Guest Interview

Gladskin Eczema Cream that Targets just the Staph Bacteria – The Top Questions that Parents Ask when Choosing Moisturizer for their Child

In the previous post, we learnt that Gladskin’s eczema skincare products contain Micreobalance™ – a patented smart protein that that actively rebalances the good and bad bacteria that naturally live on eczema-prone skin. This leaves the good bacteria on your child’s skin intact. In this post, we want to ask the questions that will help you to decide whether to choose Gladskin.

This is a 2-week series focused on Gladskin’s targeted approach in improving eczema skin, through maintaining a healthy skin microbiome. I’m honored to have the President of Gladskin USA, Skyler Stein, to help in this series. Read his bio here.

Interview with Skyler Stein of Gladskin USA

Choosing a Skincare Product – What else other than Killing Bacteria

We know that there are certain problems causing bacteria that are major culprits in eczema, and therefore, Gladskin’s targeted approach to rebalancing the skin microbiome as it moisturizes offers a logical solution that can be used daily.

By contrast, you are less likely to use antimicrobial cleansers daily because you do not want to remove the good bacteria on a daily basis. However, you may have a lot more considerations other than killing bacteria in your skincare product choice, so let’s check with Gladskin’s Skyler Stein on how they decide what goes into their Eczema Cream.

Gladskin Eczema Cream National Eczema Accepted
Picture credit:

Hypoallergenicity – What it Means to Gladskin

Hypoallergenic is a term that is not regulated, and taken to mean that it is less likely to create an allergic reaction.

MarcieMom: Can you explain what hypoallergenic means to Gladskin – for instance, do you see it as the exclusion of certain ingredients or maintaining a limit for potential irritants?

Skyler Stein: We perform extensive clinical safety testing on our products. For the Gladskin Eczema Cream we performed Repeated Patch Insult Test, 21 Day Cumulative Irritation Testing, and a phototoxicity safety panel on the formulation. In addition, we formulate our product to be free of ingredients that are commonly irritating to eczema-prone skin, including steroids, preservatives, fragrances, drying alcohols, sulfates etc

Hypoallergenic Eczema Cream from Gladskin
Picture credit:

Interaction of Skincare Products – What Happens when You Use More than One Eczema Cream

MarcieMom: I read on your FAQ page that ingredients in other skincare products may reduce the efficacy of Gladskin. I am assuming that this has to do with Micreobalance. However, parents may be applying mild corticosteroids on eczema lesions, how would that affect Gladskin? How would you recommend applying steroid cream with Gladskin, for instance, is there an interval to wait before steroids can be applied or should parents apply steroid cream first?

Skyler Stein: Yes, you are correct. The Gladskin formulation is designed to maximize the efficacy of the Micreobalance. It is possible that ingredients in other products may inactivate the Micreobalance. Gladskin can be used in combination with other treatments (i.e. corticosteroids), however, we recommend waiting 5-10 minutes after applying Gladskin to apply any other product so that the Micreobalance has time to work.

MarcieMom: Personally, when a certain cream is expensive and cannot be generously applied on the whole of my child’s body, I may use it as a first layer cream over the skin areas more affected by eczema, followed by a cheaper moisturizer over her whole body. But as I want to reduce the time taken for this routine, I would usually apply the creams consecutively. How would that affect Gladskin? Is there a list of skincare ingredients to be avoided when using Gladskin?

Skyler Stein: We do not have an exhaustive list of ingredients that should be avoided while using Gladskin and it can be the combination of different products that may inactivate the endolysin. This is why we recommend waiting 5-10 minutes before applying any other products. If possible we recommend avoiding preservatives and other ingredients that may have a negative effect on the skin microbiome. 

We recommend waiting 5-10 minutes before applying any other products. 

Skyler Stein: Gladskin can withstand temperatures of over 100ºF for a week, and 3 months at room temperature. If you plan to keep Gladskin longer than 3 months we recommend storing it in the refrigerator.  It’s safe to take with you to the park on a hot summer day, but we don’t recommend keeping it in a hot car for months. 

Thank you Skyler for letting us have an insight into how you choose the ingredients that go into Gladskin Eczema Cream and how to use it for maximum effect. It is certainly a novel approach for people with eczema. Gladskin users are seeing really amazing results, often within the first few days of using it. You can read current customers stories at

Sponsored Post by Gladskin

Guest Interview

The Invisible Bacteria Working Against Your Eczema Skin – How Can You Help your Child Defeat this Invisible Enemy?

Do you feel like you have tried everything to help your child manage his eczema but your efforts seem to be futile? Turn your attention to the skin microbiome, in particular, staphylococcus aureus (staph bacteria).

This is a 2-week series focused on Gladskin’s targeted approach in improving eczema skin, through maintaining a healthy skin microbiome. I’m honored to have the President of Gladskin USA, Skyler Stein, to help in this series. Read his bio here.

Interview with Skyler Stein of Gladskin USA

We were alerted early that staph bacteria is a harmful bacterium that colonizes eczema skin, that makes the eczema treatment less effective. Since my daughter was seven months old, she started chlorhexidine wipes and swimming. Now at ten years old, she is still using an anti-microbial cleanser.

An Enemy that is Hidden in Plain Sight & Cannot be Killed

Yet, when my daughter recently had skin swap tests on an infected persistent eczema rash, she was tested positive for staph bacteria. This was even with the thrice weekly anti-microbial skin wash. I was shocked that with all that regular anti-microbial cleansing (which I already feared may be a bit too much), the staph bacteria were still proliferating. It almost felt like we were battling with a hidden in plain sight enemy that cannot be killed!

Gladskin’s Targeted Approach – Taking out the Bad Bacteria, without taking down the Good Bacteria

The prevalence and proliferation of staph bacteria on eczema skin is a tricky situation. You have to remove the staph bacteria but doing so through bleach bath, swimming (chlorine) or anti-microbial wash would mean killing the good bacteria on the skin as well. And very often, these methods may be drying for the skin.

Gladskin has developed a patented smart protein Micreobalance which rebalances the skin microbiome in a very targeted way. while protecting the good bacteria on the skin.

How Gladskin's targeted approach removes the staph bacteria (represented by the spiked circles) and restores healthy skin balance
How Gladskin’s targeted approach removes the staph bacteria (represented by the spiked circles) and restores healthy skin balance

A Step Back: What is the Big Deal with Skin Bacteria?

Our skin is home to millions of microbes, and there are both beneficial and harmful bacteria. The harmful bacteria causes inflammation and infection – of concern for eczema patients is staph bacteria, which worsens eczema. For instance, staph bacteria1:

  • Reduces the biodiversity of skin microbiome, which would also reduce beneficial bacteria and upset the skin’s healthy microbiome
  • Produces byproducts that causes inflammation
  • Severity of eczema correlates with increased staph bacteria

MarcieMom: I really like the targeted approach for Gladskin product because it makes perfect sense! The main benefit versus anti-microbial products would be not killing the beneficial bacteria. Can you give us an idea of how long it takes for the good bacteria to ‘grow’ back on our skin?

Skyler Stein: Yes, the targeted approach with Gladskin is what makes it truly a new category of treatment for people with eczema. 

The answer to this question about how long it takes for good bacteria to grow is complicated as there are thousands of different types of “good” bacteria, and different types of bacteria take different amounts of time to grow. The most important thing to realize is that if you kill the good bacteria, it creates an environment more favorable for the bad bacteria to thrive – so it’s really important to maintain a healthy skin microbiome for long term skin health.

MarcieMom: I’m thinking about the ‘practical’ logic behind using Gladskin. For instance, if I were to use an anti-microbial wash daily on my child to kill staph bacteria, would it be difficult for the good bacteria to build up on her skin?

Skyler Stein: Yes, if you use a broad spectrum antimicrobial on the skin, it will kill both the good and bad bacteria. In a healthy rainforest with lots of biodiversity, the ‘good’ plants naturally keep invasive weeds from growing out of control. If you burn down the rainforest, killing all the biodiversity, it is much more likely for invasive weeds to grow out of control. It works the same way on your skin, if you kill the good bacteria, it creates an environment that allows the bad bacteria to take over!

MarcieMom: Can you explain how daily washing of beneficial bacteria may hurt the child’s skin?

Skyler Stein: The beneficial bacteria on the skin are like little chemical factories that produce lipids, vitamins, nutrients, etc. that are essential for healthy skin, AND they keep the bad bacteria in check. If you kill the good bacteria, the skin will miss out on the essential ingredients produced by those bacteria that are needed for healthy skin, and creates an opportunity for the bad bacteria to grow out of control.

If you kill the good bacteria, the skin will miss out on the essential ingredients produced by those bacteria that are needed for healthy skin, and creates an opportunity for the bad bacteria to grow out of control.

Spotlight on the Active Ingredient – Micreobalance

MarcieMom: I read on your FAQ page that the ideal temperature for storage is below 75 ºF. Is this going to affect whether you sell the products in tropical countries, or affect storage during the hot summer months? Would you discourage parents from bringing your cream out to the park on a hot day?

Skyler Stein: Gladskin can withstand temperatures of over 100ºF for a week, and 3 months at room temperature. If you plan to keep Gladskin longer than 3 months we recommend storing it in the refrigerator.  It’s safe to take with you to the park on a hot summer day, but we don’t recommend keeping it in a hot car for months. 

Thank you Skyler for giving us a broad understanding of the beneficial and harmful bacteria on eczema skin and why it’s so important to keep a healthy balance of bacteria for healthy skin. You can learn more about Gladskin’s science and read reviews from current Gladskin users at Continue to next week’s interview with Skyler. 

Sponsored Post by Gladskin


  1. The bacterial culprit that drives atopic dermatitis.
Guest Interview

Impact of Lactic Acid Bacteria (LAB) Fermented Extract on Skin and Eczema (#Biogenics16 series)

Last week, we learnt much about LAB Fermented Extract (Biogenics 16) and its effects on a child’s intestinal health, as well as the dosage and safety of Biogenics 16. This 2nd part of the series will focus on clinical studies on LAB Fermented Extract’s effect on skin and eczema, specifically examining the two published studies conducted by Japan researchers. It is seen in various studies the preventive effect of probiotics on onset of eczema and today’s sponsored post focus will be on lactic acid bacteria (LAB) fermented extract and its efficacy on skin.

As always, I appreciate that the marketing team at Lifestream Group has gone the extra mile to provide the case studies below and also to have the manufacturer and its team of medical professionals answer questions on Biogenics 16.

Studies on Biogenics Probiotic extract kids health and skin

The study of the effect of LAB Fermented Extract on atopic dermatitis was conducted by Dr Shigehiro Tsuchiya of Tsuchiya Hospital, Japan.

Patients: 2 children (boys), age 7 and 9

Skin condition: Reactive skin conditions characterized by generalized rashes with itch; treatment received had included oral and topic administration of 10cc per day of LAB Fermented Extract.

Duration of study: 2 months

Finding: Rashes improved gradually over two months and no longer visible, with decreasing IgE levels. No relapse of rash was seen within the next 12 months.

MarcieMom: I understand that the study was a case study, instead of a double-blind placebo controlled study. Whenever it comes to atopic dermatitis, it is difficult to control all variables due to eczema being a multi-factorial condition. To give some background to readers, many of whom are parents of eczema children, is there information on:

(a) How long did the two boys have eczema and did they have any confirmed allergies?

Both boys have been identified with eczema years prior to the study.

(b) Did the two boys continue with their corticosteroid topical or oral application during the two months of taking LAB?

They did not continue with any oral forms of medication, except for a topical corticosteroid during the test period. The test results were measured according to IgE level which has more relevance to consumption of LAB Fermented Extract. Test results indicate a significant improvement after using LAB Fermented Extract.

Study image Probiotics Fermented Extract
Image from the study provided by Lifestream Group

(c) Were there any other eczema therapeutics that were given to the two boys during the two months? (for instance, bleach bath therapy, wet wrap therapy)

No other eczema therapeutics was given to the 2 boys during the test period of 2 months. Results observed were based on the beneficial effects of LAB Fermented Extract (Biogenics 16).

MarcieMom: More research is showing the link between our gut flora and our skin flora. Similar to the intestinal gut, our skin has both good and bad bacteria. In an interview with former president of American Academy of Dermatology, readers have learnt that our skin has beneficial bacteria, e.g. staphylococcus epidermidis and bad bacteria such as S. aureus and S. pyogenes. Of interest to eczema sufferers is staphylococcus aureus which frequently colonizes eczema skin, making it difficult for eczema to recover while increasing skin inflammation.

I’d like to understand the mechanism of how LAB Fermented Extract improves eczema, does it

(a) Impact the skin flora by encouraging growth of beneficial bacteria on the skin, or

There have been studies showing the effectiveness of topical probiotics in inhibiting the growth of bad bacteria, virus and yeast in skin. In the study by Dr Shigehiro Tsuchiya of Tsuchiya Hospital, Japan, it is reflected that oral and topical application of Biogenics 16 is effective in improving the condition of atopic dermatitis in the 2 subjects. Since LAB Fermented Extract does not contain live bacteria, the risk of allergies or rejection by skin flora can be further minimized. However, further research is still being carried out at this point on the exact benefits in topical application of Biogenics 16.

(b) Impact the skin health by encouraging growth of beneficial bacteria in the intestine or other mechanism?

A healthy intestine with balanced gut flora is important to keep the skin healthy and for overall well-being. Unhealthy intestine dominated with bad bacteria may be one of the causes of poor skin condition which may be due to the following possibilities:

1. Unbalanced gut flora increases intestinal permeability, leading to a condition known as “leaky gut syndrome”. This means that bad bacteria, toxins, undigested foods and other foreign substances gets leaked out into the bloodstream, contributing to systemic inflammation which may lead to poor skin condition.

2. The damage to the mucosa triggers an inflammatory reaction from the immune system. The continuous cycle of inflammation worsens the state of the gut, leading to poor skin health.

Different from probiotics or prebiotics, LAB Fermented Extract does not contain live bacteria, but instead is a high strength extract resulted from the co-culture of 16 unique strains of Lactic Acid Bacteria extracted using a unique, patented extraction process. It encourages the proliferation of our intestine’s own good bacteria, while suppressing bad bacteria. When the condition of intestinal permeability is improved, skin condition will also be improved, as less foreign substances can reach the bloodstream. This will reduce skin inflammation as well as lower the level of IgE, which can be identified from the clinical study by Dr Shigehiro Tsuchiya in the chart in fig.1

igE values with LAB fermented extract
Image provided by Lifestream Group

By supporting the improvement of our intestinal health with LAB Fermented Extract, much of the mentioned symptoms, including skin condition may then be improved.

The next skin-related study was on Effects on Female Beauty, by Dr Shintaro Hashimoto, Daimyo-cho Skin Clinic, Japan.

Subjects: 75 female, age 30 to 70 (average age of 35)

Duration of study: 30 days

Finding: Improvement in skin texture, skin moisture retention, reduction in acne and skin breakout, improvement in skin elasticity; This was seen that sulcus, or grooves in the skin, straightened and the skin became smoother.

MarcieMom: This is an interesting study and possibly have implications for people with defective skin barrier. Often, the skin barrier is considered defective for eczema children because it is dry (inability to retain moisture and short of skin lipids) and porous (vulnerable to irritant penetration). An improvement in skin texture and moisture retention is therefore helpful and since LAB Fermented Extract is safe for infants, theoretically, parents have another ‘tool’ to use to prevent the onset of eczema. (The studied ‘tool’ is via moisturizing from 3 weeks old for high-risk infants.)

Moreover, we have seen research whereby sensitization to food comes from outside-in, i.e. via the skin. It is therefore of great comfort to parents to ‘arrest’ the allergic march by strengthening the child’s skin barrier from young.

Again, can you explain

(a) the mechanism of how a healthy gut affect the skin barrier?

Our intestine is the largest immune organ in our body. Many of the skin issues occurring maybe caused due to a lowered immunity. Therefore by improving our intestinal health through proliferation of our good bacteria and suppressing the bad ones, we will be able to effectively improve our immunity, in turn relieving skin symptoms.

(b) the layer of skin cells (epidermis, dermis) that improved with LAB Fermented Extract?

Results of the study is based on a questionnaires answered by the subjects on their skin condition. Other skin texture improvement in this study is being observed and analyzed on the epidermis of the skin. Improvement in epidermis often is reflected when there is improvement in the base layer and dermis of the skin.

(c) whether the improvement in the skin cells is permanent or is it one whereby LAB Fermented Extract has to be taken regularly to maintain the improved skin barrier?

Our body is constantly under attack from harsh environments, processed foods, stressful lifestyles and also ever changing virus strains. All these contribute to a lowered immunity, which also affects other parts of our body including skin condition. By ensuring that our intestine has sufficient support in maintain a good colony of good bacteria and suppressing bad bacteria, it will lower chances of skin issues, helping us maintain not use good quality skin, but optimal health.

Biogenics 16 is also recognized by more than 850 clinics in Japan, many of which is skin related.

Once again, thank you to Lifestream Group Pte Ltd, for sponsoring this series.

Get additional $5 of website price when you purchase Biogenics 16 at Simply quote coupon code MEI5OFF upon check out to get the discount.

  • Promotion valid from 3-31 Dec 2015
  • Terms & conditions apply

Lifestream manages LABO NutritionTM under which Biogenics 16 is distributed. Parents can understand from this sponsored post how taking LAB supplement can affect the skin and potentially, improve eczema.

Guest Interview

Impact of Lactic Acid Bacteria (LAB) Fermented Extract on Children’s Health (#Biogenics16 series)

Intestinal health has gained importance in recent years due to studies that showed the link between intestinal health and numerous other health conditions, (beyond gastrointestinal conditions) even to skin and allergic conditions. It is known that not all probiotic strains are effective and also not all probiotic supplements are of high density and quality to have an effect on intestinal balance.

Today’s sponsored post is on LAB Fermented Extract, known as Biogenics 16 in Singapore. Questions are answered by the manufacturer and its team of medical professionals, an aspect which I appreciate as it showed the level of commitment and transparency. The key features of Biogenics16 and its impact on a child’s health are the focus of this 2-part blog series.

Biogenics Probiotic extract children health

Feature #1 High Strength with 16 Unique Strains of LAB

LAB fermented extract is neither prebiotics or probiotics, but an extract of secretions and bacteria body substance of lactic acid bacteria from 16 high strength bacteria strains through a patented extraction technology. The 16 bacteria strains include L. acidophilus, L. brevis, L. casei, L. curvatus, L. fermentum, L. plantarum, L. rhamnosus and L. salivarius.

It was observed by the late Dr Kazuyoshi Masagaki that ingested probiotic supplements do not survive well in body temperature and the acidic stomach environment, thus expelled as the body may not recognize it as its own. Instead lactic acid bacteria (LAB) fermented extract helps the body proliferate and grow its own good bacteria. At the same time, it also strengthens the immune cells, 70% of the body’s immunity cells are found along the intestinal walls.

MarcieMom: I read your report that about 95% of probiotics ingested get destroyed by stomach acid and most probiotics degenerate at temperature more than 25 degrees C. It is indeed worrying as probiotics products are not cheap and if most of them get destroyed, it appears then it is of limited efficacy. On the other hand, Biogeneics 16 uses an organic, non-GMO soya bean broth as a culture medium, to cultivate and extract the friendly strains with patent technology to encourage the body to grow its own friendly bacteria while diminishing the bad bacteria.

Like to clarify:

a. When we talk about probiotics, we usually talk about the strains to be at least in billions of colony forming units (CFU). What is the equivalent unit of measure for Biogenics 16?

