive any money from Bamboo Bubby or Kelly for this interview.

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Last updated on 22 November, 2024 4:13 pm
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Guest Interview

Friday Q&A with Sue Atkins – Discipline for Eczema Children

Parenting and Discipline for Eczema Children with expert Sue Atkins

Sue Atkins is The Parenting Expert , author of the best-selling book ‘Parenting Made Easy – How to Raise Happy Children’ and also regularly appears on ITV’s This Morning, Sky news & The BBC.

This was originally a Friday Q&A for 5 weeks which is now combined into one informative post. As parenting children with eczema brings unique challenges, such as scratching (till bloody) when being disciplined, MarcieMom invited Sue to help with some thorny parenting issues that parents may face with their eczema kids.

Do you still carry on with discipline if your eczema child starts to scratch?

When it comes to discipline, many moms feedback that once they try to do so, their toddlers will start scratching (I’ve even drawn a cartoon on tantrum scratching!). Then, we are faced with the decision – do we continue to follow through our intended discipline method or do we stop and persuade our child to stop scratching. What would be your advice on this and is there a particular discipline method that you’ve seen worked better for children with eczema?

Also, when children with eczema throw tantrums, they tend to scratch too! Given how fast blood can easily come from the already defective skin barrier, it’s difficult to leave our child alone to ‘finish’ throwing tantrum. How do you recommend parents to deal with this?

Sue Atkins: I do think that children with eczema have a tough time.  Of course having an itchy skin makes your little one irritable  However I am not sure which comes first the irritability, where they are crying and getting themselves hot and bothered which makes the eczema worse, or the eczema being extra itchy and making them irritable.

I always say that the toddler years are a bit like taming jelly – all wobbles and no rules, for all parents as all toddlers are striving for independence, which can lead to frustration and tantrums and tears but add in guilt from the parent, and you have a difficult mixture. But I think  knowing WHY you are being firm, fair and consistent also helps as your child will feel more secure, relaxed and safe which will also have a bearing on their eczema as they will be more at ease. 

Toddler years are a bit like taming jelly

I work with many parents who feel a tremendous sense of guilt around their child’s eczema and over compensate by giving in to their children’s tantrums and demands but really you are setting yourself up for a short term gain but a long term nightmare. Children, of all ages benefit from firm, fair, consistent boundaries. I also teach the parents I work with to “tap” out their feelings of guilt using the latest cutting edge Emotional Freedom Technique.

MarcieMom: Thank you Sue for sharing your advice; I’ve to check myself that I’m not over-compensating but some days, parenting an eczema child can be stressful!

Parenting Made Easy

MarcieMom: I read your interview with Reading Kingdom with interest – your 5 tips to raise happy children are (i) play with them, (ii) teach them to be organized, (iii) don’t shout, (iv) keep your patience and (v) respect each other’s privacy, possessions and personal space. My guess is in eczema families, not shouting and keeping patience would be more difficult. We sometimes end up shouting ‘Not Scratching!’ (which isn’t the best way to stop the scratching!) or lose patience with each other as both of us are tired and having to keep an eye (and an arm) out for scratching is really energy consuming!

Do you have any tips for stressed out parents to (miraculously) relax while parenting our child with eczema?

Sue Atkins: My Pause Button Technique is a really simple way to empower all parents no matter what situation they find themselves in, as it allows you to press your imaginary pause button, freeze time and consider the consequences of the actions you are about to take, before making a more informed, better choice.

My Pause Button Technique http://sueatkinsparentingcoach.com/my-pause-button-technique/

MarcieMom: Thanks Sue, I’ve visited your article and the idea is to pause and ask ourselves questions such as:

  1. Now ask yourself: What do I want to happen next?
  2. Is what I am going to say bring me closer to or further away from my child in the long run?
  3. What do I need to say or do to bring this situation under my control?

This Pause Button Technique is in your Parenting Made Easy CDs.

