I remembered that detergent was one area which I received lots of ‘advice’ on, especially when Marcie’s skin was very bad about 7 months old. It’s frustrating, and that’s one of the reason I’ve set up the support group because only parents with eczema children go through all the other stuff that comes with eczema flares.
This is the seventh of my “101 Things that Moms with Eczema Child Do Differently“, a tongue-in-cheek look at the many unique situations that we face. For more cartoons, click here to view.
One thing that my husband and I can’t quite agree on is how much to moisturize – I like to slather huge amounts (think pressing the bottle pump vigorously, and just applying VERY liberally) while my husband prefers to pump with measured control as he feels that too much moisturizer get wasted on the clothing and when my baby hides under the blanket to escape from us). So how much is enough? And when to moisturize?
Let’s first establish that moisturizing is a must; it’s the one advice that I had from Marcie’s doctor Prof Hugo Van Bever, and in his words “You Can’t Moisturize Enough”. In a later follow-up consultation even after Marcie’s eczema is under control, his advice is still to continue moisturizing.Moisturizing helps to restore the skin barrier which is typically broken/thin in eczema skin, and that allows irritants and allergens to penetrate the skin. Moisturizer helps to trap water (after a bath) and also retain moisture in the skin. As you can see in the chart, people who moisturize more had to pay less visits to the doctor. I also read that the more moisturizer one uses, the less severe the eczema is.
So, how much to Moisturize? From what I’ve read is 400-500 grams per week, that’s one bottle of QV 500ml lotion or 2 bottles of Physiogel lotion, which is also the amount that I’ve been applying for Marcie. If you read my budgeting post, you will know how much it cost.
Steroid first or Moisturizer first? That’s another item that my hubby and I can’t agree on, but I think he’s right. Steroid first, then moisturizer.
When to Moisturize? Immediately after shower, and roughly at every diaper change/ 2-3 times per day. Moisturize even when the eczema is under control and for whole body, not just the rash area.
What Moisturizer to choose? I’ve tried to decipher the ingredients with not much success, but have posted here on what to generally look out for.I’ve later read that silicone is to protect the skin, butylene to re-hydrate and prolipids to restore. I know that propylene glycol and sodium lauryl sulfate may irritate the skin. You can also refer to this link for more on the ingredients (I didn’t summarize them ‘cos I’d tried for 2 days to compare ingredients across brands and they just don’t label them the same way…)Whatever it is, don’t give up on moisturizing! Anyone has any brands that worked for your child? Do post in the comments, thanks!
Update on:
How Much to Moisturize – read this Q&A with dermatologist Dr Jeff Benabio here
On Steroid or Moisturizer first – read this Q&A with Dr Bridgett here
On which ingredients to avoid in skincare production – read this Q&A with Dr Verallo-Rowell here
Are you considering whether to have a second child? I am, as Marcie is turning two years old, and I am really scared that my second child will have eczema. It feels like we’ve just got past the ceaseless scratching, the blood, the tears and still struggling with a good night’s sleep. Can I, should I, really have a second child?
I did a search online, and sad to say there’s no conclusive research on whether a second child will get eczema, here’s a quick summary of the research results:
1. Having older siblings have a protective effect on the younger siblings, because the younger sibling has more chances to mix with an older child, thus immune system more likely to be strengthened with more chances of infections
2. Having older siblings have NO protective effect! (so, you see it’s really contradicting) There are more instances of younger siblings with eczema due to filaggrin (FLG) deficiency, which is a deficiency in skin barrier protection. This FLG deficiency leads to dry skin, and increased chances of allergic march (i.e. getting asthma, allergy after eczema). When the younger siblings attended day care, there is less instance of this FLG deficiency.
3. There is a higher chance of the younger sibling getting eczema when both one parent and one sibling has eczema. There is also a stronger association between eczema in siblings and with parents.
4. Having more children protects the younger siblings. Problem is there is no answer as to how many children you need to have for one not to have eczema/allergy.