Biogenics 16 does not contain live bacteria. It is instead an extract of Secretions and Bacteria Body Substance of 16 strains of lactic acid bacteria that are clinically proven to increase natural growth of body’s own friendly bacteria effectively for better health. Thus, it is unnecessary to measure the forming units of bacteria.

b. If LAB’s Fermented Extract is able to encourage the growth of good bacteria, why is it recommended to be taken daily? i.e. should it be taken more initially and when the gut is able to produce the good bacteria on its own, the dosage can then be reduced?

Factors such as poor diet, stress, pollutants, prescription of drugs and antibiotics deplete the amount of good bacteria in our body while contributing to the proliferation of bad bacteria. The imbalance of intestinal flora may lead to many health problems especially constipation, indigestion and undischarged toxic waste accumulate and may leak back into the body. Thus, it is important to take LAB’s Fermented Extract daily so as to ensure the balance of good bacteria while continuing to inhibit the on-going growth of bad bacteria, in order to achieve optimum gastrointestinal health.

Feature #2 High Resilience and Higher Performance

LAB Fermented Extract had been tested in clinical studies to improve

  • Intestinal health – 1. The level of bad enzymes/ carcinogens decreased during the time of administering LAB; 2. The intestines appeared cleaner after taking LAB for 4 weeks to 2 months
  • Immunity – where a higher amount of bad bacteria led to increase in intestinal toxins in the intestine, bloodstream which can affect nutrient absorption and oxygen circulation
  • Bowel irregularity
  • Rash and skin texture – will be covered in part 2 of this series
  • Oral health

MarcieMom: Children suffer from a range of gastrointestinal conditions, such as indigestion, constipation and diarrhea. At the same time, parents want to feed their children healthy but if the healthy food is not absorbed due to gut imbalance, it seems pointless to have good nutrition. I’m interested in how LAB Fermented Extract helps in nutrition and immunity:

a. We won’t know if a child is absorbing nutrients properly – do you have pointers where a parent can use to ‘gauge’ if the child has enough good bacteria?

A healthy child with enough good bacteria does not fall sick as easily, has lots of energy, clear skin, bright eyes and a good appetite. His weight will also be within healthy range.

In contrast, one with an unhealthy intestine tract has low immunity, bowel irregularities (constipation/diarrhea), is more lethargic and easily succumbs to allergies and infections. These symptoms can be indicators that your child does not have enough good bacteria in their intestine.

b. How does having good bacteria in the gut translate to high nutrient absorption and immunity? And which of the 16 strains help with this?

The small intestine is the place where nutrients are being absorbed in the body. If there are insufficient good bacteria in the intestines, the ecology of the good and bad bacteria gets upset. With insufficient good bacteria to digest food, bad bacteria take over and undigested food that is not discharged regularly from the bowels will clog up the gut. Undischarged wastes create toxins and cause the body and its vital organs to work harder and this creates stress on the body. Nutrients absorption is naturally compromised.

LAB Fermented Extract in Biogenics 16 is produced from the co-culture of specially selected 16 strains of LAB. When consumed, Biogenics 16 works in three ways, namely:

  1. Creating a conducive gastro intestinal environment to encourage the natural proliferation of the body’s own bacteria, which is the best fit for the individual as compared to foreign ingested probiotics.
  2. Suppressing bad bacteria. As the good bacteria flourish in the environment facilitated by LAB Fermented Extract, the bad bacteria colony shrinks and its reproduction is inhibited.
  3. Strengthening the immune system and Peyer’s Patch (an immune sensor of intestine) to activate immunity cells. (70% of entire body’s immune cells – Gut-associated lymphoid tissue (GALT) are located in intestine).

Feature #3 Premium Quality and High Potency

The fermentation and maturation of Biogenics16 is maintained at a fixed temperature and humidity for a period of 1 year. The patented technology helps to deliver high quality and consistent active ingredients. The dosage is half a sachet for children two years and above, and 1 ml drop for children below two years old. Biogenics 16 is lactose-free and gluten free.

MarcieMom: On the dosage for children, I’m curious to find out if (a) taking a full sachet will have side effects or will it be ‘wasted’?, (b) the effect of taking LAB Fermented Extract on alternative day as opposed to daily?, (c) what if the child is already taking fermented drinks like Yakult and Vitagen or already taking probiotics supplement?

a) Biogenics 16 LAB Fermented Extract does not contain any live bacteria, sugar, additives, pesticides, colouring or flavouring, making it absolutely safe for children consumption.

b) Observing your child’s stool is a good way to gauge if he/she is actually taking enough. Yellowish brown and odorless stool would indicate that your child is having good intestinal health, while dark brown with foul odor would mean otherwise. Through this observation, you will be able to better decide how much LAB Fermented Extract your child actually requires.

c) According to Dr Hiromi Shinya, a pioneer of modern colonoscopic techniques and author of many bestselling books in Asia, taking fermented drink that contains non-resident (ie. Not the body’s own) bacteria are not fully effective in increasing the beneficial bacteria living in the intestine. This is because the live bacteria in fermented drink are not heat stable and as much as 95% of the bacteria are dead even before consuming. Thereafter, the remaining bacteria are easily destroyed when passing through our acidic stomach environment, or excreted in the stool if the body recognizes it as a foreign bacteria. Aside from that, fermented milk products may also contain high amounts of sugar, which is unhealthy for the child’s diet.

Biogenics 16 is 100% resistant to heat and stomach acids. It encourages the growth of our body’s friendly bacteria while inhibiting the growth of bad bacteria, while strengthening the immune cells.

Feature #4 High Safety Assurance and Patented Extraction Technology

Biogenics 16 is safe for all ages, including infants and elderly and in full compliance with the Japan Health Authority. There is no added sugar, preservatives, pesticides, artificial coloring and flavoring.

Feature #5 Proven Results, Trusted Choice

Biogenics 16 is an established product, researched for 100 years and backed by clinical trials.

MarcieMom: How long from the time it is manufactured can Biogenics 16 be safe to consume (product expiry)? And is there a certain period after which the product will degenerate?

The shelf life of Biogenics 16 is 3 years from the date of manufacturing. Made from high potency with controlled fermentation process and patented extraction technology in Japan, Biogenics 16 provides LAB Fermented Extract that is highly stable and provides the same effectiveness and benefits for consumption by the date of expiry.

Once again, thank you to Lifestream Group Pte Ltd, for sponsoring this series.

Get additional $5 of website price when you purchase Biogenics 16 at Simply quote coupon code MEI5OFF upon check out to get the discount.

  • Promotion valid from 3-31 Dec 2015
  • Terms & conditions apply

Lifestream manages LABO NutritionTM under which Biogenics 16 is distributed. It is very useful information for parents and certainly help parents to be more aware of the child’s intestinal health and also in assessing products for it. Next week’s sponsored post will help readers of this blog understand how LAB Fermented Extract affects skin and improves eczema.

Eczema Tips Guest Interview

Makeup for Sensitive Skin – Eczema Makeup Dos and Don’ts

For this 3-post series, we have Alana Mitchell, the founder of She’s the most suitable expert I know for this topic on makeup for sensitive skin, where we will be covering not just the basics of makeup, but very practical steps on applying and removing makeup and even how to mask the appearance of scars or pigmented skin. 

More on AlanaAlana acquired her esthetician license from the State Board of Barber and Cosmetology of California, allowing her to practice skincare in the California state in her spa business. Alana has worked in the beauty industry for over 15 years, and teaches advanced education classes for esthetician students.

Eczema Skin

Eczema Makeup - What You Have to Take Note Of!
Eczema Makeup – What You Have to Take Note Of!

Eczema skin is quite difficult to manage when it comes to make-up; for one, the cause of the eczema could be irritant or contact dermatitis, whereby the eczema rash is triggered by contact with allergens. Secondly, the nature of eczema skin is dry and the skin barrier is defective. It requires applying emollient for moisturizing, protection from moisture (occlusion) loss and increase moisture absorption (humectant). Thirdly, eczema skin may have more scars/ blemishes or even lichenified/ thickened skin from prolonged scratching.

MarcieMom: Thank you Alana for helping us for the past two weeks on:

Today, we are focusing on eczema skin. Let’s tackle the above difficulties one by one and round-up with your makeup tips for eczema skin.

Eczema Skin and Makeup Ingredients

We mentioned in our previous posts that there are ingredients we can avoid for those with sensitive skin. What in your experience are the ingredients not to have for makeup on eczema skin type? 

Alana: Amongst the most common are: alcohol, artificial fragrances, harsh sulfates (such as sodium lauryl sulfate), chemical preservatives, and chemical sunscreens (such as octinoxate and oxybenzone).

Ingredients to Avoid in Eczema Makeup
Ingredients to Avoid in Eczema Makeup

Moisturizer and Implications on Makeup

MarcieMom: Assuming that an eczema sufferer has very dry skin and needs frequent moisturizing – what is the practical way to go about this? (since it’s not practicable to constantly remove makeup and apply moisturizer, then apply makeup again)

Alana: That is super easy! Find a tinted moisturizer that you love! There are many brands that have tinted moisturizers that will not only deliver SPF protection, but will also provide vital hydration and beautiful coverage to your skin. Granted, the coverage on these products is typically rather light. But if you are doing what is right for your skin, and keeping it healthy, odds are you will only need a light coverage product. If you need heavier coverage, again, do some research. As long as your skin does not tend to get oily with reapplication, and as long as the product you are using is quality, reapplication should not be an issue at all.

MarcieMom: Is there makeup step to avoid for eczema skin? e.g. not to use mascara or adopt a simplified makeup routine

Alana: I wouldn’t say there is anything eczema skin needs to avoid. That is, of course, if you’ve found the right products for your skin type. As I’ve mentioned before, there are products out there for you! It is simply a matter of finding those products.  Of course, if something in your makeup regimen is bothering you, or causing an eczema flare-up, discontinue use immediately!

Covering Scars, Pigmented Skin and Blemishes on Eczema Skin

Prolonged scratching of eczema skin can lead to scars, pigmented skin and thickened skin. It is important not to scratch eczema patch due to infection risk as well as scarring and discoloration.

MarcieMom: Alana, what are your makeup tips to cover these scars and blemishes on eczema skin? Are these concealers typically more irritating to skin than the usual foundation? 

Alana: Much like foundation, there are many fabulous concealer options that not only mask but heal your skin. Do not, no matter how tempting, apply the first concealer you see in an effort to mask your eczema! This can lead to a negative reaction that will cause you even more problems. Take time to research brands that are especially good for sensitive, eczema prone skin, and take the time to patch test it before slathering it on the effected area. What many people don’t know is that irritated skin is often broken skin, and you do not want to be quick to slap a product on top of that. You will want a product that is specifically indicated to be able to be worn on irritated skin. Many of my eczema clients have had success using Lycogel’s Breathable Camouflage, which was designed specifically for users with rosacea (yes, even when it is in a reactive state).

Alana’s Makeup Removal tips for Eczema Skin

MarcieMom: Can you share your makeup removal tips for eczema skin? (with a view to minimize skin irritation and hydrate skin)

Makeup Removal tips for Eczema Skin
Makeup Removal tips for Eczema Skin

Alana: My makeup removal recommendation for eczema skin is honestly the same as it would be for eczema skin (and normal skin), just with different products! If you go beyond simply having sensitive skin, and have eczema prone skin as well, use products that are indicated to be good for super sensitive skin, and more importantly, for eczema skin as well. Just because a product does not indicate these things does not mean it cannot be used, but you should discuss it with your skin care professional before use. As I mentioned before, fewer and more natural ingredients are usually better. If you know your skin agrees with a certain oil (coconut oil is fantastic), you can use this to remove your eye and lip makeup before cleansing.

Thank you so much Alana for being with us for these past three weeks, it’s been such a pleasure and a great learning experience!

Eczema Tips Guest Interview

Makeup for Sensitive Skin – Applying and Removing Makeup

For this 3-post series, we have Alana Mitchell, the founder of She’s the most suitable expert I know for this topic on makeup for sensitive skin, where we will be covering not just the basics of makeup, but very practical steps on applying and removing makeup and even how to mask the appearance of scars or pigmented skin. See last week’s post on Skin Types and Makeup

More on AlanaAlana acquired her esthetician license from the State Board of Barber and Cosmetology of California, allowing her to practice skincare in the California state in her spa business. Alana has worked in the beauty industry for over 15 years, and teaches advanced education classes for esthetician students.

Sensitive Skin

There is no strict definition for sensitive skin but generally, it means being more prone to getting a hypersensitive reaction to ingredient/chemicals. You can find out which ingredient you’re sensitive to via a patch test and your patch test results can be entered into the CAMP (Contact Allergen Management Program) database in the US to obtain a list of products you can use.

Makeup and Removal for Sensitive Skin
Applying and Removal of Makeup for Sensitive Skin

Applying Makeup – Moisturizer and Foundation

MarcieMom: Alana, thanks for helping out this week with application and removal of makeup. We are getting into the specifics of makeup for those with sensitive skin this week.

Can you share with us how we can figure out our skin tone and choose the right foundation (color, texture)?

Alana: If I’m being totally honestly, there is a lot of guesswork that goes into finding your perfect shade. Foundation shades are typically crafted on the most common skin tones, and you will notice that there are usually only 10-20 shades in a typical range. Since everyone has their own unique skin tone, it is usually a matter of trying a shade that looks closest to yours. Another option is to buy one shade darker, and one shade lighter, so you can blend them to meet your exact skin tone.

For brands that label based on undertone, finding your exact shade might be much easier. The first step in figuring out your skin tone is knowing your skin’s undertone, which is a lot easier than many people might think! Simply look at the inside of your wrist and observe the color of your veins. If they appear to be blue, you are likely cool toned. If they appear to be green, you are likely a warm undertone. If you notice both blue and green, or something in between, you are likely a neutral undertone. Whichever tone you observe, you will want to lean towards that range (warm ranges are usually labeled with a W, cool with a C, and neutral with a N). After that, it is all a matter of finding the right shade. Just because it matches your undertone, does not mean it will be an exact match. It might still be too dark or too light – so trial and error will come into play yet again.

Figuring out Your Skin Tones for Foundation
How do you tell your Undertone?

When in doubt, there are two things you can do: ask you local makeup artist or esthetician. They should be able to give you some recommendations, and might even be able to test products on you in an effort to find your exact match. When it comes to testing makeup, I am a huge advocate of doing so in a safe manner. If you head down to your local department store, see if they have small, sealed samples that you can test in-store or take home to test. If you feel comfortable allowing a makeup artist to test products on you in-store, make sure you understand the risks (those products are tested on many people, not just yourself) and watch them sanitize both the product and the makeup brush properly. I am not personally an advocate of using in-store testers, unless they are housed in an airless pump container, which most makeup products are not. But is very much a matter of personal preference.

MarcieMom: What about for those with sensitive skin? How can sensitive skin types choose the right foundation and what ingredients should sensitive skin types look for or avoid in foundation?

Alana: When it comes to sensitive skin, I always recommend seeking the advice of a dermatologist or medical esthetician. They are going to be able to give you the best recommendations for your skin type, because they have an understanding of the ingredients that go into skin care and makeup, and also have an understanding of sensitive skin in general.

As far as things to avoid: many sensitive skin types don’t do well with harsh chemicals, alcohol, artificial fragrances, and the like. However, each person is different, and an ingredient that does not irritate one sensitive skin user might irritate another. Brands like YoungBlood Cosmetics and Glo Minerals are fabulous options for sensitive skin users. YoungBlood Cosmetics, founded by Pauline Youngblood, delivers a range that can cover raw, inflamed or discolored skin while allowed it to breath and heal! So yes, most sensitive skin types can definitely use this ultra-gentle makeup range. Glo Minerals bills itself as being a “clinically advanced mineral makeup that covers, corrects, and protects”. They indicate on their site that they are suitable for “even the most sensitive skin,” and I have seen great success with sensitive skin clients using this brand.

MarcieMom: Moisturizing the skin and sun protection are important. How do these go with make-up? e.g. apply them all separately or it’s better to choose makeup that is both moisturizing and offers broad-spectrum UV protection?

Alana: While I am a firm believer in keeping moisturizing and makeup separate, you can definitely combine SPF protection with beautiful skin coverage. As I mentioned in my last post, I am a huge fan of tinted sunscreen. If dry skin is a concern for you, you can definitely reach for products that are more moisturizing.

There are many products that offer full coverage results with SPF foundation. I do urge users to be selective when it comes to picking out a brand and formulation, and to really consider if this option is best for them. Full coverage products are typically “heavier”, meaning most people will not want to reapply it throughout the day. Reapplying SPF every 2 hours (at least) is crucial for optimal sun protection, which is where product selection comes into play.

Lastly, powdered sunscreens make for a great and easy option! Though these are typically on the lighter side of the coverage spectrum, they do a great job of masking imperfections, while absorbing excess oil and mattifying the skin. I happen to be a huge fan of this method for touch-ups (after applying my tinted sunscreen in the AM).

Alana’s Makeup Removal tips for Sensitive Skin

MarcieMom: Alana, what would be your top makeup removal steps/ pointers for those with sensitive skin? (with a view to minimize skin irritation from the products, the beauty tools used e.g. brush and cross-irritation)

Alana: Makeup removal should always be a priority, but I personally like to keep it simple (and enjoyable) to make it feel less tedious at the end of a long day. First and foremost, be sure to remove any makeup around your eye area. There are many eye and lip makeup removers out there that are gentle enough for sensitive skin, and many that are actually indicated for sensitive skin. After you remove makeup in these areas, it’s time to cleanse your face. If you are not the proud owner of a skin cleansing device, make sure you cleanse twice a night to ensure you get any excess dirt, oil, and makeup off of your skin. That is about it! Of course, be sure to follow your cleansing up with your typical skin care routine.

Makeup Removal Tips for Sensitive Skin
Makeup Removal Tips for Sensitive Skin

Thank you so much for sharing the makeup basics for those with sensitive skin. It’d give those of us with sensitive skin so much more confidence when we approach makeup. Next week, we will focus on makeup for those with eczema, an area that many eczema sufferers struggle with.

Eczema Tips Guest Interview

Makeup for Sensitive Skin – Skin Types and Makeup

For this 3-post series, we have Alana Mitchell, the founder of She’s the most suitable expert I know for this topic on makeup for sensitive skin, where we will be covering not just the basics of makeup, but very practical steps on applying and removing makeup and even how to mask the appearance of scars or pigmented skin. 

More on AlanaAlana acquired her esthetician license from the State Board of Barber and Cosmetology of California, allowing her to practice skincare in the California state in her spa business. Alana has worked in the beauty industry for over 15 years, and teaches advanced education classes for esthetician students.

Skin Types and Makeup

Skin Types and Makeup with Alana Mitchell, the founder of
Skin Types and Makeup with Alana Mitchell, the founder of

If you check out product labels, you will generally find that they cater to (i) normal skin, (ii) dry skin, (iii) oily skin or (iv) sensitive skin. In this blog, we have always been focused on eczema skin that typically belongs to the dry skin type, sensitive skin (when we cover and irritants to avoid) and to some extent oily skin, when we discussed about acne

MarcieMom: Alana, thank you so much for helping out with this series on makeup! I’m excited to learn more about it, especially when I’m clueless when it comes to makeup (I hardly use any!).