Punishing Fingers

Sucking fingers or putting items into the mouth is obviously not hygienic. In particular, hand food mouth disease (HFMD) which Marcie has got twice, is at epidemic level in Singapore. Most parents urge me to STOP this bad habit, by either slapping my toddler’s hand, slapping her mouth, implementing naughty corner or even putting chilli on her fingers! I haven’t implemented any of these and frankly, sometimes I’m glad she’s doing something with her fingers instead of scratching!

How would you recommend a parent to get the toddler to stop this unhygienic habit? And is this something you think warrant ‘punishment’ or ‘discipline’?

Sue Atkins: We are our children’s first role model and of course we all love our children so my views on smacking are well known on British Television as I ask parents to ponder what sort of message they are sending to their children if they hit them I wonder…..?   ……that’s OK to get physical when you feel annoyed, frustrated or angry? And because you are a role model in everything that you do…. guess what your kids will do when they get annoyed, frustrated or angry……. lash out too.

https://youtu.be/JwdJapH9Pe8

I know lots of parents feel a little “tap” never hurt them …… but times change, we evolve and a little smack can escalate……. I think a mum who came on one of my workshops put it really well when she said, “I didn’t smack my 13 year old son, but I did smack my 10 year old daughter because she was so strong willed. One day when I smacked her, she said, “That didn’t hurt!” I knew then that I mustn’t smack her again because of what might happen.” Read more at ‘Is it Ok to smack your child?‘

Clearly it’s very important to prevent the spread of the virus so

  1. Wash your hands frequently and properly with soap and running water, especially after changing nappies/diapers and after using the toilet.
  2. Teach your child good hygiene and to wash their hands frequently using soap substitutes after having their nappy changed or after using the toilet or playing outside or sharing eating and drinking utensils.

I encourage all the parents that have toddlers to use my Easy Button Technique where your toddler gets rewarded for the positive behaviour you do want to see more of by running over and pressing their Easy Button – as this using positive psychology instead of negative association which lots of fun and brilliant for your child’s self esteem.

Co-Sleeping & How to Wean your Child off it

Many moms who have children with eczema do co-sleep part of the night with their baby or toddler. I co-sleep with Marcie but aware that there’re pros and cons; related to eczema, co-sleeping may help the parent to check on the child’s scratching at night but also possible to increase dead skin cells and overheat (both dust mites and heat can trigger eczema flares). What I commonly hear from other moms (without eczema children) is that babies should be taught independence from young and sleep in their own cots. There is of course little couple time with a toddler in our bed and we’ve tried to wean her off co-sleeping so many times, but once we’re on holiday and sleep together, or if she had chickenpox/ HFMD and her skin was really affected, we would switch back to co-sleeping.

Is there any technique to get a child to sleep on her own?

Sue Atkins: It helps to think about the message you are sending to you child if you co sleep indefinitely – so this issue is usually around the clarity and confidence of the parent when they decide to change the co sleeping habit. Here is an article I wrote when I was coaching a mum on my ITV Parenting Power slot on “This Morning”

The simple secret is routine and consistency and not giving in too soon! Think long term and keep the bigger picture of success in your mind at all time and don’t send out mixed messages.

TV for Scratching Distraction?

We know the American Academy of Pediatrics does not recommend TV before the age of two. I’ve tried my best to limit TV to Barney, Signing Time (which distracted her from scratching when she was a baby!) and 2 to 3 other kids’ DVDs series. I wouldn’t let her watch TV or iPad if I can help it, but it really gives me some breathing time when she’s entertained by TV and forgets about her itchiness.

The strange thing is that my friends who let their toddler watch cable TV such as BabyTV, Disney or Nick Junior, actually swear by these cable programs improving their toddler’s language skills. The even stranger observation is that their children indeed can talk much better than mine!

What age to let baby/toddler watch TV, what kind of programs are preferred and whether cable TV with lots of programs are indeed better than selected DVD series or no TV at all?