5. Younger siblings’ cord IgE is less, i.e. younger siblings have fewer instances of allergy than the older child. The first born tend to suffer from hay fever and pink eye from food or other allergies.
So, there you go, still no answer, anyone have more than one child, do share how the eczema in your children is. I’m really at crossroads…
If your child has eczema and has been avoiding a food that he/she has been tested positive in the Skin Prick Test (SPT), it may be time to review if there is indeed a true food allergy. Research indicates, as I understand from various online articles, that the skin prick test is a test of sensitization, and not clinical relevance. Below are some points on the accuracy of skin prick test:
1. Skin Prick Test is more accurate for non-food allergen, such as dust mite and pollen, than for food allergen.
2. Skin Prick Test is More Accurate in predicting when there is NO food allergy and Less Accurate in predicting a Positive food allergy. The implication of this is that children who have been avoiding food (for example more than 50% of those tested positive for milk and eggs, and more than 70% of those tested positive for peanuts) actually didn’t have an allergic reaction to these foods. (There is only a 0.5-10% chance that a child who is allergic to a food will test negative for it.)
3. Follow-up tests are required for skin prick test for children at different age, sometimes about 1-2 years later. The results can be different as children may ‘outgrow’ some allergy or develop new ones? (hopefully not…)
4. An oral food challenge is the most accurate (less than 5% incorrect).
5. For children with eczema, there is an 80% possibility that food that the child is avoiding turn out not to be one he/she is allergic to. Refer to this article for detailed research.
Despite above, Skin Prick Test still remains the most recommended first test for allergy, as it is by comparison simpler, lower cost, faster results, more tolerated (children won’t feel much pain, you can read this post on my baby Marcie’s experience) and more accurate than blood test. If anyone has an experience to share on skin prick test for your child, do comment below this post.
One of the most contentious parenting issues between my parents and I are over giving my baby cold water. From about six months old, when my baby Marcie was started on water and solids, I realised that she preferred cold water, refrigerated baby juice and fruit puree. My parents had always disagreed over the temperature of her food, even to go as far as suggesting it caused her eczema and low weight gain; both of which, I countered with (a) my baby whose eczema is triggered by heat really prefers cold stuff, and eating cold food is better than no food and (b) the low weight gain is due to abnormally high birth weight (heavy newborn at 4kg plus) and possibly, lack of good sleep.
So, is giving cold drinks to baby really that bad? My answer, if you do not believe in TCM, is no – drinking cold drink will mean that your baby needs to use energy to warm the liquid up, thus less energy for body functions. If you believe in TCM, the theory is that cold drink weakens your lungs, lowers your immune system and as my parents believe, causes asthma (which again is a myth). However, certain cold drinks (not due to the temperature) are indeed bad for your baby:
2. Sugary drinks that increase chance of tooth decay.
3. Artificially flavoured drinks which have been linked to ADHD.
As you can see in my baby bag, I always pack ice or cold drink (or both if going to the zoo). To me, if cold water can stop my baby from scratching, offer her (and me) some relief when dining out or when outdoors in a park/zoo, why not?
It all depends on whether your child is allergic to pet dog dander/hair and you can find that out by getting your child tested, usually through a skin prick test or blood test. If your child is tested allergic, then the best way to avoid triggering an eczema flare is to not have a pet dog. There’s website offering information that certain dogs are hypoallergenic because they have less hair/dander but studies have debunked that correlation.