I read that the first step to figuring out what makeup and beauty products to use is to figure out your skin type. From WebMD, I noted that the different skin types are characterized by:

Normal Skin Type – (i) No or few imperfections, (ii) no severe sensitivity, (iii) barely visible pores and (iv) radiant complexion

Dry Skin Type – (i) Almost invisible pores, (ii) dull, rough complexion, (iii) red patches, (iv) less elasticity, (v) more visible lines and (vi) when exposed to drying factors, skin can crack, peel, or become itchy, irritated, or inflamed.

Oily Skin Type – (i) Enlarged pores, (ii) dull or shiny, thick complexion, (iii) blackheads, pimples, or other blemishes

Alana, most people may have difficulty figuring out their skin types or have a combination of skin types. Moreover, certain conditions such as skin disorders, smoking, medications, diet, stress, sun exposure, pollution, climate and existing beauty products may mask the real skin type. What is your advice on how we can figure out our skin type and how important is it to get the skin type right?

Alana: First, finding your right skin type is so important. Many people purchase products that aren’t necessarily right for their skin type, which can be either useless, or counterproductive in terms of achieving desired results. For instance: if someone with dry skin were to purchase a product specifically designed for oily skin, they are not likely to get the level of hydration they want (and more importantly, need). Figuring out your skin type is not always easy, which is where dermatologists and medical estheticians come into play! Going to one of these professionals may seem extreme, but it is the best first line of action in realizing your skin type and finding products that will work best for your skin type!

It's important to figure out your skin type to get the right make-up
It’s important to figure out your skin type to get the right make-up

MarcieMom: I’m interested to find out what are the key differences in the formulation when a company label its product as suitable for (i) dry skin, (ii) oily skin and (iii) sensitive skin? Are there any regulations that govern when a company can label itself as such? 

Alana: Key differences in these formulations typically address the markers of each skin type. For instance: dry skin formulas are typically more emollient. Many of these products use oils to nourish the skin, which is essential when you are dealing with any type of dryness or dehydration. In regards to makeup, dry skin users will want to lean more towards liquid formulations more than powder. I highly recommend looking into mineral makeup brands like YoungBlood Cosmetics, which use only the finest minerals while catering to even the most sensitive skin types.

Products designed for oily skin types are typically more mattifying. These formulas are often oil free, and lightweight, which helps to absorb excess oil and regulate oil production. Many people with oily skin will favor makeup that comes in powder form, but there are many fabulous mattifying liquid options that have recently hit the market as well.

Sensitive skin products are known as the more “gentle” formulas. These are typically (though not always) formulated with fewer harsh ingredients, and have been made with sensitive skin types in mind. It is important to note that just because a product is designed for sensitive skin, that does not mean your skin will take a liking to it! All skin is different, so even with sensitive or gentle products, you will still want to apply a patch test 24-48 in advance to using the product to ensure your skin will react well to it. I have not typically seen brands that put out a “sensitive” range for makeup. They are either friendly to sensitive skin as a whole, or they don’t formulate with sensitive skin in mind at all. Because of this, it is essential to look into the brands you are buying from, before you actually make your purchase. I have had wonderful experience with brands such as 100% Pure, Blinc Cosmetics, Glo Minerals, La Bella Donna, and again, YoungBlood Cosmetics.

There aren’t any firm regulations when it comes to labeling products for skin types. That being said, companies do have reputations to uphold, so it is important that they label their products for the right skin types accordingly. Your best bet is to ask your esthetician or dermatologist, and reading product reviews can also be very helpful as well!

What to Note for Makeup when You have Dry, Oily or Sensitive Skin
What to Note for Makeup when You have Dry, Oily or Sensitive Skin

MarcieMom: I’m the sort of gal whose makeup is just foundation and lipstick. Alana, what in your view, are the must-haves for makeup and are there certain types makeup (foundation, blusher, mascara, eyeliner) that certain skin types should not use or is it possible to find something for every skin type?

Alana: My three essentials are: mascara, tinted sunscreen, and lip gloss. Being a busy mom and business owner, I know all about getting ready on-the-go, and these three things are fantastic for making you look and feel confident in a pinch!

Makeup must-haves are always a personal thing, but if I could list one essential, it would be some form of tinted SPF. Tinted sunscreens are a great way to get coverage, protection, and hydration. If oily skin is more of a concern for you, you can also reach for a powdered sunscreen brush! These brushes are amazing, because they are so easy to keep in your purse, so easy to touch up, and will mop up oil without making your face look cakey or over-done.

The good news is: regardless of you skin type, there is bound to be an option out there for you. It is all a matter of research and recommendation. If you have had little to no luck, call an esthetician! My medical estheticians and I are available during business hours via phone, chat, and email to help shoppers in finding the perfect products for their skin type. It may sometimes be difficult, but I guarantee you it can be done.

Thank you so much for sharing your expertise on skin types and makeup with us. I think we all benefit from knowing more about skin types and understanding how that relates to selecting makeup. Next week, we will focus on sensitive skin, can’t wait!

Guest Interview

Toddler Nutrition series with Natalia Stasenko – What and How Much to Eat

Natalia Stasenko, a registered dietitian, is passionate about pediatric nutrition and shares nutrition tips and coaching on FeedingBytes. Natalia has a Master of Science in Nutrition Education from Columbia University. She co-wrote to books Baby Led Feeding and Real Baby Food with Jenna Helwig.

oddler Nutrition with Registered Dietitian What How Much to Eat and What not to Eat Eczema kids

This was originally a 4 week interview series which had since been combined into one informative post. The series was focused on nutrition for toddlers, in particular dealing with picky eaters or children who cannot eat certain foods.

Baby Starting Solids

It is recommended by the American Academy of Pediatrics to start solids at 6-month old. During the first year, the primary nutrition should still come from milk, preferably breast milk as this is still the best nutrition for infants. Before we get into what to eat, let’s first start with the basic of how much to eat.

How Much To Eat

MarcieMom: Given the small tummies of young children and that solids have a different place in their nutrition at various stages, would you summarize for busy moms and dads

what portion sizes their children should be eating?

Natalia: This is a great question and I get it a lot at my workshops and online classes. Generally speaking, babies start with a very small amount of solids and gradually progress to more solid foods in their diet by the time they turn 12 months. At around 9-10 months many babies go through the “big switch”, as I call it. At this point, more calories and nutrition start coming from solid foods than from formula or breastmilk and many babies want bigger portions of solids and also start snacking on solid food rather than drinking milk or formula for snacks. It is important to remember that any guidance on portion sizes for babies can be interpreted only as an estimation, as babies’ appetites vary greatly.

Baby Portion Sizes

Toddler Nutrition portion

What I provide in this chart is more of a “starter” for portions. Some babies need more and some babies need less food.

Babies should never be pressured to finish a portion of food or be restricted in the amount they are hungry for.

Picky Eaters

MarcieMom: With regard to picky eaters, I’ve attended a talk by Dr Sears who suggested ‘grazing’, eating small-size food portions throughout the day. Since then, I’ve seen increasing number of articles that recommended it.

Would you recommend grazing, and if yes, why and for which groups of children would ‘grazing’ work best?

Natalia: Toddlers need to eat more frequently than older kids – every 2 to 3 hours. And serving them snacks in a muffin tray is a great idea! I did it for my own kids and always recommend it in my classes. But I think that the word “grazing” is a little confusing here. Grazing suggests eating small portions throughout the day without any mealtime structure. Dr Sears suggests serving the tray mid-morning and mid-afternoon and I think these are great times for a scheduled snack.

Toddler Meal Structure

Some parents may leave the tray out all day in a hope to get a few extra bites into their toddler. This will most likely result in eating out of boredom and/or no appetite for dinner. Structure in meals and snacks help kids of any ages to eat better at meals and stay attuned to their hunger and fullness signals.

Childhood Obesity

MarcieMom: Obesity is a rising problem among kids, actually not just in US but in Singapore as well. I’m thinking that the main meals or snacks which are planned and prepared ahead by parents and caregivers are likely to be ‘correct’. However, some parents (me included!) may slip and offer ice-cream, ice milo, juice (even diluted) and grandparents may offer chocolate-coated snacks (who can resist?!).

What is the practical way to look at and control these ‘extras’? 

Natalia: Those delicious extras can be a legitimate part of your child’s diet. In fact, research shows that it is important to serve your child’s favorites from time to time because kids tend to value restricted foods even more. It is up to parents, of course, to decide how many treats their child will get per day or per week.

A good rule of thumb I use with my kids and clients is that anything marketed to children or with added sugar is a treat.

To help kids feel in control around “forbidden foods”, we recommend serving them in unlimited amount from time to time (an example will be a glass of milk and a plate of cookies for snack once a month). If served for dessert, the treats should be smaller (think of a size of an oreo cookie) but they should never be served as a reward for eating dinner. Instead, try to serve a small dessert alongside the meal, to “neutralize” it as much as possible. And do not forget that a bowl of fruit with plain yogurt also makes a great dessert!

BMI Chart for Portion Control?

MarcieMom: A final question on how much to eat – is the BMI-chart for kids accurate or should looking at a kid and assessing whether he/she is all chubby/flabby or look firm and fit be a better gauge? !

Natalia: The most important information we can derive from growth chart is if the child is growing consistently. Some health professionals call it “following the curve”. We aim for comparing the child to himself, not to other children. Some children are consistently on the 90th percentile and completely healthy while others thrive on the 5th percentile. If the child suddenly starts “dropping” or “climbing” percentiles on a growth chart, on the other hand, it may indicate a medical or feeding problem. For the most accurate results, it is also important to pick the right chart. BMI chart is available for kids only 2 years and older and breastfed babies are best assessed on the World Health Organization charts, not the CDC ones.

What to Eat for Toddlers

Toddler Nutrition series on Eczema Blues
Photo from Natalie Stasenko

Is the Toddler or the Mom Picking the Food?

Come to think of it, the willingness to open one’s mouth, put food in, chew and swallow can’t be forced. So seen in that light, your toddler is the one choosing the food. The problem steps in when he/she is choosing so much, the term ‘picky eater’ soon becomes how you see your child. Natalia has a special interest with helping parents feed picky eaters, given her own parenting experience, let’s find out more from her!

What are your top 3 must eat foods that are essential for toddlers, on-top of the standard fruits and vegetables, protein source and carbohydrates?

Natalia: I would change the term Must-eat to Must-served. I feel like when parents are under pressure that their child must eat a particular food, children sense it and are more likely to reject it.

The Must-Serve foods to Toddlers are:

Orange and dark green rich fruit and vegetables, due to Vitamin A, important for eye health and immune system

Oily fish such as salmon and tuna, due to DHA, important for retinal and brain development

Red meat, fortified cereal, beans, due to Iron, important for oxygen transportation and storing it in cells. Most common nutrient deficiency in small children is iron deficiency

Which Option to Encourage Healthy Eating on Served Foods?

MarcieMom: Assume that the child is refusing to eat the healthier butternut squash, broccoli and fish. What would you recommend a parent to do?
i. Forget about these foods, try new ones
ii. Stick to these foods, try new way of cooking
iii. Keep cooking these foods and let the child ‘starve’ if not eating
iv. Keep cooking these foods and more, just in case

In the option(s) you choose or maybe another option or a combination, how long should a parent try a certain tactic?

(It’s already starting to sound laborious to me, lucky for me, my child happen to love superfoods!)

Natalia: I would suggest to keep serving these foods, in the context of family meals, alongside the foods your child has already warmed up to. The biggest mistake parents make is creating pressure at mealtimes in an attempt to get their children to eat particular foods. This does not work. Catering, i.e. giving only the foods that your child likes, also backfires. Non-pressure, pleasant mealtimes, role modeling and plenty of exposure help kids push themselves to learn to like the foods the rest of the family is enjoying. Exposure to less liked foods outside of mealtime through shopping, cooking and taste-testing also works.

New ways of cooking may also help.

For example, many toddlers dislike texture of meat so in the class we will share a recipe of meatballs cooked in broth that are literally melting in the mouth. When it comes to vegetables, even the simplest of them can be prepared in a variety of ways. For example, you can grate a carrot, cut it into matchsticks, make it into ribbons, steam it, roast it or pan fry it with some butter.

We definitely do not suggest starving your child till he eats certain foods. After years of working with children with feeding problems, I know that some of them would rather starve than eat something that is not acceptable to them. Besides, it creates a very negative mealtime dynamics that leads to smaller appetites and ultimately less variety in diet.

Anti-Inflammatory Food Choices

MarcieMom: Various nutritionists have shared on this blog about inflammatory foods. Would you think this is of concern to young children as well?

Which are the top inflammatory foods that you see commonly given to children and should be avoided?

Natalia: While we are still learning more from research what exact benefits anti-inflammatory diet brings to adults and children, it is clear that reducing processed foods and boosting fruits, vegetables, lean protein, oily fish and whole grains is a path to good health for both kids and grown ups. However, research shows that an overall dietary pattern seems to be more important than adding or removing specific foods from diet. I often use 80 to 20 ratio in my talks and classes, where 80 percent of food in kids’ diet are minimally processed from the list above and 20 percent are fun foods including treats. That said, I do not think that hydrogenated fats and artificial colors have a place in children’s diet. Of course, eating a blue lollipop or commercially prepared french fries from time to time is not likely to have a big health effect but if parents have an opportunity to choose candy with natural colors or bake french fries at home in the oven, it is great.

80 percent of food in kids’ diet are minimally processed and 20 percent are fun foods including treats.

MarcieMom: A final question, how would you grade my ‘food grading’ chart that I use to educate my child? Feel free to shift items around!

Food Grading for Eczema Child

Natalia: I think it definitely helps to create a balance in the diet, with the focus on more nutritious foods. I think that following a chart like this can help lay down very good foundation for healthy eating habits in the future. However I must say though that as kids are growing up and have more outside influence on their diet from the peers, I had to adjust my feeding strategy to occasionally include “forbidden” foods like soda and cookies. 

Research shows that kids who are restricted tend to over indulge when they are given access to foods that are forbidden at home. 

Again, serving the foods you want your child to eat all the time is the key to get them learn to enjoy their flavor, which is the best nutrition education parents can provide.

What Not to Eat for Kids

Toddler Nutrition on Eczema Blues with nutritonist Natalia Stasenko
Photo from Natalie Stasenko

What a Child Cannot Eat due to Allergy, Food Sensitivity or Intolerance?

When a parent should suspect there’s a problem with the child after eating the food?
When should a parent bring a child in for allergy testing?

Natalia: In case with allergic reactions, the typical symptoms to look out for are hives, swelling of the face and mucous membranes found in the nose, ears, lungs and throat, nasal congestion and sneezing, intestinal cramps, vomiting and diarrhea. With smaller kids who cannot talk yet, general discomfort and crying after eating a specific food may also indicate an allergic reaction to food. If your child has any of these symptoms after trying a certain food for the first time, food allergy may be suspected. It is a good idea to call your doctor who will probably refer you to an allergist for a testing.

Food Allergy Testing

Food allergy is often diagnosed by one of the widely available tests: skin prick test and blood test for antibodies, neither of which gives a 100% guarantee of true clinical reactivity. These tests may be helpful to assist in diagnosing food allergy when the patient history indicates that a specific food may be a problem. A double blind placebo controlled food challenge is considered by this and other reports as a diagnostic “gold standard”. This basically means that a person is given the suspected food once and a placebo another time, without knowing what is what.
The challenges are provided in gradually increasing doses and neither the patient nor the practitioner knows in which order they follow, thus patient and clinician biases are removed.

Food Elimination

Once the offering food is identified, the doctor will likely recommend to remove it from a diet. Children with food allergies may be at a high risk for nutritional deficiencies if important foods like dairy, eggs, or wheat are not replaced by nutritionally optimal alternatives. For example: calorie, protein and fat contents of cow’s milk are much higher than those in most milk substitutes, including almond and rice milk. A child who drinks rice milk instead of cow’s milk may not be growing properly because he or she will not be getting enough nutrients in the diet. Soy milk, on the other hand, is closer in calories, fat and protein to cow’s milk and could be considered a good alternative.

Figuring out Replacement Foods

MarcieMom: We know that there are certain foods that are the more common food allergens of children, while others are likely to cause intolerance. Given that a food (say fish) has more than one nutrients, how should a parent know what is a suitable replacement food i.e. as long as replacing the main nutrition, say is a protein or replacing the more beneficial nutrients, the omega-3 or finding a food that is as close to fish as possible (but that may trigger the same allergy?).

Natalia: It is a great question and I would like to provide some background information. Food allergy is an adverse reaction to protein in food. So every time the allergen is eaten, the immune system starts fighting it using the whole arsenal of chemicals causing the potentially life-threatening symptoms. Food allergy is often confused with food intolerance, which is caused by lack of digestive enzymes, such as lactase in case with milk intolerance. However, food intolerance does not involve immune system.

Food allergy can be IgE-mediated and/or non-IgE mediated. IgE-mediated basically means that when the allergen is ingested, the body produces Immunoglobulin E antibodies, which attack the allergen causing the release of histamine and other potent mediators that cause the symptoms of a food allergic reaction. Non-IgE mediated reactions primarily affects the gastrointestinal tract lining and causes allergic disorders such as protocolitis and
entrocolitis. To complicate matters further, a bunch of adverse food reactions can be both IgE and non-IgE mediated.

Fish Allergy Alternatives

As you see, there are many different ways we can react to certain foods. To answer your questions, in the case with fish allergy it is more likely to the protein the child is reacting to so the health care provider will probably recommend stay away from all fish and seafood and take a DHA supplement instead.

Milk Intolerance Alternatives

In case of milk intolerance, switching to lactose-free milk will help to avoid the symptoms but if your child. has food allergy to milk i.e. reacting to milk protein, all dairy products lactose free or not, should be avoided. In my private practice I worked with many kids with food allergies who needed a safe and balanced diet to meet their nutrient needs after removing the allergens. In most cases I needed to collaborate with their allergists and pediatricians to create a plan that works for a specific family.

Foods NOT for Toddlers

Toddler Nutrition series with nutritionist on Eczema Blues
Photo from Natalie Stasenko

What are the top 5 foods that you think under no circumstance a child should be given, or as infrequent as once a month?

Natalia: It is hard to ban certain foods from a child’s diet, especially as they become more independent in obtaining their food when they grow up. To avoid vilifying certain foods, that may only increase their appeal in children’s eyes, I prefer to focus on staying away from certain ingredients and buy or make a better version of children’s favorites most of the time. 

My top 5 food additives to avoid are artificial dyes, artificial sweeteners, sodium nitrate, certain preservatives (BHA and BHT) and trans fats. 

The good news is that by preparing most of the food at home and reading food labels a family can easily cut on their consumption of these foods.

Cutting Sugar in Kids’ Diet

I also believe in watching sugar in kids’ diets because too many sugary foods not only leave less space in small tummies for more nutritious foods but also create real health risks in the future. American Heart Association recommends only 4-5 teaspoons of added sugar per day for children, while most children get 3-4 times the amount. To calculate the amount of sugar in a serving of food, divide the number of grams of sugar on the label into 4, it will give you the number of teaspoons of sugar the food contains.

Children Supplements

MarcieMom: I’m giving my child supplements – she eats a balanced meal but I think 1. Probiotics, 2. Omega-3 and 3.Multi-vitamins (in doses below 100% of daily requirement) could strengthen her immune system. Is that the right thinking/approach or should I throw these out of the window? 

Natalia: When it comes to supplements, it helps to remember that it is a very loosely regulated market. FDA controls (somewhat) their safety, not efficacy. In our class we talk about consumer organizations that test and review supplements and I use their input in my work and personal life all the time. I see a lot of multivitamins of supermarket shelves that are mostly sugar and food coloring, missing the nutrients children are most likely to fall short on. So I think it is important to work with a dietitian to choose the supplements your child may truly need.