Sue Atkins: I am not a fan of tooooo much –  TV The “electric babysitter!”

  • What is a reasonable, balanced amount of time for you?
  • What programmes and games are suitable for your children?
  • What boundaries do you set for your kids and are they flexible as they get older?
  • What’s your gut reaction and instinct to this whole topic?
  • What do you do if you and your partner disagree?
  • Are you able to stand firm and say “no” to your kids…. if not why not?

Just spend a few minutes making up your mind, setting your limits that feel right for you and doing your kids a great service by standing by your limits, consistently – no matter what!

MarcieMom: Thanks Sue for the post above; I’ve also read the Daily Mail article mentioned in your post and it’s mentioned that ‘Researchers in France found that watching television impacted on the development of children under three‘, leading to delayed language learning, encouraged passivity, reduced concentration, increased agitation and caused sleep disorders. TV channel in France has been banned from promoting educational benefits on shows aimed at under 3 year old and largely seen as a move against foreign baby channels such as BabyFirstTV and BabyTV.

Thanks again Sue, for joining with me for July’s Friday Q&A.

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Last updated on 22 November, 2024 9:05 pm
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101 things that Mothers with Eczema Child do Differently

43 of the 101 things that Moms with Eczema Child do Differently – Shopping Perks

One more reason why I love shopping malls! Do you have a similar painting station in yours?

This is the 43rd of my “101 Things that Moms with Eczema Child Do Differently“, a tongue-in-cheek look at the many unique situations that we face. For more cartoons, click here to view.

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Support Group

Eczema Forum Notes – Good Overview on Child Eczema

Last Saturday’s Eczema Forum in Singapore presents a good overview on child eczema, explaining the various causes, factors and treatment options. It was well attended by over 100 people, and I’m amazed half of which looked like grandparents who were wanting to find out more information for their grandchildren (how proactive they are)! The other half were parents with eczema children and what I’m even more puzzled is how everyone except me and another family managed to find alternative childcare during the talk! Marcie was the only (sometimes noisy) toddler in the room!

So here are my notes for those who wanted to attend but missed it!

By Dr Mark Koh, Dermatologist at Changi General Hospital – Why Does my Child get eczema?

Emphasis was on eczema being a chronic condition, without a cure but possible to control.

Common skin condition – affecting 20% school-going kids with no gender bias

Common eczema areas – Flexural areas – behind knees, elbows and for the older patients, ankles (with lichenification), around the mouth for infants with saliva, face, hands

Appearance of eczema skin – pictures were shared, generally, red, patchy, inflamed (a point was mentioned about eczema skin being unable to tan, thus more likely to look whitish), read this post to learn more on eczema skin color.

Eczema Causes – Multi-factorial, genetic factors, environmental factors

1.  Defective skin barrier that is more susceptible to water loss and unable to form an effective natural barrier and  lacking in filaggrin, lipids and proteases (read post on cause-skin barrier) – point was made that no oral medication can improve skin barrier, but moisturizing remains as effective treatment. Best moisturizer? One that the child will use, can be used frequently and affordable, brands such as QV and Physiogel were mentioned. (Side note: Two parents feedback that Seba-med didn’t work for their child)

2. Inflammatory cells – Immune system incorrectly attacking the skin, triggered by allergens and leading to production of chemicals that trigger itch (read post on cause-auto-immunity). This can be treated by steroid cream in most cases. Relevant posts on steroid:

Is Steroid Cream Safe? (shows table with various steroid potency)

Are you Suffering from Steroid-Phobia? (a table was shared on what’s a safe amount to use, and on the face and neck, up to 10g is safe on a child in 10-day period, twice application. Striae (stretchmarks), skin thinning, elangiectasia, hair growth are some side-effects of steroid but generally reversible)

Friday Dr Q&A with Prof Hugo – Steroid Cream

3. Hygiene Hypothesis – Body is prepared as a defense against bacteria but with increased use of soap, anti-bacterial wash, the body mistook skin to attack (read more in post on cause-auto-immunity).