Bedlington Terriers
If you have a pet dog, there are a number of ways to reduce the chances of your child coming into contact with the pet dog’s dander/hair:
By Keeping the Pet Dog Dander/Hair out of the House and the Air
By keeping the dog outside of the house and off the furniture, at least off your child’s bedroom
By minimizing materials that trap animal dander such as carpets and curtains, upholstered furniture, wool bedsheets (best if you have polished floor, plastic/wooden furniture and cotton sheets)
By removing airborne animal dander by using HEPA air purifier
By vacuuming frequently using a Miele or another HEPA filtered vacuum cleaner (my colleague’s daughter’s allergy specialist recommended Miele brand and I see it being recommended on most sites)
By Reducing the Pet Dog Dander/Hair that your Dog Shed
Wash your dog at least weekly with dander reducing shampoo
Wash your hands thoroughly (remembered watching on ‘The Doctors’ that a test done on various items of a dog owning family revealed dog poo even on the owner’s wallet)
The Good News…
The good news is that a study conducted by Dr. Tolly G. Epstein suggest that children who have an allergy to dogs AND who have exposure to dogs before the age of one year old has a lower chance (14% vs 57%) of getting eczema by age four years old, compared to children with a dog allergy and did not have a pet dog. (note to cat lovers: It’s the reverse, i.e. more likely to develop eczema after having a cat if already have a cat allergy 54% vs 33%)
And the other good news is that children who don’t have a dog allergy won’t develop one after having a pet dog (is that true? didn’t see this published much, anyone has experience?)
Here you see a very happy baby playing at the pool, and the next?
Fallen ill with stomach flu
That happened TWICE to my baby girl Marcie, as she always thought it’s funny to drink the pool water. Marcie has eczema and we brought her to the swimming pool from about nine months old, at the advice of her doctor. It didn’t do much good nor bad to her skin till one time when the baby pool was closed, we brought her to the 1.0m pool. Her skin improved markedly every time we brought her to the deeper pool and we thought it might be due to soaking in a deeper pool versus just standing mid-waist in the baby pool. But Marcie started getting more at ease in water and dared to walk off the pool into her daddy’s arms. That, on top of always trying to drink pool water, could have made her ill. So while it is good to go swimming with your baby, here’re the do’s and don’ts.
Do’s
Check with your baby’s doctor (I’ve read that some severe eczema babies not recommended for swimming)
Check with the pool staff on how they disinfect the pool if you’re really concerned (chlorine is supposed to be the least irritating of the disinfectants)
Apply sunscreen lotion before swimming (choose one suitable for baby)
Shower immediately after pool and apply moisturizer generously
Don’ts
If your child has not recovered from cold/fever for more than 10 days or has not recovered from stomach flu (i.e. solid stool) for more than 48 hours, don’t bring your child to the pool.
Don’t leave your child alone, drowning or water intoxication (swallowing too much water) is dangerous.
Don’t continue swimming if your child is shivering (hypothermia is a risk); bring baby out of the pool and wrap in warm towel.
Don’t swim for too long, limit to no more than 30 minutes for child below 1 year old
Feeling sad for Eczema Girl! Does your child sleep well?
Have you seen those rompers that has a mitten over the long sleeve to reduce damage from baby scratching? Recently, I keep coming across parents recommending such clothing as it worked for their children. So, I googled and the interesting thing is almost all of the companies that retail these clothing were started by moms desperate to find a solution for their babies scratching at night. That, to me, is quite inspiring, making something good out of managing eczema, which we all know is something we don’t wish on any child (AND it is the moms!). Below are some of the price comparisons (I haven’t bought any for my baby, so I can’t comment on the product; I also don’t get paid for this post).
Pounds 30 for a Poplin Sleepsuit – (can’t find made where, company based in UK) 100% cotton with 47th Element Silver Technology (according to their site, silver can prevent secondary infection and remove bacteria overgrowth). Clothes made with mid weight cotton, not too warm nor too thin to be scratched through. Tear-off labels on outside and no seams inside.
Pounds 17.99 for a full suit romper – (can’t find made where, company based in UK)
Uses Okeo-tex 100 cotton which reduces chances of allergy from dyes
Clothing using bamboo
Quite a few online shops selling organic baby clothing uses bamboo as the main material, citing that bamboo is hypo-allergenic, soft, breathable and thermal regulating. Also supposed to be 3-4 times more sweat absorbent than cotton and that since bamboo is not prone to pests, no pesticide is sprayed on bamboo and that there is anti-fungal property.
As a guideline, avoid wool and synthetic fibre. Wash new clothes to remove chemicals from manufacturing. If you are currently tying mittens on your baby, well.., one of the site wrote that it’s not recommended as it is the hand/eye coordination practice time for baby development and squashing the fingers together, make them even hotter and itchier and and the knot may lead to skin damage if baby uses it for scratching. Also, that it creates stress.. that I think is quite hard to avoid!