For example, many toddlers do not get enough iron in their diets and at the same time it is missing from most multivitamins. The good news is that there are specific additive and allergen-free comprehensive multivitamin formulas I recommend to parents of picky toddlers but they are not typically sitting on the eye level in supermarket shelves and some may only be purchased online.

Back to your question: providing your child with multivitamins, probiotics and DHA may be a good strategy to help close the potential nutrient gaps if your child does not eat many fruit and vegetables, eats no fermented foods and oily fish. But we know that nutrients are best absorbed when they come in the whole package, in foods. So I would still focus on exposing children to the nutritious foods that they are still learning to like, which I feel you are already doing wonderfully!

Thank you so much Natalia for being with us and sharing so many nutrition tips!

Guest Interview

Parenting and Newborn Tips with Angela Jacobsen

Angela Jacobsen, also known as OzSuperNanny, has worked with children in different countries for more than 15 years, including for celebrities (Madonna) and ordinary parents needing help. Angela has studied child care, personality development and pediatric first aid.

OzSuperNanny Parenting Tips on EczemaBlues

We met in Singapore and there were many Google hangouts and live events where Angela’s tips had been shared on this blog. This post combined the best of the Q&As into one informative post.

Bullying & Eczema Kids

My question: Children with eczema may get picked on in school, either due to their appearance (for those with apparent eczema), or due to differences in routine, for instance, shower and moisturizing required after sports. 

What do you recommend that school, parents can do to help the child not get bullied?

Angela: Children do get picked on based on appearance; Parents can talk to teacher, who may inform the class and let them know eczema is due to dry skin. As children are naturally inquisitive, it helps to answer their questions about why a classmate of theirs look different, so that they will understand it is not anything that ought to be picked on.

Parents can empower their child with more information about the skin condition, and also build up their self-confidence.

Photographer Zurina mentioned that her child’s school had information leaflet sent to everyone, informing them that a new classmate who has psoriasis will be joining and requested the parents to help educate the child about this skin condition.

Eczema Baby Sleep Tips

What do you suggest the best routine for bedtime?

A: Routine can including feeding the baby, followed by bath, pajamas, quiet time (transition to less movement and noise), stacked bedtime for those with more than one child, so that every child has one on one time.

Eczema children often can’t sleep through the entire night and wake up frequently due to the itch and scratching. 

Is there a shortened bedtime routine during the middle of night?

A: Reduce time for each of the bedtime routine, but as with traveling, keeping a routine helps.

Q: Babies with eczema, due to Interrupted sleep, often don’t get enough hours of sleepHow can we help the baby to have sufficient sleep/rest so that growth is not compromised?

A: 12 hours of sleep for a baby and if sleeping at night is an issue, should get the baby to have more day naps or rest time during the day.

Keep bedtime, ie the staying in bed part, non-negotiable.

Preparation for Newborn

Once a woman finds out she is pregnant, there are various aspects of preparation shared by Angela:

Medical & Body Pregnancy Prep

  • Appointment with gynaecologist, and also decide and book the hospital for delivery.
  • Physically, relax as stress is not good for the mother or baby. Look into yoga and other gentle exercises. Swimming & water aerobics can be great gentle exercises too, if you can swim! Alter your diet and lifestyle suitably. Talk to your doctor about this. Sign up for prenatal and antenatal classes for you and your partner. Get more sleep! Rest when you can.

Environment – Home & Outdoor

Avoid dangerous places filled with smoke or pollution. Also create a loving and nurturing environment between you and your partner. It is worth interacting with your unborn child by touching, singing, talking, reading stories and playing music. Plan for the nursery, write a list of what you will need and a list in Angela’s book Baby Love can be used as a reference.

Working Mothers

For working mothers, there are various options how to continue to feed your baby:

If your baby is breastfed, you need to decide whether you will express milk for your carer to provide or whether to have your baby brought to you at work to feed throughout the day (if possible). Various equipment are required, namely:

Baby Bottle – A bottle with a teat that has features similar to mother’s breast is sought after for the benefit of baby’s development as well as avoiding nipple confusion. During the day, about 3-4 bottles are required.

Breast Pump – Working mothers will need to look into an electrical breast pump for frequent and faster expressing.

Breast milk Storage Devices – Working mothers will need to prepare larger quantities of breast milk for storage.Different products will cater for the needs of different types of usage. The easiest option is storage bags as they can be stacked up.

Breast milk Warmer -A breast milk warmer becomes an essential item for working mothers as they to have one for their caregiver to use.Please always test the temperature of the milk on the inside of your arm before you give to your baby. If your helper is feeding the baby while you work, she has to be taught how to use a baby warmer safely.

Breast milk Cooler Bag – This is needed for use by working mothers to transport their expressed breast milk from office to carer.

Parenting Styles

There is no set parenting style and you can mix and match various ideas, including changing parenting styles. The important thing is that both parents should decide and agree on how to raise the child. Brainstorm with your partner on your beliefs and values as a family, perhaps involve your extended family. Do discuss any conflicts that arises and try to find solutions, before the baby is born!

Parents as Role Models

Children learn from watching their parents, and they are like little sponges, taking all in long before they can talk. Therefore, model appropriate behaviour, and be consistent in what you teach and also surround your child only with people who follow the same behaviours. Those with alternative caregivers should make sure they know and follow your parenting rules. Update the rule list for your carer and be vigilant to monitor and ensure that your baby is taken care of as you would desire them to be.

Giving Time to Your Child

Angela often gets asked how much time is appropriate to spend with your child, but each parent will have their own answer to this. It is important though to spend regular time doing enjoyable activities as a family, without the interruptions of phones, iPads and computers. Set your own priorities, including that between career and family. Time spent do matters to the child and therefore it is not unexpected that some children grow attached to their carers who spent the whole day with them.

Set your own priorities, including that between career and family.

Sneaking in a question on parenting eczema children here: Very often, children with eczema itch terribly and parents usually end up saying/shouting (in exasperation!) ‘Stop Scratching!’.

Do you have any positive reinforcement ideas to distract from scratching as I understand encouraging a child works better than saying no all the time?

Angela: You can also try to redirect children into doing something else rather than scratching, use positive words and also say please don’t do that. Perhaps suggest applying cream rather than scratching.

Guest Interview

Tackling Obesity in Eczema Children with Nutritionist Rania Batayneh

Nutritionist Rania Batayneh, MPH, is the author of The One One One Diet and a certified Wellness Coach through the American College of Sports Medicine. Rania has been featured in MSNBC, Oprah, Dr Oz and is a contributor for MarthaStewart. She holds a master’s degree in public health nutrition from the University of Michigan School of Public Health. She offers nutrition and wellness coaching at EssentialNutritionForYou

This was originally a 3-part post series which had been combined into a single informative post. It was a timely series due to rising childhood obesity as well as studies linking obesity with asthma symptoms and eczema in children.

Childhood Obesity

Marcie Mom: Thank you Rania, I’m so pleased to have you help in this series. I’m passionate about helping eczema families, and for those who have eczema children who are obese, they may have concerns over the type of foods to eat. Let’s tackle obesity, and along the way, offer some alternatives to children with eczema. Let’s get started!

Wait, what’s Obesity? Isn’t a little plump ok?

According to CDC’s data, the number of children from 6 to 11 year old in the US who were obese increased from 7% in 1980 to 18% in 2010. In 2010, more than 30% of children and adolescents were either overweight or obese. Overweight is defined as having excess body weight for the particular height while obese is defined as having excess body fat.

Parents in certain cultures may wrongly think that children ought to be chubby, but data collected showed obesity in children can carry on to adolescence and adulthood.  Children who are obese are also at risk of high cholesterol, high blood pressure, diabetes, heart diseases, bone and skin problems.

CDC’s Children BMI Calculator

MarcieMom: I’m looking at CDC’s page on BMI for children and parents should know that BMI for kids though calculated the same as for adults, don’t have a healthy weight range to follow. Instead the BMI should be compared versus growth chart that takes into account the child’s age and sex.

Rania, can you share with us how you would assess if a child is beyond his/her acceptable weight and for parents who wish to monitor this themselves, should they be looking at local growth chart (vs CDC) or is there a even simpler way for parents to monitor?

Rania: A child’s weight is largely dependent on his age and gender, and even taking into account those factor, it’s still variable. Because the calculation for BMI takes into account height, BMI-for-age percentiles are often regarded as the most precise way to measure obesity in children. Based off of this measurement, children who are below the 5th percentile are classified as underweight; between the 5th and 85th percentile is regarded as a healthy weight; between the 85th and 95th percentile is classified as overweight; and equal to or greater than the 95th percentile is classified as obese.

Contagious Eating Behavior

Rania, you have blogged about the likelihood of someone being obese if there is a friend or family. Do you have any example to share where you’ve helped the whole family (parents and child) to overcome obesity? What is usually the key motivation for these families who have successfully lost weight?

Rania: Yes, eating is a contagious behaviour not only between groups of friends but also within our own families. Clients come in and they see the effect they have on their families. They may be bringing donuts home or they like to snack on the couch. Of course, we like to share but sometimes this is not always caring!  Oftentimes, I will have a client come in who wants to lose weight and sometimes couples decide to get healthy together. They also realize that their diets/lifestyles affects their children’s food choices and preferences (frozen and fast food preferred to fresh/home cooked meals). When working with families it is important to get the children involved. Take them to the grocery store, get them involved in menu planning, and find ways to get them excited about being in the kitchen. You also want to keep in place some of their favorite meals but find a way to make them healthier and fun.

Kids Eating Strategically

For children, including those with eczema, fruits and vegetables, omega 3 and probiotics are beneficial (see Dr Sears series here). In a study of more than 500,000 children over 50 countries, three or more weekly servings of fruit reduced the severity of asthma, hay fever and eczema symptoms in 11 percent among teens and 14 percent among children. Moreover, essential fatty acids in Omega 3 are also good for the heart, brain, hair and skin.

Children’s Calorie Needs

MarcieMom: To maintain a healthy weight, one part of the equation is not to consume more calories than we need or use (for living and exercise). On WebMD’s website, an active child of 2-3 year old can consume 1000 to 1400 calories, while a 4-8 year old girl consumes 1,400 to 1,800 calories (boys 1,600 to 2,000 calories).

Rania, few questions –

1. You are America’s Eating StrategistTM! Do share with us what eating strategically looks like for a child?

Rania: Eating strategically for a child is actually very similar to eating strategically as an adult. Regardless of a person’s age, he should aim to eat as nutrient-rich a diet as possible; this would include plenty of (and a variety of) fruits and vegetables, lean protein, whole grains, nuts, seeds, and dairy. Certain nutrients are especially important for children, like calcium (which supports bone health and nerve, muscle, and heart function), iron, folate, vitamin A, and vitamin C. While treats are okay in moderation, aim to limit calories from saturated fats, trans fats and added sugars; these foods can often displace healthier nutrient-rich foods.

2. I’m looking at the calories guideline (above) by CDC. Would this differ for a girl in US who is Caucasian versus a girl in Singapore who is Chinese?

Rania: A child’s recommended calorie intake is consistent across all cultures and ethnicity.

3. For a child who is obese and need to cut down on calories, how many calories are safe to be reduced without compromising the health of a growing child?

Rania: The number of calories a child can safely reduce in his diet is dependent on the child’s age, current weight, activity level, and gender, so there’s no specific, all-encompassing number. For younger children, sometimes allowing the child to grow into his weight–as opposed to losing weight–may be preferred. Talk with your child’s health provider to determine a safe weight loss or weight maintenance goal.

A 3-part Nutrition series discussing childhood obesity with celebrity nutritionist Rania Batayneh

Sample Meal Plan

MarcieMom: Rania, for a child who has eczema and obese, what do you think is a sample meal plan to ensure that the calories to be consumed include sufficient fruits and vegetables, fish and other sources of omega 3, and probiotics?

RaniaBreakfast: Steel cut oats with blueberries and almonds; Lunch: Hummus and chicken wrap with vegetables (tomato, lettuce, onion, etc.); Dinner: Salmon, mashed sweet potatoes, and a salad; Snack: Yogurt with probiotics

Vitamin D, Milk Allergy

MarcieMom: I read on your blog the benefits of Vitamin D and calcium. For children who dislike milk or have a milk allergy, what would be your recommended alternatives to ensure they get the protein and calcium?

RaniaQuality sources of protein include lean meat, poultry, fish, eggs, nuts, seeds, legumes, and beans. Different types of dairy, like cottage cheese, kefir, and Greek yogurt, combine both protein and calcium. Besides milk, good sources of calcium include leafy greens like kale and spinach, white beans, cheese, some fish, tofu, and fortified products like cereal.

MarcieMom: The common food allergens for children are egg, cow’s milk, wheat, peanuts and soy. Which of these do you consider important to be in a child’s diet and what are the alternative sources of food to get the same nutrition benefits?

Rania: None of these foods are absolutely essential for a child’s health, but they do contain valuable nutrients.

Eggs and milk are probably the two most important foods in this group, but there are other foods that provide the same nutrients as they do. Eggs are a great source of protein and contain vitamin D and choline. Vitamin D can also be found in certain fish and fortified orange juice, milk, and yogurt. Choline, which maintains proper cell functioning and communication between muscles and nerves, is also found in chicken, turkey, shrimp, grass-fed beef, collard greens, swiss chard, and cauliflower.

Cow’s milk is another good source of protein, and it also contains calcium and vitamin D. Calcium is found in leafy greens like kale and spinach, white beans, cheese, some fish, tofu, and fortified products like cereal.

Anti-Inflammatory Foods

MarcieMom: Obesity is linked to chronic diseases, and chronic inflammation. Which are the anti-inflammatory foods that you would recommend as part of a child’s meal plan?

Rania: An anti-inflammatory diet should include plenty of fruits and vegetables; omega-3 rich foods like salmon, flaxseed, and walnuts; and herbs and spices, especially turmeric and ginger; and whole grains (refined grains exacerbate inflammation); nuts and seeds.

Snacking for Kids

MarcieMom: From what I’ve read in magazines, advice on snacking or no snacking and eating before 7pm or not seem to be changing all the time. 

For children, what do you think is the right snacking approach? Is there a difference if the child is obese?

Rania: The belief about the healthfulness of snacking is constantly changing–studies have found that people lose weight when they snack, and others have found that people gain weight when they snack. It seems as though there’s no hard and fast rule; instead, it’s an individual thing. Some kids may perform and feel better with snacks; others might do better with three square meals. It’s helpful to teach your child about mindful eating and to listen to his body–as opposed to external cues, like the amount his friend’s are eating–to determine when he’s had enough food. If he eats when he is hungry and stops when he’s full, your child should naturally fall into an eating pattern that’s ideal for him.

It’s helpful to teach your child about mindful eating and to listen to his body

Dessert Recommendation

Any dessert recipes would you recommend for eczema kids?

Rania: Because dessert’s main ingredients–sugar, saturated fats, and refined grains–are inflammatory, it’s best to limit desserts. Desserts that include anti-inflammatory foods, like zucchini chip muffins, can help counteract the effects of those ingredients and add valuable nutrients at the same time. Look for desserts that include fruits, vegetables, nuts, seeds, and spices (like cinnamon), which can display less healthy ingredients and add flavor. If desserts with healthier ingredients are unavailable, it’s okay to indulge in less healthy desserts once in a while.

Exercise for Weight Loss

MarcieMom: A last question on the other part of the equation to lose weight – through exercise. What is your recommended type of exercise for children, and number of hours, taking into account that some children with severe eczema may not be able to go swimming or tolerate excessive sweating?

Rania: The CDC recommends that children get 60 or more minutes of aerobic exercise per day. Exercise doesn’t have to be planned; just running around on a playground during recess contributes to a child’s daily 60 minutes. Exercise can exacerbate symptoms of eczema, but even moderate exercise, like brisk walking, is beneficial to a child’s health. Team sports are another good option: in one study, it was found to decrease depression and emotional upset in patients with eczema.

Guest Interview

Parenting workshop with Heidi Murkoff – Parenting Babies Q&A

Heidi Murkoff is the author of ‘What to Expect When You’re Expecting’, a book conceived during Heidi’s first pregnancy and her What to Expect series has since sold more than 34 million copies in US alone and published in over 30 languages. It has even been turned into a movie, ‘What to Expect When You’re Expecting’.

What to Expect when Expecting Heidi Murkoff Parenting EczemaBlues

This was originally posted as a 4-week series which had since been combined into a single informative post. I met Heidi in Singapore, during the Rise and Shine Expo where I got the front seat to her workshop “What to Expect in the First Year”. Heidi had kindly reviewed the Q&A before I published the 4-week post series.

Baby Feeding

Q1: How do Mothers who Breastfeed know that their babies are getting enough milk?

Heidi: Breasts don’t come equipped with ML mark – but fortunately healthy babies usually know exactly how much they should eat.  Breastfeeding is based on demand and supply – babies demand what they need to grow, breasts supply it.  Still, many moms worry that their babies are not getting enough to eat.  Since you can’t determine exactly how much is going in – best way to tell if baby’s getting enough is by checking how much comes out.  If baby’s pooping plenty and peeing plenty – and most breastfed babies do plenty of both.  Also keep in mind that babies are very good at what they do – feeding from a breast.  They’re better at extracting breastmilk than a pump is.

Also remember, whether you’re pumping or feeding from the breast, make sure each breast gets drained before you move on to the next.  That way you’ll be sure your baby’s getting both the foremilk (the thirst quencher, which is thinner) and the hindmilk, which is creamier, full of more fat and calories and which helps a baby feel full and satisfied.  Wonder if baby will get enough as he or she grows?  No need to – as baby grows and his or her appetite grows, too – your breastmilk supply will increase to keep pace.

Q2: How can Dads help out in Feeding?

Heidi: First of all, dads can help by being supportive of breastfeeding efforts.  Research shows that when dads are supportive of breastfeeding, it’s much more likely to succeed.  But also keep in mind that moms don’t have a monopoly on nurturing a baby. In fact, here’s an interesting father fact: Dads-to-be and new dads experience a drop in testosterone and a surge in esterone – most likely nature’s way of bringing out their nurturing side.  And those hormonal changes work.  There’s nothing (besides breastfeeding) that a mom can do that a dad can’t do equally well if not better, given the chance. Like a mom, dads can talk to, sing to, hold, rock, cuddle, and hug their babies. And while they can’t breastfeed, they can feed bottles of supplemental formula or expressed breastmilk-and do so with their babies snuggled bare skin-to-skin, to nourish and nurture their babies at the same time.  Can’t find a teat your baby will take? Ask around and shop around-different babies like different styles of nipple. Just make sure it’s slow flow so that it takes more effort, like a breast nipple does.

Q3: Should a 6-month old baby prefer solids to milk, is it ok to provide only solids and milk at night?

Heidi: Breastmilk or formula is still the main source of nutrition for a 6-month old – and will continue to be for most of the first year.  While some babies will take more, about 24 ounces per day is considered the right amount of formula (or if you were expressing your baby’s milk, breastmilk) for this age.  Solids, at least in the first few months of introduction (which should happen at about 6 months) are less for the nutrition, which formula or breastmilk has covered, and more for the experience…getting used to taking different textures and tastes.  But again, solids enough won’t give baby everything that he or she needs at 6 months.  Sometimes babies who don’t take enough milk are drinking too many other calories in the form of juice – so skip the juice altogether, or limit to no more than 4-6 oz a day.

Q4: When should the baby be weaned?