4. Environmental Factors – Weather changes (individual will react differently in different weather), Sweat (irritant), strong soaps and chemicals (Dettol and Johnson & Johnson baby were mentioned), House Dust Mites (that can be trapped in carpets, pets, stuff toys), Insect bites

Read these relevant posts:

What Triggers Itch?

What and How Much Detergent to Use?

How to Shower your Child? (mentioned that can bathe twice a day in cool/lukewarm water, soak in bath oil for 15 minutes, can choose one with antiseptic if not open to bleach bath. Water loss after shower is high, so be sure to moisturize immediately after. Bath oil can help maintain moisture better than soap.)

Should you be worried about House Dust Mites?

Top 10 Cooling Places to go with your child in Singapore 

Swimming recommendation – Not longer than an hour, not from 10am to 4pm, 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 % of bacteria, amount of chlorine used.

Relevant posts:

Do not drink pool water!

Swimming Q&A with Doctor Bridgett

Block Sun, Irritate Child’s Skin?

Other Triggers for Eczema – Eczema flares can also be caused by staph bacteria (read post on cause-staph bacteria), virus (including herpes simplex virus, read post on eczema herpeticum) and fungus. Stress (read interview with Dr Bridgett on stress, read post One more reason not to stress your child). Allergy (read post on cause-allergy where you’ll see the table of common allergens for infant, pre-schoolers and older children), food is mentioned as unlikely to play a major role in eczema and a skin prick test can be performed to check on common allergens.

Posts on Allergy tests:

Friday Dr Q&A with Dr Liew on Allergy Tests

Friday Dr Q&A with Dr Liew on Elimination Diet and Allergy Tests 

Friday Dr Q&A with Prof Hugo on Skin Prick Test

Taking the Fear out of Skin Prick Test

Is your child wrongly avoiding a tested-positive food in skin prick test?

To control eczema well, will allow the child to break the itch-scratch cycle; read this post on ‘Why Scratching Feels so Good but is so Bad for your child‘.

The second talk was by by Dr Ang Seng Bin, KKH ‘How do I manage my child’s eczema?’

The contents were somewhat similar to Dr Mark Koh’s talk, so I’d just focus on the more interesting points:

Eczema statistics: 25% get from 0-1 year old, 22.7% by 7 year old and 17.9% by 12 year old, thus there’s a likelihood of ‘outgrowing’ the eczema

Costs of Eczema: Financial costs – direct cost of consultation, treatment, moisturizers and indirect cost of taking leave; Stress – in family of severe eczema is higher than that with children of type1 Diabetes (read popular post – 10 reasons why parents with eczema child have a tougher time)

Characteristics of Eczema Skin – Some interesting points mentioned:

1. Unable to regulate temperature effectively, sometimes feeling too cold in air-con while feeling too hot in the sun.

2. Sensitive to Fever, eczema flares during fever with rashes resembling punched-out ulcers. See post on eczema herpeticum, generally if eczema get worse rapidly, with fever, lethargy and distress, should see doctor rather than continue to self-medicate/treatment. Antibiotics may be prescribed by doctor and can treat inflammation and thus, also reduces inflamed skin.

3. More susceptible to conditions such as viral wart and Molluscum

4. Some contact allergens include (from most common to least) nickel, thimersol, colophony and lanolin.

Treatment

In all cases, moisturizing is a must. Mild cases require mild potency steroid, and increasing potency for more severe cases but always under doctor’s prescription. Wet wraps and calcineurin inhibitors (which are immune moderators) can be used for moderates cases. Read this interview ’Easy to Use Wet Wrapping to Keep Child’s Skin Hydrated‘ on using Tubifast Garments for wet wraps. Azathioprine, cyclosporine and UV light therapy (for adults) may be prescribed in more severe cases.