Do you co-sleep with your child? Ever wonder if she sees it as you loving her?
Taking a nap
About 60 to 80 percent of children with eczema suffers from sleep disturbance, resulting in about 2.5 hours less of sleep per night. As you know, as a parent of eczema child, our sleep is affected too! (and usually we get cranky, tired, irritable when sleep is disturbed for consecutive days, usually days when there is an eczema flare, resulting in more itch and more scratching)
I have often wondered if my baby has enough sleep and how does a lack of sleep affect her?
Number of Hours of Sleep for Your Child
There is no standard must-sleep-how-many-hours and if your child is putting on healthy weight gain and alert and happy during the day, you should not be unduly worried. My baby girl Marcie has always slept 10 hours per day, no matter what different routine we adopt to increase her sleep. The rough guide for a new born is 16 hours per day, 3-6 month old is 13 to 15 hours/day, 6-12 month old is 12 to 14 hours/day and 1-year old onwards is 10 hours/day.
How a Lack of Sleep affect Your Child
Sleep is important and a lack of sleep results in:
– Low weight gain, due to less growth hormones (lack of sleep may also lead to obesity and diabetes due to imbalance of hormone that regulate hunger and metabolism of sugar)
– Slower healing of the skin and aggravate eczema, lower the immune system (haven’t we fall sick before when burning the midnight oil?)
– Behavioral disturbances such as irritable, impatient, fussy, moody, hyperactive and impulsive
– Difficulty in concentrating, poorer memory (as long-term memory improves with adequate sleep)
– Accident-prone (think overnight drivers who suffer from lack of sleep)
– Tired (If possible, send your child to school later when sleep is badly disturbed by eczema flare)
All is not lost though, since (keeping my fingers crossed) eczema child is brighter (see this post) and the better the eczema is managed, the better the sleep will be. Read my 5 tips to help your child sleep better (I co-sleep with my baby and I think I will as long as she wants to and still scratches at night…)
TCM uses herbs, acupuncture and cream for treatment
TCM uses herbs, acupuncture and cream for treatment
You may have been asked by your friend to explore TCM (“Traditional Chinese Medicine”) treatment for your child and wonder if it is viable. I wondered the same and read whatever I could online on it. The information is sparse and prescriptions seem to differ based on the TCM doctor’s interpretation of your child’s condition after examining his skin, tongue, pulse and asking questions about his urine, stools, behavioural and sleep patterns. There is therefore no standard prescription and as a result, there is much less research on the effect of the treatment. Below are whatever I understood based on reading online.
TCM Treatment
The treatment is based on that the skin is affected by the ‘inside’ of the body and thus, herbs or acupuncture may be used to treat your child’s kidney, spleen or liver. The treatment is usually to remove toxins, phlegm, dampness and ‘heat’ in blood. Acupuncture for kids may use the Japanese system sho-ni-shin which does not involve puncturing the skin. Herbs, of up to 15 types, may be prescribed for you to boil and give your child. Cold compress using herbs, oatmeal bath, moisturizing herbal lotion may be prescribed too. Read more about TCM and eczema in this interview with TCM practitioner.
Versus Western Approach
There appears to be many similarities such as moisturizing, soaking in bath oil and control of allergic food. Diet control seems to be prescribed without conducting a skin prick test, and generally food such as cow’s milk, sugar, addictive, food colors and preservatives are to be avoided. I came across an article that suggested not having the child vaccinated as vaccination has toxin (I think vaccination is important and unless supported by strong medical evidence, we should not be excluding vaccination for our child).
So is TCM Safe?