Heidi: You’re actually starting to wean a baby from the very first moment you offer solids.  Start a cup by age 7 months (sooner if baby seems eager to try and is sitting well), but you can continue the bottle until the first birthday – at which point best to graduate to a cup full time.  In the meantime, so baby will be ready for this momentous transition, make sure your little one becomes a sippy or straw cup pro.

For teething babies, sucking on a feeding or teething bag filled with frozen banana, mango, or peaches or chilled avocado can be soothing – but also a great way to feed a fussy baby.  Chilling spoon-fed foods (or even formula or expressed breastmilk) can also spell relief for teethers.

Baby Sleep

Q1: What is a suggested Bedtime routine?

Heidi:  Bedtime routines are a relaxing way to unwind at the end of the day for both parent and baby – and allows an older, active baby an opportunity to brake gradually for bed, instead of trying to go suddenly from 100 to 0 gradually. A bedtime routine should last about 30-45 minutes and should include a bath, massage, jammies, snack or milk, brushing teeth (if there are any), story time, cuddles and with good night ritual of saying ‘good night’ to family members, toys, animal friends. Keep lights low and music soft (no TV in the background) during the bedtime routine.  A snack of complex carbohydrates and protein can help keep a little one’s blood sugar even through the night, which can result in sounder sleep. Most important advice on bedtime routines: keep them consistent…same time, same amount of time, same order.

Q2: How to encourage afternoon naps?

Heidi:  First watch for your little one’s sleepy cues (yawning, rubbing eyes) and catch them before baby goes from sleepy to overtired (an overtired tot has a tougher time settling down for sleep).  Use a modified, shortened routine for naps – without the bath. Naps are as important for a baby or toddler as nighttime sleep – and in fact babies who don’t nap are less likely to sleep well at night.  Plus, babies do some of their most important developing during sleep, including naps – and it gives little ones a chance to recharge their batteries.  Just make sure the nap doesn’t come so late in the day that it interferes with nighttime sleep.

Q3: What about a baby who keeps waking up in the night?

Heidi: The problem isn’t waking during the night – we all wake during the night, but we’ve learned (hopefully by now!) how to fall back to sleep on our own.  That’s an important life skill that all babies eventually have to learn.  While feeding a baby during the night is fine for younger infants, by 4-6 months, they no longer need those nighttime feeds…they’ve just become a habit.  To help your baby learn how to fall back to sleep on his or her own, look at how he or she is falling asleep at bedtime.  That’s a child’s “sleep association”.  Feed or rock or cuddle your baby to sleep, and he or she will come to expect that same crib-side service at 2 am.  Best to put a baby down for the night drowsy but still not asleep, so he or she can fall asleep on his or her own – and know how to fall back to sleep on his or her own.  Bedtime routines are also a consistent, predictable transition to sleep – a positive sleep association: bedtime routine means I’m getting ready to sleep.

Falling back to sleep is an important life skill that all babies eventually have to learn.

Q4: What about Co-Sleeping?

Heidi: Sleeping with a baby in the same bed generally isn’t recommended by doctors, simply because it can be less safe and has been linked in research to a higher risk of SIDS (sudden infant death syndrome).  If you do want to sleep in the same bed with your baby, there are safety precautions you must take, such as sleeping without pillows of fluffy blankets, not putting baby against a wall or near any headboard that baby might become entrapped in (or entrapped between mattress and headboard).  Better and safer is to keep baby in the same room with you (being close to you but not in the same bed actually reduces the risk of SIDS), but in a safe sleeping space (crib or bassinet).  SIDS can also be prevented by not over-bundling the baby in heavy clothing (baby should be dressed lightly and the room should be comfortably cool), not putting anything in the crib but the baby (no pillows, blankets, plush toys, or bumpers), and keeping a fan on, circulating air. Also, use a pacifier (if your baby will take one) during sleep.

Do keep this in mind if you share a room (and doctors recommend that you do): babies are noisy sleepers (‘sleeping like a baby’ isn’t really as restful as people think).  They make a lot of noises, they move around a lot in their sleep.  So parents who co-sleep may actually find themselves sleeping less restfully, too, and may pick their babies up more often than necessary.  To avoid this, wait until your baby’s actually awake and crying to offer comfort or a feed.

What to Expect for Babies

Q1: Is it OK for baby to suck fingers?

Heidi: Babies are born suckers, and in fact many suck their fingers or hands before they’re born.  Sucking is a strong reflex in babies – and it’s their go-to habit for comforting themselves (and that’s a very good thing).  So no harm in baby sucking his or her thumb or fingers – in fact, it’s the most convenient comfort habit your baby could settle on (fingers are attached to their hands – no dropping them in the middle of the night, like a pacifier).  Let your little sucker suck away for now – there’s no likely to be harm to teeth until much later in the preschool years.  If thumb sucking is interfering with talking and socializing, occasionally use your little one’s hands to play finger games or clapping games or anything else that engages them.  If later on the dentist says it’s time to pull the plug on that finger, a positive reinforcement campaign – instead of pressure or scolding – will work best.  Say, a chart with stickers for sucking-free days.

When to schedule that first dental appointment?

While some pediatric dentists believe it should take place sometime after the first birthday, it’s probably safe to wait until the third birthday if there are no signs of decay or other dental issues, you’re brushing and flossing consistently, and the pediatrician is checking your baby’s teeth at each visit.  Also, wean baby from the bottle at a year to avoid tooth decay, and limit sippy cup use (sippies allow juice or milk to pool in the mouth).  Instead, as soon as your little one is able, switch to a straw cup, which is safer for teeth.  Another reason to break the bottle habit at a year: babies who drink their bottles lying down (as when falling asleep) can be more prone to ear infection.

 Q2: When should parents start baby-proofing the home?

Heidi: A lot of parents assume they’re safe (or, that their home is safe from baby and their baby safe from their home) until their little one is walking, or at least crawling well.  But it’s safer to start sooner – usually around 5 or 6 months – since you can never underestimate the resourcefulness of a curious baby.  In fact, it’s always safer to overestimate you’re your baby can reach/get into/climb to/manage to open or grab.

Q3: How much should parents clean the home?

Heidi: No need to put your baby into a bubble – and of course, that’s not practical. Neither is keeping your home white glove clean or laboratory sterile. Regular weekly cleaning is plenty, as long as you’re also sticking with the most important hygiene habits, like handwashing. In fact, research shows that some exposure to everyday germs actually boosts a baby’s immune system – making them less suspeptible to illness later on. Babies who attend day care or have siblings bringing germs home from school have fewer illnesses later on, too.  Same holds true for exposure to furry friends – studies show that young children who have dogs are less likely to suffer from allergies.

Q4: How many times is a child expected to fall sick in the first year?

Heidi: There aren’t any set number of infections a baby can be expected to come down with.  Some babies, especially those in day care or with older siblings, have more frequent colds and other viruses, others never get a single one.  Breastfeeding boosts the immune system, so breastfed babies are less likely to become sick and when they do, are more likely to recover faster.  And of course, making sure your baby gets all necesssary vaccines (and making sure anyone who spends time with your baby, including you, daddy, and grandparents and other babysitters does too) will help him or her stay well. And hands down, handwashing is the best way to prevent illnesses of any kind.

Q5: How to select a good stroller?

Heidi: The right stroller is the one that best fits your needs.  A travel system can be convenient, especially when the baby is young, but those strollers are often very heavy.  If you’ll be doing  a lot of stroller pushing, also make sure the one you choose folds up easily (particularly important if you’ll be in and out of the car with it or on and off trains and buses).  And make sure the height of the stroller is comfortable for you to push.  A good alternative to the stroller for shorter trips is a sling or other baby carrier, which allows you to go mainly hands-free and keeps baby snuggled close to you.  Try before you buy, since every mom, dad, and baby is will find different models comfortable.  And if you’re thinking about buying one while you’re expecting, be aware that your bump will definitely get in the way!.

Q6: What are the causes of colic?

Heidi: Colic is really a catch-all phrase that covers any kind of extended crying in a young baby.  It’s usually defined loosely by the rule of 3’s: at least 3 hours of hard-to-console crying at least 3 days a week, starting at about 3 weeks and tapering off by 3 months – but of course, many babies cry much more than that. There are plenty of theories to explain colic, but the top ones are gas (babies have immature digestive systems, so gas happens…a lot) and overstimulation.  Babies at 3 weeks lose the abillity to block out extraneous stimulus in their environment – so by the end of the day they’re often at stimulation overload, and just need to unwind with a good cry (and by good…of course I mean, long).

Q7: What about sex?

Heidi: The answer is YES.  Staying intimate is one of the best ways, of ocurse, of staying connected – especially in that first year as parents, when there are so many baby-focused distractions. Try to remember that the most important relationship in your life, even once baby comes on the scene, is the one with your partner.  Babies should and often do take priority, but try not to put your twosome on the back burner – be a couple, not just a couple of parents.  A weekly or monthly date night, even if it’s just snuggles and movies on the sofa.  Scheduling in sex – or being spontaneous (baby’s napping?  Get busy!).  And taking the time for quick hug or a kiss.  When it does come to the main event, delivery can leave you quite sore, even if you didn’t tear or have stiches, and postpartum hormone changes can make your vagina uncomfortably dry.  So make sure you get all the warming up you’ll need, and don’t skimp on the lube – use it liberally until your own juices are flowing again.

Try to remember that the most important relationship in your life, even once baby comes on the scene, is the one with your partner

Q8: You have written “What to Expect when You’re Expecting” close to 30 years ago, has what to expect change?

Heidi: There is definitely a lot more information available now, and also more empowerment to women. Husbands and doctors now understand the role and importance of moms. Also parents can turn to online communities and social networks for support.

Thank you Heidi for helping so much for the past four weeks; as you all know, I’m passionate about childhood eczema and looking forward to have more experts on board and a community to especially help new moms with eczema babies.

Guest Interview

Multiple Intelligence with Dr Thomas Armstrong

Dr Thomas Armstrong, Ph.D., is the Executive Director of the American Institute for Learning and Human Development, and an award-winning author and speaker. He has authored 16 books that have been translated to 28 languages, including 7 Kinds of Smart: Identifying and Developing Your Multiple Intelligences and Neurodiversity in the Classroom.

This was originally a two-part series (combined into a single post), live coverage of Dr Thomas Armstrong’s workshop in Rise and Shine Expo, Singapore. His workshop was titled 8 ways of teaching: How to teach practically anything using multiple intelligences.

Multiple Intelligences

The theory of multiple intelligences was first developed in 1983 by Dr. Howard Gardner, professor of education at Harvard University. He took a broader interpretation of intelligence other than just linguistic and logic/mathematical intelligence that still remain as the main focus in schools today. A society requires more than word smart and number smart people, for instance, professions such as designers, artists, musicians, dancers play an important role. The concern of a narrow definition of intelligence is that children who are actually intelligent in other ways become labelled as “learning disabled”. Furthermore, teaching the same concept in different ways allow not word or number inclined children to learn the concepts and also reinforces learning for children who are.

8 Multiple Intelligences

Linguistic Intelligence

Linguistic intelligence (“word smart”) – This intelligence refers to being good with words, and children who are word smart may love reading books, telling stories, good at spellings and taking tests and good at writing. Parents can help these word smart children by bringing spoken/written words into learning.

Logical-Mathematical Intelligence

Logical-mathematical intelligence (“number/reasoning smart”) – This means being good at numbers and logic/reasoning. Children who have more of this intelligence are typically good in science, mental calculation, patterns and taking number-related tests. Parents can help number smart children by thinking of ways to use numbers or patterns into learning.

Spatial Intelligence

Spatial intelligence (“picture smart”) – This means being good with pictures and images. Children who have more of spatial intelligence are usually creative, loves arts, doodles, legos and video games. Parents can help these children by using visual aids, colour, art and metaphors.

Bodily-Kinesthetic Intelligence

Bodily-Kinesthetic intelligence (“body smart”) – This refers to being good with the body and hands, such as children who are hands-on, loves to act, moves, sculpts and athletic. Learning for these children can be aided by involving the whole body and hands-on experiences.

Musical Intelligence

Musical intelligence (“music smart”) – This refers to being good with tone, rhythm and timbre and such children are often good in instruments, singing, rhythm and remembering music. Parents can help these music smart kids learn better by including music and rhythm into the learning experience.

Interpersonal Intelligence

Interpersonal intelligence (“people smart”) – This intelligence deals with being good at social interactions and these people smart children are natural leaders, street smart, good at mediating or persuasion. Learning for these children can be aided in peer to peer sharing, co-operative learning or large group simulation.

Intrapersonal Intelligence

Intrapersonal intelligence (“self smart”/ personal reflection) – This refers to being good at knowing oneself and these children are independent learners, confident, good at setting goals for themselves and reflecting. These self smart kids learn well when they are given choices or from forming associations with their personal experience.

Naturalist Intelligence

Naturalist intelligence (“nature smart”) This intelligence is for children who learn best using nature, who loves animals, have a green thumb or loves outdoors. Bringing learning for these children to nature or relating to nature can help their understanding of concepts.

For parents who want to assess which areas their children (or themselves!) are the strongest in, see this slideshare by Dr Thomas for the multiple intelligence inventory listing.

Identifying Multiple Intelligences in your Child

Dr Thomas shared that there are many ways parents can gather which intelligence their child is better at, and the best is by observation. Trips to art exhibits, zoos, parks, museums, libraries, music events and different environments can help parents to know what their child is interested to explore. Parents can document their observation using a scrapbook and observe over time what their child is better at. They can also go to the child’s school, ask the teachers and review the work done during school. A sparkle in the child’s eyes is the best indication!

Parents’ Questions on Discovering Child’s Multiple Intelligences

Q1: What if the parent is not strong in the intelligence that the child is good at? How can the parent then help the child to learn using this area of intelligence?

Dr Thomas: Parents can take the effort to learn and strengthen the intelligence in the particular area, and turn to other parents/tutors/technology to learn (both for themselves and for their children). One point to note is that every child is good at an area, it is not possible that a child is not intelligent in any area.

Q2: How to build a child’s intelligence and know that they have improved in it?

Dr Thomas: Parents should worry less about testing and think more about creating stimulating environments as a family, for instance, playing games, reading, stories, taking walks and visiting new places. Avenues to learn are already embedded in everyday life – for instance, questioning about why nature is as such, get them thinking instead of opting for an intensive learning program. Flash cards are not recommended as even if the child can get it right, flash cards do not encourage deeper understanding – some parents do it to feel good about themselves!

Multiple Intelligences/ Learning for an Eczema Child

I can’t resist the urge to sneak a question in for an eczema child. A child with eczema suffers from poor sleep, may lack concentration from lack of sleep or the itch be taking much of their mind. Dr Thomas, I wonder if there are certain areas to help these children in class (apart from treating the eczema so that the child can get proper sleep and not feel like scratching in class).

For instance, will it be even more important for parents to figure out other ways to help the eczema child learn apart from linguistic and logic as these require more sitting (leading to chances to scratch)?

My baby started learning her words using sign language, which helps as she has to sign and not scratch (her experience).

Dr Thomas:  I think any activity that involves hands-on learning would be good for the same reason as sign language:  the student’s hands will be involved in learning and not scratching.  Some examples of hands-on learning include:  fingerpainting, building with legos, working with math blocks, playing with clay, making a collage, creating a diorama (a three-dimensional model of a scene from a book, for example), and woodworking.  These, of course, are excellent for all children, but have this added benefit for children suffering from eczema.

Thank you so much Dr Thomas Armstrong for helping with the questions above and offering a very enlightening workshop for parents during the Rise and Shine Expo.

Guest Interview

Taking Eczema Kids in the Best Light with Photographer Zurina Bryant

This is a special edition post for many reasons! #1 It’s the first time a photographer is featured #2 She’s a mom who successfully turned her photography passion to a business, with celebrities, TV personalities as her clients and #3 It’s high time we parents of eczema kids have nice photos of our child!

Marcie Mom: Thank you Zurina for joining me here. As I’ve shared with you, taking photos of an eczema child may be difficult for various reasons (1) they may be scratching and so it’s another hurdle to get them to focus on the camera, (2) their skin may be having an eczema flare-up. I’m not a photographer, and I definitely don’t carry a camera around apart from my smart phone (plus my baby bag is already so heavy, check out this cartoon!) So, I’d be asking you questions on how to make the best of my current situation when taking photos of my child, I’m sure many parents will be facing the same!

Family Photo with Eczema Kids

MarcieMom: Ok, let’s get started with my upcoming wedding anniversary photo. I’d head out to a neighborhood studio, for a photographer to take a picture of the family (my hubby, my eczema toddler and I). Half the time she’s either scratching or too shy to look up.

What can I do before, during the photo session to help the photographer to get her to look into the camera? Like should I bring my own toy, or is there a way to carry her for optimal positioning?

Zurina: As a parent myself, if I know I’m going to be taking photos of my kids I don’t do too much talking to them about it before the actual session. I want them to be as relaxed as they can be when they get there. If you’re dealing with a photographer who has experience working with kids they are usually well equipped to get the kids to pose with you or alone (or at least sit still for the required number of shots). Of course, kids are kids and sometimes bribery works! If you can bring their favourite toy that helps – so long as you know that once they get their hands on the toy it’s likely to be featured in the shot too! The other thing is…to have some sort of bribery ready…whether it be a promise of a new toy or treat.

Indoor Photography with Kids

MarcieMom: Assuming we are taking a family photo for the Zoo membership card – all our faces are required to be in the photo, and we’re taking it inside our home.

What’s your take on positioning the smart phone, e.g. lighting or height?

Zurina: The key to taking a shot in your home is about the light. Turn on as many lights as you can and take a practice shot to check out the light. If you need to, pull in some other lights to brighten up your face in the photo. Lights should not be directly overhead otherwise you’ll get some harsh shadows.

Zurina Photography Eczema Blues
Zurina’s kids!

Outdoor Photography with Kids

MarcieMom: Now, we’re heading outdoors.

Where should I stand to take the best light? Also, if say her legs are having eczema flare-ups and I want to take just the upper body, how best to ‘frame’ the photo? (Is ‘framing’ the right word?)

Zurina: The light (think sun) should generally be in front of you so you aren’t in the shadows. Of course, this means that for those who are sensitive will find this a little uncomfortable. In this situation, you can do the 3…2…1…countdown. Tell your subjects (family, friends, kids) to close their eyes and do the countdown. Tell them to close their eyes (to rest them) and to open them up when you hit 1. As for framing (yes, that’s the right word) – that really depends on how close a shot you want to get. Most new photographers will follow the Rule of Thirds when they start out in photography. I’d suggest checking out the Wikipedia page on that one.

Zurina Photography Eczema Blues Taking Photos of Eczema Kids outdoors

Taking Selfies

MarcieMom: If we are taking photos of ourselves, using the front-facing camera. Is there a way for the faces not to be so huge, especially my girl may be having some rashes on her neck – anyway to take a shot so that the focus is on my girl’s smile instead of on her rashes?

Zurina: I’m terrible at taking photos of myself from that angle! I always feel like faces are massive in them! It’s all about the perspective. For this I would suggest learning how to use the timer on your camera instead. This allows you to move further away from the camera.

Thanks Zurina for taking time off your busy family life and photography sessions to help parents take their eczema children in a better light!