More on moisturizing:

1. Moisturizing can reduce amount of steroid used and reduce frequency of eczema flares.

2. It may have some preventive measure, as an unpublished study that tracked 75 newborn being moisturized from birth showed none of them had eczema.

3. Moisturizing is to be used both during eczema flares and when there aren’t any, for the maintenance of the skin barrier.

So What Moisturizer?

Let’s cover the NOs – Fragrance, color, soap, protein, Seba-med mentioned by parents to worsen the skin and a patient was sensitized to aloe vera and started being allergic to it, Aqueous cream contain sodium lauryl sulphate that is an allergen. Nothing that the child will complain painful, itchy or sticky after application. For more posts on moisturizers:

Sensitive Skin Product Series – What Ingredients to Avoid?  

Sensitive Skin Product Series – Understanding Ingredients and Patch Test

How Much Moisturizing is Enough?

Help! What Moisturizer to Use on our Eczema Baby?

Managing the Scratching 

Various tips – Delay the scratching, Distract the child, Drink cool water seems to help some kids (read this post – Giving my Eczema Baby Cold Water), De-Stress and Divine intervention (meaning using religion, Marcie and I do pray every night using the prayer hand from church where each finger represents a category of people. So we pray for eczema babies often!) Not to say (or shout) stop scratching! to your child, read my post here.

Q&A Time

There were many questions and I do feel like declaring, ‘Read my ECZEMABLUES.COM for answers‘ as really all of the questions have been tackled in my blog. And if you haven’t realized, there’s a tag cloud on the bottom of right sidebar where you can choose the topics you want to find out more about.

Some Q&As below, others are collated with doctors’ talks summary above.

1. Can Moisturizer and steroid creams be kept in fridge? Yes, no issue with that if child likes it cooling. Also mentioned that steroid should be applied before moisturizer and if can be done at the same time. Moreover, inflammatory skin cells tend to be more widespread than the visible eczema patch, so not an issue to have steroid spread more than the original application area when moisturizing.

2. For scalp eczema, can try anti-inflammatory shampoo such as Coal Tar or SebiTar. Read this Dr Q&A with Dr Bridgett on cradle cap shampoo.

3. Is probiotics helpful? Answer was generally no effect, but can try if start taking pre-natal up to child is few months old. May delay eczema. Refer to posts:

Do you or your child take probiotics? Is it what you ate during pregnancy?

4. Is omega 3/6 helpful? Answer was no conclusive research. Read my posts on Kids’ Nutrition which I’m working with Toby Amidor, a registered dietitian. You’ll find links on antioxidants, fish, fluids and inflammatory foods to avoid.

5. What to do when air-con dry skin? Read this post on Keeping Cool with Air-Con and Moist with Humidifier.

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101 things that Mothers with Eczema Child do Differently

42 of the 101 things that Moms with Eczema Child do Differently – Identifying Talents

Who thinks likewise?

This is the 42nd of my “101 Things that Moms with Eczema Child Do Differently“, a tongue-in-cheek look at the many unique situations that we face. For more cartoons, click here to view.

Categories
Support Group

Asthma and Allergy Awareness Day in Singapore 27 May (Sun) 830-1130am

There’s another exciting event for Singapore parents! Dr Liew Woei Kang, who is my current Doctor in Friday Q&A who also heads the Asthma and Allergy Association has just informed me of the Asthma and Allergy Awareness Day, see details below!

Date/Time: 27 May Sunday 8.30-11.30am

Venue: Hortpark, Multipurpose Hall and HortLawn, near Alexandra Road at 33 Hyderabad Road

Events: Leisure park walk with fun family events, such as bouncy castle, face painting, balloon sculptors and epipen training stall

Topics: Living with Childhood Asthma by Dr Ho Ling, KKH; Myths about living with Asthma by Dr Augustine Tee, CGH

For more details and the map, see pdf