I always think it is safer to consume something when the side effects are known then to consume something with no known side effects (since no one tested it)! The herbs that TCM prescribe may be anti-inflammatory, antihistaminic or immunosuppressant. The improved results may not take place at all or from 2 weeks to 8 months from what I’ve read on other parents’ forum posts or blog or research. The biggest question obviously is we know oral steroid works very fast but we know it is not for long-term use (in fact, my baby Marcie’s doctor said strictly once for Marcie), is it possible then for a TCM medicine to work equally fast and yet so safe that no side effect is known? So far, there are people online that sent their TCM medicine for lab analysis and found to contain steroids (equally, you will find others saying TCM doesn’t contain steroid), people who stopped the TCM medicine and the rashes came back or others who continue with steroid application while undergoing TCM treatment.
As mentioned earlier, the research is too little on TCM and for children, I personally won’t risk it, unless I have access to a lab and can test everything the TCM doctor gives my baby.
Pause for a moment and think how many times you have said “Stop Scratching!” today. I used to keep saying that to my baby girl Marcie until I read that it is not the best way to get her to stop scratching. There’s little research done in this area available online, but supposedly, asking your child to stop doing something is less effective than rewarding him/her for not doing it. Also, it can annoy/upset your child to be told consistently to stop doing something that they can’t control. My own guess is that they are smart enough to know that scratching gets our attention and even do it more when throwing tantrum.
Here are a few tactics for teaching our children not to scratch that I read online, some which I use:
1. Get your child to hold the itchy part tightly (supposed to help relieve some itch, but I don’t practise it as my baby is too young and likely result in her to focus more on the itchy part)
2. Distract the child (that’s what I do all the time, check my post on keeping fingers busy, coloring and I also learn sign language with my baby. Sometimes, at night, when she scratches while trying to fall asleep, asking her to show me a sign works)
3. Set up a reward chart with stickers to reward not scratching
4. Try wearing eczema clothing (I haven’t tried this but a parent have recommended to me)
5. Cut nails short (I haven’t cut Marcie’s nails for more than half a year cos she “files” them herself)
What is most important to me is to stop remarking to my hubby that it is his bad gene and also to banish the words “bad skin”. I noticed that my baby scratches even when alone, as scratching feels good, so I am also very careful not to imply she’s doing it on purpose.
I have drawn a picture book (published as e-book, “A to Z Animals are not scratching!” to teach young children not to scratch and also starting a support group for moms (and dads) who need people to understand what we are going through (and hopefully, we can reduce the inadvertent “Stop Scratching!” to our children!).
Is your child just irritable with his/her skin condition or has ADHD (attention deficit hyperactivity disorder)? Just came across two studies in 2003 and 2009 that suggest an association between eczema and ADHD in children. 5.2% of 1,436 children with eczema also have ADHD versus 3.4% of children without eczema. Also the younger the child has eczema, the increased likelihood of ADHD. When I read this, I’m thinking “Oh no! Watching TV is already linked to ADHD (and we do let Marcie watch TV to distract her from scratching while we do some housework/eat a quick meal) and now eczema also?!”
The good news is that the studies do not suggest a causal relationship, not definitive and it could also be that eczema children see a doctor more often, thus more chances of detecting ADHD. It could also be that eczema children who suffer from lack of sleep get restless or cranky, and not that they have ADHD. The even better news I read online is that eczema children are “very bright” as the skin and the brain develop at the same time, so “very reactive skin and very reactive mind” according to Sophie Worobec MD at University of Illinois.
In case you are wondering if your eczema child has ADHD, as we sometimes wonder, below are some symptoms of ADHD:
– Can’t focus on the task, easily distracted
– Unable to pay attention
– Fidget when sitting/ climbing all the time
– Talk excessively, can’t play quietly
– Impulsive
The ADHD behavior has to continue for 6 months. ADHD, like eczema, is also linked to genetics and immune system. Having a daily schedule, immediate reward system for good behavior, eating high protein food (like meat, beans, eggs) and complex carbohydrates have been reported to help with ADHD (but again nothing conclusive). So.. while I can’t survive without letting Marcie watch TV and can’t do any better than what I’m already doing for her eczema, I will read more books and build more blocks with her.. hopefully, it helps.
2014 update: Read also Dr Cheryl Lee, dermatologist, views on ADHD, eczema and environmental pollutants here.