Guest Interview

Helping Dads be a Better Dad – #DadChat with Bruce Sallan

Bruce Sallan and his Family EczemaBlues Dadchat
Bruce Sallan and his Family

This is a special sharing by Bruce Sallan, the host of every Thursday ET 9-10pm Twitter #DadChat. I’m super privileged to have Bruce share his tips on Being a Better Dad, something I feel is so important particularly after I’ve evaluated my own Parenting Incompetency. Furthermore, parents of eczema children often spend so much time and energy on managing eczema that we forget to do the real parenting. Husbands are expected to take a leadership role in the family (biblically), sons are expected to take care of aged parents, men are expected to excel in their career – leaving our dads’ today treading a difficult line to balance all that are expected of them.

Bruce had been in a similar situation (though his family did not have eczema) – on his website, he shared about being a single dad, taking care of his sons after his wife left, and leaving showbiz to take care of his ailing parents. Bruce writes a weekly column from a Dad’s Point of View, has his own comic strip Because I Said So, radio show and wrote two books. 

Marcie Mom: Hi Bruce, thanks again for being my guest! I love your #DadChat on twitter and it really got me thinking about the roles Dad play in today’s parenting. Let’s do a reality check – What do you think is the Top Parenting Activity/Task/Role that Dads are doing today and what do you think is the one that is most important, yet overlooked?

Bruce: First, thank you MarcieMom for being such a great new friend. I love your coming to #DadChat every Thursday while commuting to work. I love that the Internet allows us to “connect” with people we might not otherwise ever meet. You’re a great example of that and a blessing.

As to your question, it’s ironic that my answer comes back to something very simple. It also really applies to both dads and moms.

In our very busy world – busy lives – it is a myth to think that parents can schedule “Quality Time” with their children. Quantity Time is what works. It’s simple. Kids open up on their schedule, NOT on yours. The more time you spend with them, the better you will know them, and the better chance they’ll open up and hopefully reveal things you need and want to know.

Marcie Mom: There are a lot of tasks that dads have to do, take for instance a dad of eczema child (ahem.. without naming who!):

  1. Work – 9am to 9pm
  2. Visit parents, if they are ill (which is highly probable given our generation’s parents are close to their eighties) – an hour per day or 8 hours per week
  3. Do housework – either one or more, but hopefully not none! Washing dishes, laundry, ironing, sweeping, mopping, cleaning toilet – 4 hours per week
  4. Spend time with child – two hours per day
  5. Spend time with wife – probably only in the car! Commuting time, 1.5 hours per day
  6. Spend time managing eczema – skincare, bath and sleep routine, likely 2 hours per night

All in, that’s 19 hours, leaving 5 hours for sleep! What would be your take on how to be a Dad for our child despite the demands of the day?

Bruce: It’s funny that, so far, each of your questions really don’t inspire a dad-specific answer. I believe my answer to this will equally apply to moms.

Your husband’s situation is perhaps a bit more extreme than many overwhelmed and busy dads or moms. When there’s a sick parent to add to the mix of a full-time job, life is hard and time is precious. There is no simple answer for those situations except to remember the old biblical saying that “This Too Shall Pass.” Therefore, for someone like your husband, all I can suggest is to endure, do the best you can, and be patient for easier and better times. I also would urge your husband to get more sleep. It will do NO ONE any good if he gets sick.

But, most people choose to be busy. It really is all about time management and so many people waste so much time. Once you’re married, working full-time, and then have kids, your life is going to be hectic. The challenge is to be smart with your time. Efficient. And prioritize.

Before I was married or had kids, when all I had to worry about was ME, I took a Time Management class. It was invaluable. When you really analyze how you spend your day, there are almost always many ways you can make better use of your time.

With parenting, it’s about priorities. For instance, maybe during some of the parenting years – when the kids may need you most – you don’t put your work ahead of everything else. Maybe you don’t choose to take on that extra assignment that might get you points with your boss. Yes, you still do a good job, but maybe you just have to wait a few years before accelerating your career. Will you go to your deathbed saying you wished you’d worked more or wish you’d spent more time with your family?

Marcie Mom: I always ask myself how I’m worshipping the Lord with my heart, my mind, my body and soul. With that in mind, I find that I’m grossly overlooking growing my child’s heart and soul. What do you suppose to be a baby step that Dads can step in/ step up to groom our child’s heart?

Bruce: Ahhh, such a complicated question and, maybe, one that would only be asked by a woman? I do think – generally – that women look at the soul of their children’s lives with concern and that this is so important, too.

Religion has been marginalized by contemporary society but organized mainstream religions, in which G*d is the centerpiece and, at least for me The Ten Commandments have meaning, is one of the only ways we can teach our children true values and to care of others. Otherwise, it’s just opinion and about what feels good. Feelings have replaced values far too much in our world.

Marcie Mom: One final question – what do you suppose a wife can help her spouse to Be a Better Dad?

Bruce: This question made me smile. I will first answer simply of my wife and myself. Personally, I need validation. When my wife praises me, it reinforces my good behavior. When I’m doing a good job, I want to know that those around me – especially my wife – not only notice, but appreciate it. So, verbal affirmation is very important for me.

That said, just as we often say that what we parents “model” is what our kids will learn, I think a wife modeling good parenting will rub off on her husband. But, men tend to be dense and sometimes we men need to be hit over the head to get a point. So, this is where communication comes to bear. Sit down with your husband and talk. Never assume he will simply know what to do – or what YOU want him to do.

If there’s tension in your household, seek others for counsel. Even other couples friends can be of great support, as can clergy or a good therapist.

Men need to feel they are contributing to the world and doing a good job – both at work and at home. Let him know that. My wife bakes me pies when she either wants to praise me or as a sign of apology. She’s Chinese so verbal affirmation comes hard for her. But, she shows it in other ways.

Bruce Sallan Fav Pic
This is a picture of Bruce Sallan having fun and adventure!

Marcie Mom: Thank you so much Bruce, I love hearing from a dad’s point of view because it just reminded me that dads have different thoughts, responsibilities and pressure and I’ve to be mindful of these and work with my husband for the family to thrive!

Guest Interview

Anti-Inflammatory Recipes by SkinnyChef – Broccoli, Kale, Mushrooms

Jennifer Iserloh, also known as SkinnyChef, is a trained chef, certified health coach and healthy cooking celebrity. She is a bestselling author, including 50 Shades of Kale, The Healing Slow Cooker. She graduated with honors from the Institute of Culinary Education, worked as a celebrity chef and became a certified health coach through the Institute of Integrative Nutrition.

Anti-Inflammatory Recipes for Eczema SkinnyChef Jennifer Iserloh

This was originally a three-post series that had been combined into a single informative post. I got to know Jennifer via Twitter and asked her to share her anti-inflammatory recipes, including broccoli which is a super vegetable that my daughter still loves.

Broccoli with Garlic Sauce

garlic-broccoli recipe
Picture contributed by SkinnyChef


  • 1 large bunch fresh broccoli, (about 1 1/3 pound)
  • 3 large cloves garlic, minced
  • 1/2 cup fat-free, low-sodium beef or vegetable broth
  • 1 tablespoon low-sodium soy sauce
  • 1 tablespoon cornstarch
  • 1 tablespoon brown sugar or sugar substitute
  • 1 teaspoon sesame oil
  • 1 tablespoon canola or corn oil
  • 4 scallions, thinly sliced
  • 2 tablespoons chopped almonds


  • Trim broccoli and cut into florets. Peel stalk with a vegetable peeler and slice thinly. Set aside.In a medium bowl, stir garlic, broth, soy sauce, cornstarch, sugar or sugar substitute, and sesame oil.
  • Heat a large skillet over heat high and add the canola or corn oil. When the oil is hot, carefully add the broccoli. Cook 3 to 4 minutes, stirring continuously until the broccoli begins to brown slightly. Reduce the heat to medium and add 1/4 cup of water. Cover and cook 3 to 4 additional minutes until the broccoli begins to soften.
  • Lower the heat to medium low. Pour sauce over broccoli, cook 2 to 3 minutes longer until the broccoli is tender-crisp and the sauce thickens. Sprinkle with scallions and almonds if using. Serve immediately.

MariceMom: Thanks Jennifer for sharing the above yummy and healthy broccoli recipe. Now, I usually chop off lots of stalk and only cook the floret; I noticed that you peel the stalk and slice it thinly.

Is there a different cooking time for the stalk vs the floret?

Jennifer: They cook up well together as long as the stalk is thinly sliced, that cuts back substantially on cooking time.

When broccoli starts to brown, does this mean that part of its nutrition is lost?

Jennifer: No vitamins are lost after about 20 minutes of high heat cooking. Also I never boil my veggies.  If you boil vegetables in high amount of water, vitamins like vitamin C – which is water soluble will leach out into the water.

If you boil vegetables in high amount of water, vitamins like vitamin C – which is water soluble will leach out into the water.

MarcieMom: How do you gauge which is broccoli is fresh? Is there a best way to keep it? I noticed that broccoli kept in plastic bag tend to turn watery for the parts touching the plastic bag.

Jennifer: Florets should be tightly closed and dark green, with no yellow spots. Also look at the end of the stalks, if they are hollow or look dry that is a sign that they’ve been in transit too long.

Sunny Side Up with Kale

Sunny Side up Egg with Kale Recipe
Picture from SkinnyChef


  • 3 cups Kale, chopped
  • Non-stick cooking spray
  • 1 egg
  • 1/8 teaspoon salt
  • 2 teaspoons chipotle mayo or barbecue sauce


Rinse the kale under cold running water, drain in a colander. Heat a large skillet over high heat. Pull it off the heat to coat it with cooking spray. Carefully add the kale. Cook 2 to 3 minute, pressing down the kale with a spatula. Move the kale to the side and add another spray of cooking spray in the center of the skillet.

Crack the egg in the center of the skillet and sprinkle it with the salt. Reduce the heat to medium. Continue to cook 3 to 4 minutes, until the white part of the egg is cooked through. Top with mayo and serve immediately.

Can kale be eaten raw?

Jennifer: Yes kale is delicious raw but the baby varieties are best for this preparation.

MarcieMom: How do you usually wash Kale? It is quite soft and sometimes I find that I over-wash it after running it under the tap and soaking it! (I’m one of the really paranoid moms who keep washing everything, even when it’s labelled pre-washed!)

Jennifer: Kale is hearty and it doesn’t absorb water when it’s washed. You can clean it in a 1-4 water to vinegar ratio water bath if you like, dry it well with a towel before making my kale chips so it crisps properly.

MarcieMom: How best to spread the oil if one has no cooking spray?

Jennifer: Be sure the pan is hot first, then the oil will coat the pan more efficiently.

Mushroom Stuffed with Sausage and Goat Cheese

Stuffed Mushroom Recipe
Picture from SkinnyChef


  • 4 ounces spicy turkey sausage (about 2 links), crumbled
  • 24 white button or Cremini mushrooms, stems removed and reserved
  • 2 sprigs of fresh rosemary, one sprig left whole, plus 2 teaspoon minced
  • 2 tablespoons white wine (optional)
  • 1/4 cup low-fat, skim milk
  • 1 6-ounce package of fresh goat cheese
  • 1/4 cup reduced fat Parmesan cheese, grated
  • 1/4 teaspoon pepper


  • Preheat oven to 350° F. Heat a large heavy bottomed skillet over medium-high heat. Add sausage, stirring occasionally, breaking it up with a spoon as it browns. I like my sausage well-done, so I cook for about 20-25 minutes until the meat is a rich golden brown.
  • While the sausage is cooking, prepare the mushrooms. With a damp paper towel or dishcloth, wipe off any dirt clinging to the mushroom caps and stems. Remove stems, mince them and set aside. Place mushroom caps, stem side up in a 9-inch baking dish with one of the sprigs of rosemary. Sprinkle with 2 tablespoons of wine or water and bake 8-10 minutes until the mushrooms are tender.
  • Once the sausage is to your liking, turn off the heat and drain (if it is too oily). Add 2 tablespoons of the milk and scrap any brown bits sticking to the bottom of your pan. Place the sausage and its juices into a large bowl. Stir in the goat cheese, Parmesan, minced rosemary and season with salt and pepper. If the mixture seems heavy, add the remaining milk.
  • Fill each mushroom with 1 teaspoon of sausage mixture. Bake the mushrooms for an additional 10-12 minutes until the filling is hot. Serve immediately. Warning: These guys move fast so if you might want to prepare a back-up plan or make double!

MarcieMom: In this recipe, I noticed you suggested wiping the mushroom. I always run it under the tap, does that affect the texture of the dish?

Jennifer: Yes mushrooms are like a sponge and they soak up a lot of water.  This keeps them from browning properly when you cook them.

MarcieMom:  Is it possible to overcook mushroom? What to watch out for to ensure that it doesn’t become too soft or get too dried out?

Jennifer: If you over cook mushrooms they can taste a bit spongy but usually they do well in all cooking preparations since they are high in water content to start with.

MarcieMom: Which mushroom cook best with soup, and which one best in oven, and which for stir-frying?

Jennifer: All mushrooms do well in soup and in the oven, for stuffed mushroom Cremini, portobellos, and white button are best. I prefer shiitake for stir frying since they have this delectable meaty texture and taste amazing after they are properly browned.

Thanks Jennifer, I love shiitake as a superfood that is linked to strengthening immune system against flu (boy, my family sure needs it!).

Guest Interview

Improving our Homes for Eczema Children – Minimizing Indoor Allergens (House Dust Mites, Mold, Cockroach)

Celia Imrey is an architect and co-founder of SpaceKit; she graduated from Yale University (Masters of Architecture) and Brown University (Bachelor of Art and Semiotics, Magna Cum Laude). She is an Associate at the American Institute of Architects and is a LEED (Leadership in Energy and Environmental Design Accredited Professional) Accredited Professional. She has taught architecture and art courses at Yale, Brown, Columbia/Barnard and NYU.

This was originally a two-part series combined into one informative post.

For parents with eczema children, it is very likely you’ve ‘scanned’ your homes looking for possible triggers of eczema flare-ups (I know I did!). Whilst most of us think about our bed sheets, our laundry and carpets, we may not think about the layout and materials of our homes.

MarcieMom: Hi Celia, it’s so good to have you share with us on improving our homes. It’s also the first time I’ve an architect as featured guest, so I’m excited for the fresh perspective your interview will give to readers of this blog.

Common Indoor Allergens

The common indoor allergens are dust mites, mold, pet dander and cockroaches (droppings). We will consider how we can improve our home environment to minimize indoor allergen. Let’s start with the dreaded, all pervasive dust mites!

Dust Mites – Eczema Trigger for Children

Dust mite is a very common trigger of eczema for children, and more of it can be read in this post. They thrive in room temperature, humid environment and feeds on our dead skin. There are different allergens within the dust mite dropping, and they vary in particle size which renders some airborne while others tend to stay on surfaces. It may trigger different allergic conditions and symptoms for different ones in your family, depending in part, whether their airways or their skin is sensitized to the allergen.

Measures to reduce house dust mites are listed here, and they include removing carpets and stuff toys, washing in above 60 degC water and getting dust mite covers.

MarcieMom: Let’s suppose we are not changing where we live, but able to change our room layout and materials we use (ie major renovation):

Reducing Dust Mite through Home Design

Do the materials which we use for our floor, and for our walls, make a difference?

For instance, will certain wall materials or paint or finishing increase the surfaces for dust mites to live while others make it more difficult for them to thrive?

Celia: At Space Kit, we recommend using natural materials where possible, especially for carpets. Dust mites take refuge in carpets but can’t live on hard surfaces like wood floors or plastic. Wherever you have carpets or rugs, use wool. The natural lanolin in wool repels dust mites.  Paint does not affect dust mites that we know.

The natural lanolin in wool repels dust mites. 

How Home Design Affect Humidity & Dust Mite Growth

Is there a way to manage the humidity of our home?

Both in the overall sense, meaning to reduce trapping moisture in our home; and also particular to the child’s bedroom, should it be say further away from the bathroom or have windows positioned a certain area (or if windows can’t be moved, for the bed to be positioned differently)?

Celia: Proper natural and mechanical ventilation are essential for healthy living, especially in bathrooms, kitchens and laundry areas. A well designed home takes air circulation (and thus temperature and humidity) into account; there is directionality to air circulation, and Mechanical Spaces (where air handling equipment are) are designed in relation to the spaces they serve in order to maximize air circulation and minimize dead air pockets. Humid conditions can be countered using air conditioning and ensuring that windows are fully sealed when closed. Furniture placement near humid areas will encourage mites.

Humid conditions can be countered using air conditioning and ensuring that windows are fully sealed when closed.

Designing a Home to be Cool without Drying Child’s Skin

MarcieMom: For a child with eczema, like mine, needs to be kept cool and so sleeps in air-conditioned room. As the air-con dries the air, I actually have a humidifier on. The risk of a humidifier is of course it promotes the growth of dust mites and mold.

Do you have a solution to keeping the room cool, without making it dry or too moist?

Celia: You could cool the air before having your child sleep in the room. This will minimize the amount of time the child sleeps in dry air.  You could use the smaller, directional humidifiers to provide humid air only to the pillow area and then remove and treat the linens each day. It’s a lot of changing sheets but very hot water kills mites immediately, so regular laundering should be part of your solution if you use a humidifier.

Sunlight and Ventilation in Child’s Room Design

MarcieMom: Sunning and ventilation helps to remove dust mites.

What factors should we consider so that our bedroom can have sufficient sunlight and ventilation?

Celia: We love sunning and ventilation at Space Kit too! Light materials and paint colors help bounce light around. For bedrooms, use window treatment that provides sufficient privacy when open.  If you like sleeping in a dark space but have a privacy issue, you will need two kinds of window treatment, one for darkening the room and one for providing privacy while letting light (and some air) in.  Quality window treatment that is easy to use is critical.  You need to be able to operate it or pull back the curtains with a simple hook or tie.  Ease of use encourages you to use your windows to live in a healthier manner.

Mold, Another Common Eczema Trigger

Mold is another common indoor allergen and more of it can be read from CDC. Like house dust mite, they thrive in room temperature and humid environment. Their feeds include materials like wood, leather, dead skin and cotton and wool fibres. Mold spores are airborne and trigger symptoms and conditions such as watery eyes, sore throat, respiratory issues, nasal congestion, eczema and even asthma. Minimizing mold growth can be via control of temperature, control of humidity and reducing their food.

Choice of Home Materials on Mold

MarcieMom: As I’m preparing for this, I’m surprised to learn that many building materials are food sources for mold, including wallpaper glue, greases, paper, textiles and wood. 

Do you have suggested common materials to use for our walls and floors, and in our bathroom, so that there is less food for the mold?

Celia: Solutions that resist mold are a fundamental part of Space Kit’s designs. There are many design considerations to make with regard to moisture. Good designs don’t leak, cause condensation, or trap moisture. Some options include using good quality door seals and gaskets for shower doors. Usage of moisture and mold resistant backer boards and vapour barriers.

Are there other areas in our home that traps moisture easily and what can we do about them (both during renovation and on maintenance basis)? 

I’ve read that certain paints, leaks, damp basements, poor drainage or plumping traps moisture, and also condensation on cool surfaces can increase mold.

Celia: Basically mold feeds on untreated, natural surfaces. Space Kit promotes the use of natural materials, like stone, ceramics, plaster and wood and we advocate finishing them properly. For example, wood is a beautiful home material, especially for floors, but it needs to be finished properly, so use varnishes, stains, paints, and fill all the cracks. In using any natural material, make sure all the surfaces are coated and maintained.  Wool carpets are dyed and the dye is bound with a sealer. If you keep carpets clean and off any floors that have moisture issues like concrete floors in a basement, they should not feed mold. Space Kit’s window treatments use materials that hinder mold, like synthetic materials. For bathrooms, we recommend tiling the full walls.

Note: be vigilant about spotting mold: undersides of tables, on ceilings, etc. and treat immediately before it spreads.

What about the selection of cabinets, walls, wall coverings, bookshelves and also the positioning of furniture? Do these affect mold growth?

Celia: None of these affect mold growth if there if proper air circulation.

Bathroom Design on Mold Growth

MarcieMom: My guess on the common area in our homes where mold thrive is the bathroom where it is often damp. 

What are your recommendations to minimize mold in bathroom?

Celia: Our designs are intended to minimize moisture retention, for example, we like glass shower doors (with systematic wipe-down after showering) instead of curtains. Proper ventilation for bathrooms and dryers is critical.

Cockroach – The Yucky Eczema Trigger

Cockroach, more precisely the allergens found in their droppings, saliva and bodies, is another common indoor allergen. From the AAFA website, it is mentioned that When one roach is seen in the basement or kitchen, it is safe to assume that at least 800 roaches are hidden under the kitchen sink, in closets and the like’.

Cockroaches thrive in warm and humid environment, and they feed on our food (thrash, scraps, starch) and water. The particle sizes of cockroach allergen are large and tend to settle on surfaces. They not only worsen allergic conditions, but carry bacteria.  Symptoms or conditions of allergy to cockroach may be itchy eyes, itchy skin, eczema rashes, nasal congestion, asthma and allergic rhinitis. Minimizing the growth of cockroach can be done by observing hygiene and minimizing their food source, water and shelter.

Prevalence of Cockroach Allergen in Dust

In a study published in the New England Journal of Medicine, of the children in the study, “36.8 percent were allergic to cockroach allergen, 34.9 percent to dust-mite allergen, and 22.7 percent to cat allergen. Among the children’s bedrooms, 50.2 percent had high levels of cockroach allergen in dust, 9.7 percent had high levels of dust-mite allergen, and 12.6 percent had high levels of cat allergen”.

I understand that cockroaches hide outside the home, what are the possible areas in our home to ‘seal off’ cockroaches?

Celia: Sealing the hole around the steam pipe and sealing the hole around all plumbing and electrical pipes. Also, you can utilize drain covers to prevent critters from entering up into your home through showers and sinks.

MarcieMom: Chemicals may trigger irritation either in airway or skin for young children. It is best, therefore, to use cockroach trap. This may sound strange, but is there a need to plan ahead where cockroach traps should be placed?

Celia: If proper preventive measures are appropriately taken such as sealing of holes and cracks, then there is no need to plan for precautions.

Safe Chemicals at Home for Children

MarcieMom: While we’re on the topic of chemicals, which are the materials you would commonly recommend that are safe for young children, and for how long would ‘airing’ be required before the family moves into the home?

Celia: Materials with zero or low VOC content are recommended for children and adults. It is best to move in after all the fumes from the paint have disappeared (i.e. that are no off gassing smells) and the home is dust free.

MarcieMom: Thank you so much Celia for helping us improve our homes and minimize the indoor allergens, right from the renovation stage!

Guest Interview

Improving Self-Esteem for Teens

Improving Self-Esteem for Eczema Teens series with Annie Fox

Annie Fox, M.Ed. is an internationally respected educator, award-winning author and a trusted online adviser, specializing in helping teens become people of good character who’ve got the social courage to do the right thing online and off. Annie is a return guest to my blog, who previously shared on her own teen eczema experience here.

This was originally a two-part series which had since been combined into one longer informative post.

Dermatologists recognized Self-Esteem concern for Teens

Marcie Mom: Dermatologists have told me that self-esteem is a concern for teenagers with eczema, and even asked me to do a teen graphic book (I did one for the toddlers here). Let’s try to tackle self-esteem in parts, so let’s get started!

What is Self-Esteem?

I understand that it’s very much to do with how one views himself/herself, can you explain this giving an example relevant to teens?

Annie: How one views oneself (on a physical level as well as on a personality/character level) is self-perception. Self-esteem, is the value we place on who we are. People with “low self-esteem” tend to shy away from challenges (speaking up, reaching out to others in friendship) because they may experience feelings of not “measuring up” for whatever reason. Most teens across the board, report feel ‘insecure’ to one degree or another at one time or another. They may think: “I’m not __________ enough.” You fill in the blank (hot, cool, smart, athletic, thin, rich, good, etc.)  Obviously if a teen has a physical condition (like eczema) that is noticeable, it can make that girl or guy feel self-conscious. And that’s likely to have a negative impact on self-esteem.

But if that teen has a strong support system, among family and friends, plus personal strengths in the areas of abilities, talents, etc. then that can be a powerful counter-balance to whatever feelings he/she may have about the eczema.

What can you do about Self-Esteem?

Marcie Mom: Now, knowing what is self-esteem, I’m assuming the whole point is we can do something about it, something to improve it even for teenagers with eczema that is apparent on their skin.

What can a teenager do for himself to improve his self-esteem? And is there anything a parent can help in?

Annie: Real self-esteem comes from within. And typically that means a sense of satisfaction in one’s abilities. When a teen has opportunities to pursue his/her interests (sports, music, writing, dance, theater, art, etc.) then he/she is likely to have many moments of joy and pride. He/She may think “I can do that well!” and those occasions will build self-esteem. Does that make the eczema better? Probably not. But it will make it easier for the teen to deal with whatever emotions come with the territory, Teens with real self-esteem may feel “down” about the way their skin looks, but they don’t stay down for long.

Sharing about Teen Eczema

Marcie Mom: For a teenager with eczema, do you recommend that he/she take a different approach to let his/her friends know, depending on their personality? Or is there no need to openly share about eczema?

Annie: When I was dealing with eczema as a teen, I regret not ever having an open conversation with any of my friends about the conditions. We were close friends and shared so many teen secrets, hopes, dreams, but I somehow decided that I couldn’t talk about my eczema. Looking back, I realize that was a mistake on my part. My friends would not have rejected me. Rather than expending all that energy “hiding” the rashes on my arms or on my neck, if I had chosen to talk about it with a few close friends, I could have relaxed when I was with them.

So, yes, my advice is, that if you’ve got eczema, it’s not your fault and you’ve got nothing to be ashamed of! Educate people and you will find it easier for yourself in social situations.

There is power in honesty.

Social Media Posting on Eczema

Do you think that posting pictures of his/her eczema on facebook will help or worsen the pressures the teen is facing?

Annie: I don’t know the answer to that one. Facebook is a very public forum. And there is a group mentality of cruelty on social media. My gut reaction to your question is “no.” I don’t think that would be helpful. In fact, I think it would result in certain people using a teen’s honest posting as an opportunity to be disrespectful and insensitive. It’s a personal choice, of course, but I doubt that one would get the kind of universal acceptance that one was looking for. And then what? You’re left feeling hurt, embarrassed, and upset.

‘Cool’ with Eczema? How should Teen Respond to Outside World?

Marcie Mom: Now a tricky question – if a teenager is really bothered by his eczema and feels bad about it, should he hide it by appearing not bothered and ‘cool’ about his skin? Is it even possible to do so?

Annie: I’m not a fan of pretending… even though I was voted Class Actress my senior year in high school. That gives you an idea of what a very skilled “pretender” I was! But like I said before, pretending to be something you’re not expends a lot of emotional energy. It is also very stressful because, actually, to “appear” not bothered about your skin when you are actually extremely bothered… is probably going to stress you out even more! And one thing we know about stress is that it contributes to inflammation! Instead of pretending anything, and stressing yourself out, I would strongly suggest that any teen with eczema, look into studying meditation. There are simple beginning breathing techniques to calm the mind and body. And from there you can learn more about how your mind works and how thoughts (worries about your social standing and the way your skin looks, etc) can be managed so that they don’t control you.

Marcie Mom: Finally, I may not have asked the right questions, as it’s based on what I’ve learnt from other parents. Is there any aspect of teen eczema and self-esteem that I’ve missed out asking?

Annie: You’ve asked very thoughtful questions, Marcie. I thank you for this opportunity to share some of what I know with teens and their parents.

Marcie Mom: Thanks Annie for taking time to share your journey with us, teenage years are so difficult even for those without eczema and those with eczema would certainly appreciate your advice.

Guest Interview

Eczema Kids Nutrition with Judy Converse: Breastfeeding – Impact on Eczema & Infant Reflux

Newborn Eczema Kids Nutrition with Judy Converse Dietitian Nutritionist EczemaBlues

Judy Converse, MPH RD LDN is the founder of Nutrition Care, a licensed nutritionist, a registered dietitian who has a master’s degree in public health nutrition and a bachelor’s degree in food science and human nutrition. She has also testified for safer vaccines and consulted with industry partners on specialized formulas for infants and children with inflammatory conditions. Her books include:

This is a 4-topic series focused on nutrition for babies and toddlers with eczema. It was originally spanning 7 posts, and combined to 3 longer informative posts.

Breastfeeding – Does it Prevent Baby Eczema?

MarcieMom: Judy, thank you for joining me today! Now, on breastfeeding’s impact on eczema, it appears to be still a controversial conclusion if it helps prevent eczema (I did a quick online search, and here and here already present varying conclusions).

Are you aware of any definitive study on whether breastfeeding (i) prevents eczema and (ii) lessens the severity of eczema?

Judy: Okay, this gets technical, so bear with me. One of the papers you’ve mentioned comes from a collaboration with the International Study of Asthma and Allergies in Childhood (ISAAC), which is an ongoing survey across several countries for inflammatory conditions in children. Given the large numbers in the study, the finding of “lack of benefit” from breastfeeding was puzzling. It also puzzled me that other papers from ISAAC have been equally muddled on benefits of breastfeeding relative to asthma.

Sounds impressive – a “study” with over 50,000 subjects? But this was a weakened tool in many ways: It is a survey, not a study; it is retrospective, not prospective; it is uncontrolled (no control subjects to compare who had only formula); it is based on voluntary parent reporting, which may be faulty or biased some of the time; and I did not see that there was a comparison of exclusively breast fed to exclusively formula fed children. It appears that the survey may only have looked at degrees of breastfeeding relative to eczema.

How can we measure the impact of a variable (breastfeeding), if nearly all of those surveyed got some of it? You need an exclusively formula fed population as a control to really find the answer.

Also, the abstract doesn’t allow us to see detail for methodology. It mentions that over 50,000 children with asthma and allergies were evaluated somehow, but doesn’t say much about the breastfeeding survey, methodology or numbers, or introducing solids, which is another big factor. It says that the benefit of breastfeeding that was noted disappeared after age four months – which is when many babies are first given some solid foods. The authors state that benefit of breastfeeding for eczema disappeared at that point. There is no mention of introduction of solids here – was this observed in any way?

I think it is over-simple to state that benefits cease at this point. If the survey only looks for “ever” breastfed and “any eczema ever”, it is weakly designed and can’t give very clear information. It also takes a somewhat trivializing tone on the finding that breastfeeding lessened “sleep disturbed” eczema, which is a significant benefit for weary families and babies struggling against inflammation. Having your baby wake in pain or bleed from scratching is pretty unpleasant.

To make this survey powerful, the authors would have needed a control group of over 100,000 matched children (8-12 year olds with asthma or allergy) who were exclusively formula fed ever, that is, never breast fed at all.

When I see information gathered in this way, I am skeptical – Why go to such lengths to collect or evaluate data in a weak fashion? Surveys are useful to point researchers toward next questions. But I think this survey almost does a disservice, by casting doubt on benefits of breastfeeding for eczema, without careful controls. Even with the design flaws in this survey, the authors still found a small benefit to breastfeeding. Breastfeeding is so important for so many reasons.

Childhood Vaccinations’ Impact?

A further dilemma here, the elephant in the room, is the influence of vaccination, which strongly correlates with more allergy, asthma, and eczema (the authors of that study inexplicably attribute this effect to doctor visit frequency). Earlier vaccination correlates strongly with asthma, another inflammatory condition. There is meanwhile a compelling ongoing survey that shows less allergy, eczema and asthma in unvaccinated children (and better health over all). This too is limited by voluntary parent reporting, no true controls – but the difference in the two groups is so dramatic that a true trend appears to exist. It certainly needs closer study. A prospective study comparing exclusively breast fed babies to exclusively formula fed babies, vaccinated and/or not, would be fabulous. We need robust prospective design to really answer these questions. But there is considerable opposition to work in those areas.

Probiotics in Breastfeeding Moms’ Diet

All that said, there are still other studies that show weak or little impact on eczema for breastfed babies. We may simply be looking at the wrong parts of the puzzle, or looking at it in too narrow a way. For example: A baby’s gut biome may be quite predictive of who gets inflammatory conditions like allergies, eczema, and asthma. This well controlled and blinded study found a dramatic reduction in likelihood of eczema for babies who were breastfed by moms supplemented with probiotics. And, breast milk supports a different, healthier gut biome than formula. Bifido species bacteria appear so far to be more useful at lessening eczema for infants than Lactobacillus species, which may play more of a role as the baby grows toward childhood.

Do Allergens Go into Breast Milk?

MarcieMom: As mentioned in the previous Q&A, allergy testing is not accurate for an infant. Many moms with eczema children feel really stressed about whether it’s what they eat, that ends up triggering the rashes via the breast milk.

How does the mom’s body process the food that she eats into breast milk? Do the proteins (or whatever else?) in common food allergens like cow’s milk, wheat, egg, peanut and soy go into the breast milk and therefore capable of producing the same allergic reaction as if it’s ingested directly by the baby?

Judy: I was one of those moms whose baby could not tolerate my breast milk. It was devastating. I agreed to a trial of hypoallergenic formula and had mixed feelings when it helped my son. In my training, there was no explanation for this. I was taught that there was no such thing as a baby allergic to breast milk, but here we were. What I ate clearly affected my son too. So when I did go back to nursing him, because I wanted him to have all the benefits of breast milk, my diet was limited to rice, meats, some vegetables and fruits, and nuts for fats. I ate a lot of pecans and walnuts, and a little peanut butter, because I craved fats and was shirking all the fish I loved to eat (this was 1996, and we lived near the ocean). Well, those are the only tree nuts that my son is still quite allergic to at age sixteen, even though he has never eaten them himself! His only exposure to pecans, walnuts, and peanuts was via my diet through breast milk. He has shown IgE reactivity to these ever since.

I was taught that there was no such thing as a baby allergic to breast milk, but here we were.

I don’t know if we can confidently say that we know everything about how we process dietary proteins into breast milk, but we can likely assume variation across individuals. There is an interesting conversation here on this topic. Certain things don’t seem to vary much – like how much total protein is in mom’s milk, mineral levels, or total calories – these can waiver very little – but vitamins, types of fats, or amounts of fats can vary quite a bit relative to mom’s food intake, and toxins certainly do too.

Leaky Gut – Mom & Baby

One of the emergent pieces is the gut biome, again – that is, what microbes populate the mom’s gut, and the baby’s gut, and are either of their intestinal lumens compromised in any way? Is there any permeability that shouldn’t be there? If mom harbors a suboptimal biome that allows for “leaky gut”, then larger fragments of food proteins may enter her blood and will be picked up by breast tissue, which is richly vascularized with high blood flow. If on top of that, the baby’s gut biome is weak or his gut wall is leaky, you have a double hit for increased odds for eczema and allergy.

So, again, several moving parts to this puzzle: The mom’s diet, mom’s gut biome, digestion, and intestinal wall integrity; mom’s toxicity level, stress, fatigue, and endocrine functions that regulate her milk production. Then we have the same factors to consider for the baby, including stress. 

The mucosa that lines a baby’s throat and gut is less developed and more permeable than an older child’s or an adult’s, so mom having a healthy gut may be the best prevention, to keep larger food peptides or proteins out of her milk in the first place. Antibiotics, certain toxins, heavy metals, and vaccines can interfere with intestinal wall permeability and function too – and infants now get more exposure to these than ever.

Is there an Ideal Breastfeeding Diet?

MarcieMom:What about some foods that a mom ought to eat more when breastfeeding? I understand that the field of epigenetics is gaining more attention as results of studies on animals are promising – the eating and health habits of one can reduce the chances of an individual being diagnosed with a disease he is genetically predisposed to. 

Should a mother who is breastfeeding then consume more anti-inflammatory foods, probiotics or foods that aid skin repair? If yes, which foods would you recommend and how to ensure that moms don’t over consume?

Judy: Anti-inflammatory, probiotic foods are good for everyone. Though there is plenty of debate on this topic, this generally means eating a plant strong diet: Lots of fresh raw organic vegetables, greens, and fruits, along with traditional fats like those from organic meats or dairy products, butter, whole unprocessed, unsweetened organic coconut milk, olive oil, and oils from organic raw nuts and seeds. Humans have always made and eaten fermented foods. If you don’t like or can’t eat yogurt, kombucha, kim chee or sauerkraut, naturally cured meats, poi, or other fermented foods, or if you don’t have access to safe raw dairy products (which contain healthful fats and enzymes that are altered or lost when pasteurized), you can supplement with probiotics. There are now hundreds of probiotics products available.

Look for diverse strains and high potency, over 15 billion colony forming units (CFUs) per dose.

I often use much higher doses than that in my practice.

Anti-Inflammatory Foods for Eczema Children

Beyond that, if there are still skin symptoms, then work with an experienced provider to identify the trigger foods. I usually use an ELISA IgG food antibody profile for this in my practice. There is debate about that too, but used in the context of a total nutrition assessment (which should always include signs, symptoms, a food diary, and a medical history – never just lab tests alone) I can use that lab result as a jumping off point to make a good elimination plan for my clients. Then we add in anti-inflammatory supplements if more is needed: Things like nettles, curcumin, fish oils, N-acetyl cysteine, and of course the right probiotic.

Dealing with Reflux in Eczema Infant

My baby had from drinking more than 100ml per feed, it dropped as low as 20ml due to the reflux. I don’t even know what type of reflux it was – sometimes she simply seemed not hungry and refused milk; other times, she would drink all (after much coaxing) only to vomit a flying trajectory of milk over her head about 30 minutes later.

Is there any conclusive study linking eczema and reflux?

Judy: I have not looked for that, but I have witnessed it often in my practice. My experience agrees with often finding the two together. It doesn’t matter anyway, because the baby just needs to feel better! My first suspects are always protein intolerance, and gut biome imbalance – and yes, these two problems are often linked. It’s easy to assess and begin treating both, even with just a good history (no lab tests), though at most a stool test may be useful.

In my book Special Needs Kids Go Pharm Free, reflux, colic and eczema are what I address in the first chapter. What amazes me is that many pediatricians don’t seem to realize that while this is quite common, it is not normal, and may not be benign, for a baby to experience all this.

What Infant Reflux Mean?

It can mean that there is inflammation, weak absorption, or gut dysbiosis, especially after ruling out structural or mechanical concerns that cause a baby to reflux. Reflux medications assume that the baby’s stomach is too acidic, when the opposite may be true. If these can give a little short term relief, that’s fine, but I like to see them used only short term, and after a well managed trial of natural steps have failed. Long term, medications for reflux can exacerbate it. They diminish nutrient absorption, and favor colonization of the gut with fungal species – which in turn may worsen gut permeability. Once you have more permeability, you are likely to have more allergy/eczema.

Types of Infant Reflux

MarcieMom: What types of reflux are there? I looked it up online and but got quite confused; could only understand that Gastroesophageal Reflux Disease (GERD) is when the lower esophageal sphincter does not close properly and the stomach reverses its contents back into the esophagus. Judy, what are the common types of reflux affecting infants?