Marcie had her half-yearly check-up last Saturday at NUH’s children clinic and we are happy that her skin is considered good enough not to use steroid. Instead, we ought to follow the 3 tips from her doctor, Prof Hugo (in picture):
1. Moisturize, especially after Marcie has got in touch with water (after a bath or swimming)
2. Use chlorhexidine before applying steroid cream to clean away the bacteria so that the steroid cream will be more effective
Update 2018: Instead of chlorhexidine gluconate wash, Octenisan is recommended instead as it is less drying. Do not use an antiseptic body wash daily as both the good and bad skin bacteria are washed off. Also, the antiseptic body wash lotion has to be left on the skin for at least a minute before rinsing off to give sufficient time for the antiseptic to work.
“OH NO, could it be what I ate?” This was what went through my mind when I first read that pregnancy diet could increase the chance of my baby getting eczema (and my baby girl Marcie has eczema since two weeks old). I am not writing this post to put more guilt and blame into your life, but rather, if you’re considering a next child, it will be good to avoid some food or increase the intake of others. There is no conclusive evidence despite some scattered research reported on the web, so the overriding consideration is still to have a balanced diet (because a diet that is not balanced can lead to a whole host of other problems in the foetus and mothers who restrict their diet have resulted in smaller babies).
Here are some food to avoid:
1. Margarine; vegetable oil (too much will be too fat anyway)
2. Citrus fruit; celery (I ate lots of oranges during my pregnancy! Then again, my hubby has eczema so it’s more likely hereditary than diet)
3. Peanuts (Again, I ate peanut butter every morning! If your child has eczema or allergy, the advice is to delay giving peanuts till 3 years old)
4. No smoking or alcohol
Results of 2007 German study of 2,641 children is that food rich in n-6 polyunsaturated fatty acids and citrus fruits increase eczema in children up to 2 years old, whereas food rich in n-3 polyunsaturated fatty acids decrease chance of infant eczema. A later Japan study in 2010 shows that green and yellow vegetables, citrus fruit and beta-carotene reduces chance of infant eczema. (So citrus or no citrus?)
Here are some food to increase:
Fish or fish oil
Lactobacillus reuteri as oral probiotic supplement (my friend with eczema was prescribed this during pregnancy and both her girls turn out with no eczema)
Personally, I will eat more fish, take the probiotic supplement, not eat so many oranges nor peanut butter in my next pregnancy. I know how scary it is thinking our next child will also have eczema, fingers crossed..
Update: Almost 2 years later, we’ve decided not to have another child BUT more importantly, linking this article to a Q&A that I did with nutritionist Judy Converse on breast milk and pregnancy diet.
Update for a study in October 2014 that studied associations between maternal iron status in pregnancy and childhood wheeze and atopy. The results suggest that reduced maternal iron status during pregnancy is adversely associated with childhood wheeze, lung function and atopic sensitisation, justifying further studies on maternal Fe status and childhood asthma and atopic disease.
Update for a study in Nov-Dec 2014 that looked at all past studies Does maternal diet during pregnancy and lactation affect outcomes in offspring? A systematic review of food-based approaches. Conclusion was did not find widespread or consistent links between mothers’ dietary intake and atopic outcomes in their children. However, maternal consumption of Mediterranean dietary patterns, diets rich in fruits and vegetables, fish, and vitamin D-containing foods were suggestive of benefit, requiring further evaluation.
Lately, I came across a recommendation by a mom that using udder cream has helped with her child’s eczema. Udders are mammary glands and the care and hygiene of the udders are important in milking. Udder creams are developed to soothe the chapped skin of the udder, prevent infection and irritation during milking. Somewhere along the line, the udder creams have been re-formulated to a less greasy form, and sold to adults and infant for eczema treatment, marketed with the following points:
Natural skin care
Skin repair properties
Anti-inflammation
Anti-fungal
No paraffin oil
Over in forums, some moms have feedback it worked while a few others lamented that like other natural creams they have tried on their children, it irritated their skin. I haven’t tried it or on my child, but seems like most of these udder creams are not sold over the shelves but instead through stockists or online; read my interview with Moogoo founder.