Judy: Many things can trigger reflux in any age group, and a sudden onset of it warrants your doctor’s attention. Your pediatrician or pediatric gastroenterologist can rule out structural or mechanical triggers, or very unusual causes or circumstances that may warrant different treatment. In any case, the norm is to have peaceful digestion – not reflux, spit up, projective vomiting, or chronic hard colic (gas with a hard belly and inconsolable crying). Most often babies with reflux do not have a serious medical circumstance or mechanical flaw causing the trouble, and natural steps may solve the problem. 

It is more common that the baby is not tolerating the feeding well, or has a weak gut biome that does not aid digestion. 

This biome is so important for the baby especially at birth, when the gut is not immune-competent and has limited ability to digest food. Certain microbes appear to “train” the immune system via the gut, and help us digest first feedings. I discuss this in Special Needs Kids Go Pharm Free too. It’s an exciting niche of medicine that I think will become more and more important – what is our relationship to the biome in general, how do we best co-habitate with it, and what are the best ways to nurture a supportive biome in the body? This is where I think medicine needs to go.

Home Remedies for Infant Reflux

MarcieMom: In Singapore, it’s common to burp the baby and if the baby still refuses milk, the common assumption is that there is air in the tummy creating fullness. Remedies that parents use are usually anti-colic drops available in pharmacy and herbal oil that purports to reduce tummy air. Judy, are the abovementioned correct remedies for reflux? (or are these not reflux issues/treatments? My baby’s reflux disappeared at 3 month old, around the time I use Dr Brown, a bottle with a tube insert to release air.)

Also, when should a parent start to be concerned with the reflux, i.e. no longer a common reflux that affects babies, and seek doctor’s advice?

Judy: I’m not sure what is in the drops you mention. One brand called Mylicon (which is simethicone, an artificial compound that helps air bubbles stick together into larger ones, presumably so the baby can burp better) was found to be least effective of all treatments, compared to changing the baby’s primary protein source or using herbal remedies. Meanwhile I have been pleased in my practice with natural measures, like certain herb drops, changing up the feeding strategies and protein source, probiotics, homeopathy, and treatment for fungal species overgrowth in the baby’s gut.

When Infant Reflux Warrant a Visit to the Doc

As for when to intervene, include your baby’s comfort and your intuition in this process. Reflux medications have been overprescribed for infants, at least in the US. Reflux is common, but it has been normalized to a point where placing a baby on reflux medication is considered benign. I don’t agree. A little spit up is normal as the baby is developing coordination in swallowing and in digestive functions. But losing most of each feeding is not normal, nor is it normal for a baby to suffer constantly with hard inconsolable crying and a hard belly, or to drop away from his growth trajectory on the growth chart.

Chronic projectile vomiting is not normal.

Your baby deserves to feel well, comfortable, and happy, to gain and grow steadily, and to pass stools easily every day, eg, soft formed, or wet/mushy for breasts fed babies. Stool that explodes up the baby’s back or runs down the legs, or is dry and painful to pass, or are less frequent than daily or every other day – these are all signs that digestion is impaired and things can be made more comfortable for your baby. If those symptoms occur along with reflux and eczema, intervene for your baby’s contentment and comfort.

MarcieMom: Thank you Judy, once again I’ve learnt much and should I ever decide to have a second baby and he/she has reflux, the first person I think of calling is you!

Guest Interview

Eczema Kids Nutrition with Judy Converse: Newborn – Just Milk but Complicated

Newborn Eczema Kids Nutrition with Judy Converse Dietitian Nutritionist EczemaBlues

Judy Converse, MPH RD LDN is the founder of Nutrition Care, a licensed nutritionist, a registered dietitian who has a master’s degree in public health nutrition and a bachelor’s degree in food science and human nutrition. She has also testified for safer vaccines and consulted with industry partners on specialized formulas for infants and children with inflammatory conditions. Her books include:

This is a 4-topic series focused on nutrition for babies and toddlers with eczema. It was originally spanning 7 posts, and combined to 3 longer informative posts.

MarcieMom: Judy, thank you so much for helping us. My questions will be based on my (thankfully, past!) experience and what I know other moms of eczema children face. We know that the American Academy of Pediatrics recommend breastfeeding for 6 months, but in reality, it’s not always possible in every family. In my case, I just can’t generate sufficient milk supply even after consulting with lactation consultant, taking their recommended supplements and a harrowing ordeal with tricking my baby to latch despite my lack of milk (using the supplemental nursing system).

Selection of Milk Formula for Eczema Babies

For parents of eczema child who are choosing formula milk, would you recommend that they go for fully hydrolyzed or partially hydrolyzed formula from the onset?

Or should they wait and see if the child is allergic to cow’s milk before switching to alternatives? Since allergy testing is not accurate for a new born, how can a parent know if it is cow milk allergy?

Judy: First we should understand “hydrolyzed”. That means the formula uses an in-tact, whole protein source – casein or whey or soy – which is treated with enzymes to partly break it up or hydrolyze it. The idea is that this will make it easier for the baby to absorb. It’s a reasonable place to start. If it works, it should work in a week or so, to settle eczema down. But many babies do just as poorly on this as they do on whole protein formulas (this was my son). Then what?

But many babies do just as poorly on this as they do on whole protein formulas (this was my son)

Probiotics in Formula Mix

There are a couple of options. The baby may do better on any formula, if gut biome is replenished with probiotics. I work these into care plans for many infants and children. There are many different types and potencies. Some probiotics are not appropriate for babies. More experience and data are emerging to show that beneficial bacteria are critical to mitigating inflammation in a newborn’s gut. What grows in a newborn’s gut appears to be predictive of whether or not they have allergies or asthma years later. So, no matter what, if a baby is having signs of inflammation, I would be keen on getting a probiotic in the mix.

Elemental Formula for Babies

If trouble persists, the next step is elemental formula. These are different from hydrolyzed formulas because they are not made from naturally occurring protein. Instead, individual amino acids are blended in a specific ratio known to be essential for human newborns. These are ready to absorb. A healthy human gut will break protein down into these constituent amino acids during digestion. So this formula simply provides the protein in that form, ready to absorb, and it can’t trigger inflammation. What surprises me is how often this option is not offered to families whose infants are really uncomfortable with eczema and colic. Many pediatricians may not know about elemental formulas. Brand names are Elecare or Neocate. The caveat with using formulas is that they change the baby’s gut biome. That is, they change the profile of bacteria in the baby’s gut. Breast milk sets up the healthiest gut biome, which humans need to develop normal, healthy immune signaling and avoid allergy. Formulas, especially the elemental ones, make it easier for nasty species like Clostridia difficile or fungal strains to grow.

Breast milk sets up the healthiest gut biome, which humans need to develop normal, healthy immune signaling and avoid allergy.

To have a win win, use a probiotic for your baby. My book Special Needs Kids Go Pharm-Free guides parents on how to pick these, and what to do for colicky babies with eczema.

Is it Cow’s Milk Allergy for your Eczema Baby?

Second – how do you know it’s cow’s milk allergy? Easy. Do an elimination trial. Newborns eat one protein source (breast milk, or formula). Change it and observe. Note that soy protein is triggering often as well. My preference, if breast feeding is truly out, is to trial homemade goat milk formula (I provide recipe and steps to do this safely in my books) first. This often goes very nicely, and it may support a healthier biome than commercial formulas. If eczema is still persisting, then I suggest hydrolyzed casein or whey formulas, then elemental. If you must use soy protein, which I hesitate to do since it has other impacts as a phytogen and is usually genetically modified, then be sure you use an organic source.

Which Cow’s Milk Formula to Choose?

MarcieMom: Let’s talk about the scenario where the child has no cow’s milk allergy and parents can decide among the many brands of formula cow milk. I’ve read about the toxins in formula milk – the antibiotics given to the cows and the cows eating a diet of genetically modified corn. I’ve also seen babies who drank lots of formula milk growing very big, exceeding far more than 100% on the growth chart.

Is there (i) any conclusive study done on formula milk and its impact on the child’s health, (ii) does formula milk contain toxins and is it inflammatory? (if yes, which ingredient makes it so?) and (iii) how soon should parents attempt to replace formula milk with solid food that are rich in protein, calcium, vitamins and other minerals?

Quality of Breast Milk

Judy: Breast milk is best, hands down. We’ve all heard that, and it is still true. There are so many immune modulating components in human milk that formula will never be able to emulate. It is so powerful in this regard, that it may outperform vaccinations in protecting the baby. Its impact on gut biome and long term immune function is just emerging in the literature. Unfortunately there are toxins in breast milk too, simply because we now live in a toxin filled world. These concentrate in breast milk. Rather than not breast feed, I would like to see women become conscious prior to pregnancy about eliminating toxins from their diets. Begin early to eat very healthfully, avoid pesticides, poor air quality, heavy metals, and other toxins. Consider working with providers who can help you detoxify prior to conception.

Quality of Commercial Milk Formula – Corn Syrup & GMO

Meanwhile, yes, it is often easier for babies to gain and grow on commercial formula, as long as they are not allergic/sensitive to it. Bottle-feeding can offer faster delivery, so more is taken per feeding. But “more and faster” is not necessarily better. The carbohydrate source is often corn syrup, which is troubling for weight gain in older children. And yes all these ingredients – unless you have an organic formula – may come from genetically modified sources. I think there are enough data implying that GMO foods may be more allergenic to consider avoiding these entirely for a newborn, or during pregnancy. This is a big debate. For more info, parents can visit Click on the link for health professionals, then on the “state of the science” link.

Solids for Your Baby

Solids can be introduced once your baby is able to sit well unassisted, can hold his head up, and is able to move soft foods to back of tongue and swallow them safely with a little practice.This can be around six months, but later is okay too. This might also depend on your baby’s growth pattern. Some will want solids sooner than others.

Cow’s Milk Alternative

MarcieMom: Let’s talk about the scenario where the child has cow’s milk allergy. What would be the cow’s milk alternative? Fully hydrolyzed formula or goat’s milk (which I understand to be similar to cow’s protein, so may not help cow milk allergy?) or soy milk or rice milk?

Judy: We covered that in the previous section, except for rice milk. Rice milk should not be used for infant formula, period. It is devoid of protein and healthy fats that are essential for brain development. Please do not use rice milk! Same goes for oat milk, hemp milk, or almond milk. None of these are safe or appropriate for babies as a substitute for breast milk or formula.

Rice milk should not be used for infant formula, period. 

Goat milk has casein, as does cow or human milk. But it is in a gentler configuration, slightly different than the cow casein, and is often quite tolerable for babies who can’t take cow’s milk. Again think in terms of two parts to this puzzle – the protein source, and the baby’s gut biome. Both may need changing to successfully arrest inflammation.

Advice for New Moms – Choosing Cow’s Milk Formula Alternative & Reading Product Label

MarcieMom: I remembered the first six months when my baby was too young to take allergy test, we were advised to switch to partially hydrolyzed milk (our girl turned out not to have any allergy). When her rashes didn’t go away with the partially hydrolyzed milk, we switched to goat’s milk then soy milk (her rashes were still there all the time). It was a stressful experience copying all the ingredients across formula brands and different types of milk, and comparing which brand had higher carbohydrates, protein, calcium, DHA and more than 20 nutrition elements listed. What would be your advice when choosing formula milk – I assume first decide on the type of milk and once that’s decided, how to see which brand is better formulated?

Judy: This is too much stress for a new mom! I went through that and then some myself. This is how I became so interested in this niche of practice. I could not fathom that my pediatricians didn’t have good answers for me, or why it was so hard. I would have added an elemental option to those you were told to try, plus probiotics. As I mentioned earlier, this is commonly overlooked.

Worth Looking Into – Why a Baby’s Gut Could be Inflamed

I would also want to know what set your daughter’s gut up to be inflamed. Did she need antibiotics, C-section delivery (another early antibiotic exposure), time in NICU? All these things disrupt optimal colonization of the newborn gut with healthy bacteria. If this is found to have been the case, sometimes babies need herbs or medications to treat fungal species dominating the gut biome. I give this topic a lot of ink in both my books.

Milk Protein Sensitivity

Your daughter may have had a milk protein sensitivity and a soy protein sensitivity, without allergic to either. These are mediated by different classes of immunoglobulins, one is IgE (allergy) and the other is IgG (sensitivity). Both can cause skin changes, feeding problems, and eczema.
A negative IgE test does not mean that a food protein is safe. Most allergists do not test for IgG reactions, because they think the testing is unreliable. This is not my experience in practice. The tests are not perfect, but they are useful, when interpreted in the context of food intake, signs, and symptoms.

MarcieMom: Thanks so much Judy, honestly, I feel like bursting into tears now, just thinking how difficult the first 9 months are, sorting through the milk formula, breast feeding, solid feeding – if only I’ve known you earlier! I’m sure many parents reading this will feel the same, and start to ask their docs of other alternatives.

Guest Interview

Eczema Kids Nutrition with Judy Converse: What is Reliable Nutrition Information

Newborn Eczema Kids Nutrition with Judy Converse Dietitian Nutritionist EczemaBlues

Judy Converse, MPH RD LDN is the founder of Nutrition Care, a licensed nutritionist, a registered dietitian who has a master’s degree in public health nutrition and a bachelor’s degree in food science and human nutrition. She has also testified for safer vaccines and consulted with industry partners on specialized formulas for infants and children with inflammatory conditions. Her books include:

This is a 4-topic series focused on nutrition for babies and toddlers with eczema. It was originally spanning 7 posts, and combined to 3 longer informative posts.

Starting with the Fundamentals – What’s Reliable Nutrition Information?

MarcieMom: Judy, thank you so much for helping with this series, it’s very relevant for children with eczema and parents would be eager to learn more on nutrition (don’t we all think of what to feed our kids!). We will work through 4 different topics for this series, but before that let’s tackle something more fundamental.

Nutritional Study for Eczema

Nutrition advice is seldom given by dermatologists or pediatricians and understandably so since doctors are (i) not trained in nutrition and (ii) always careful not to advice beyond what’s been clinical proven. Are there then insufficient studies on nutrition’s impact on health and eczema? If so, can you explain the difficulties with conducting a large scale nutritional impact study? (I’ve googled eczema and nutrition study and could only find studies relating to pregnancy diet, fish oil and probiotics, and even that seem inconclusive.)

Judy: Nutrition is hardly a new science – It has been around as a science for over a century. But it has not been part of most physicians’ training for decades. So we have a huge gap in the knowledge base of physicians. Some data show pediatricians know little more than parents do about nutrition. To get reliable information, at least here in the US, parents may have to turn to a naturopathic doctor, a dietitian specializing in pediatrics, or find a physician who happens to have decided to become knowledgeable about nutrition. You would look for a masters degree in a nutrition science from an accredited university, in addition to the MD degree, in that case.

You would look for a masters degree in a nutrition science from an accredited university, in addition to the MD degree

As for data on nutrition and health – absolutely, the impact is profound. This is why there are nutrition program initiatives in UNICEF, the World Health Organization (WHO), and US government. You truly are what you eat. You grew in the womb from what your mom ate and rearranged into you! And in infancy and childhood, nothing is more predictive of healthy outcomes than strong nutrition status.

You truly are what you eat.

Challenges in Eczema Nutrition Studies

Regarding eczema, I have seen published data on this. Elimination diets, probiotics, fish oils, and other supplements are promising and frequently helpful. This may be a little harder to find since much of what gets published in medical journals is about pharmaceuticals, not natural substances.
Pharmaceuticals get researched much more, because they are patentable and thus very profitable. Nutrients and foods are neither, so there is less interest in studying these in any medical context.

Studies are hard to do on this topic because it’s hard to control the test variable – mainly, foods eaten. There are a few methods of assessing food intakes in a research context, all of which are time consuming and interviewer dependent. And, people lie or forget when it comes to reporting what they eat. They just do. You then also need well controlled subjects, e.g., 3000 kids age 4-5 years old who all have the same growth status at the start of the study, no bowel or feeding issues, and so on. Lastly there simply is no controlling the biggest wild card: What is in each child’s gut for biome (microbe population), which has much to do with how they digest/absorb food, and how inflammatory a food may become. Lots of moving parts, for something that cannot create a profitable product. This is why these studies don’t get done.

Lots of moving parts, for something that cannot create a profitable product.

Reliability of Nutrition Information on Web

Supposing that doctors won’t be able to advice on nutrition and should patients not have access to nutritionist and turn to the internet for nutrition information, what is your advice on how parents can discern which nutrition advice they ought to read and adopt?(Particularly given that there always seem to be a nutritious food that suddenly receives all the magazines’ attention or different website will go all out to propose that their type of supplement works wonders.)

JudyAssess the source of the info, and look for credentials. University degrees, clinical experience, peer review authorship, lecture experience at respected venues, and licensure demonstrate expected level of expertise. Nutritionists in the US are licensed by state, and have to complete ongoing credit hours, pre-approved by the licensure boards, to keep their credentials. Licensure is not the same as a certificate, which can mean anything, from attending an afternoon lecture to taking unaccredited correspondence courses with no professional oversight. People often identify themselves as “nutritionists” but may have little training.

Assess the source of the info, and look for credentials. University degrees, clinical experience, peer review authorship, lecture experience at respected venues, and licensure demonstrate expected level of expertise.

Look also at whether or not the info you are reading is from a person who simply writes a lot, or is actually in practice. Many dietitians choose careers in communications or media, and never actually see patients once they leave school. They don’t have hands on experience. For tough questions, case experience is invaluable. It’s where scientific inquiry incubates, when it comes to medicine.
Ultimately, if you’re really motivated, you may find that you need to delve into the medical literature yourself. This is unbelievably easy now with the web. I’ve met many parents in my practice who have become laudable experts on certain facets of nutritional biochemistry, in their quests to solve their children’s health challenges. I am grateful to learn new things all the time from the families I work with.

Supplement Trial DIY Style – What to Take Note

MarcieMom: Also suppose a parent decides to try a certain food or supplement for their child, what would be the time frame to look at to determine if it is making the child healthier (or improving his eczema) and what signs should the parent look out for to determine that the child is better or worse? (for instance, weight/height or skin or bowel or hair or teeth or alertness?)

Judy: First, parents need to know if a supplement or food is the appropriate measure. That is what I help parents sort out with an initial nutrition assessment. That’s best – you get a baseline, identify the problems, and choose the tools to fix the problems. But in reality, parents do tinker with supplements. I discuss this dilemma in both my books. You can waste a lot of time and money here, if you don’t approach this more methodically. There are tables and charts in my books to help parents sort out what might be the right next steps, with regard to using supplements. I explain dosing, time frames, and more.

You get a baseline, identify the problems, and choose the tools to fix the problems.

Kids Nutrition – A Process, not a Pill

Next, nutrition is a process, not a pill. If a child has entrenched eczema and underweight, there is probably not going to be a single answer to that, and it is probably not going to go away overnight. Unlike medications, nutrition aims to solve the problem from a deeper level and help the body heal itself. I would look at several factors in the assessment process to sort and prioritize what is
going wrong. Different problems respond at different paces; some supplements work fast; others, like fish oils, can take weeks to calm and restore the skin. Nutrition tools are only as good as the weakest piece. They all work together. If you only fix one problem and overlook others, that child will continue to do poorly, even if you’ve picked a great supplement to try.
That said, once I have the pieces in place for an initial plan, I expect a child to respond fairly quickly. Positive changes should emerge within the first month.

MarcieMom: Thanks Judy, and your explanation sheds light into why there sometimes is a disparity between what the supplements say they will achieve and why it sometimes do and don’t.