More likely than not, children with eczema tend to have poorer sleep due to eczema flares or scratching. My baby Marcie at 18 months is still co-sleeping with us, and it has helped her to sleep better (though it hasn’t helped me to sleep better, but as you can appreciate, it is joy to see our children without bloody scratches in the morning).
Apart from co-sleeping, below are my top 5 tips to help our children with eczema sleep better.
1. Keep the room cool
Heat is often a trigger but do get your child tested to know what the triggers are for him or her. Marcie’s trigger is heat and we have the room cool (air conditioner at 22 deg C, fan at low speed 1 and humidifier).
2. Apply plenty of moisturizer
There is really no running away from applying moisturizer. Moisturizing keeps the skin from drying, which in turn reduces the chance your child will scratch. If you need help with the choice of moisturizer, you can read this post.
3. Keep baby fresh
As sweat can be an irritant to broken skin, I shower my baby later in the evening, after her dinner; or if she has already showered twice for the day, I will wipe her with cool boiled water using soft cotton pad. Of course, plenty of moisturizer after bathing or wiping. You can read about showering your child here.
4. Have her wear light cotton clothing
A few times, I put her in one piece long suit that really helps to keep her from getting to her itchy skin BUT it also makes her warm. You can trial and error to see if it is better to have her wear short sleeve or long sleeve. I’m sure you know by now that your child has a knack for finding ways to scratch, even when you thought he or she is ‘well protected’ with the pyjamas.
5. Treat the eczema rash
Do treat the rash.. I use steroid cream on alternate day or when the rash is persistent and looks inflamed. I read that wet dressings are effective but I don’t know how to do it. I just like to encourage you that steroid is not that bad if used appropriately, you can read about steroid safety here.
I also set up a bedtime routine of reading books, singing songs, turning off all the lights and playing baby christian songs. We also pray for good night’s sleep!
Heat and perspiration is the most common trigger of eczema and that’s exactly what gets my baby Marcie scratching. To keep the room cool, especially when it’s summer all year round in Singapore, you would have to on the air-conditioner. However, that makes the air dry and from experience, I realized that a humidifier did help my baby to sleep better. Here’s various pros and cons of a humidifier.
Pros
Helps combat dry skin, caused by air-conditioning. Dry skin is prone to irritation and lead to scratching. Doctor Claudia Aguirre commented in 2012’s twitterverse 1st Eczema twitter party hosted on this blog that should the humidity falls below 40%, moisture will start to strip away from skin, for full twitter party transcript see here.
Cons
Dust mites thrive in humid environments, so if your child is tested to be allergic to dust mite, you would need to find the right level of humidity to get the air moist, without encouraging dust mite to thrive (usually 30% to 50% humidity)
Too humid environment encourages growth of mold, which may be a possible trigger of eczema
And as I always emphasize, it is important to have your child tested to know what triggers the eczema. You can check out my Top 10 Eczema Tips and posts on Skin Prick Test and Itch Triggers.
When my baby Marcie got hand-food-and- mouth disease, my brother introduced me to Manuka Honey as it supposedly can help to reduce the ulcers in the mouth. After doing a google search, I am surprised to find that there are many links relating to how manuka honey can help with eczema. Being curious, I did a little research and though the verdict is still not conclusive, Manuka Honey seems to be a fairly safe product with no known side effects.
What is Manuka Honey?
– Produced by bees that collect pollen from manuka bush native to New Zealand, proven to have anti-bacterial property above ordinary honey
– UMF stands for Unique Manuka Factors, where say a UMF 12 stands for 12% solution of antiseptic
Other benefits published in a 2006 article DailyMail.co.uk suggest ability to fight superbugs, bacteria that causes gum disease, soothes sore throat and helps with digestion
Word of Caution
– Got to find active manuka honey in cream form, rather than applying honey direct onto baby, o.w. so sticky (and yucky or yummy, depending on how you see it!)
– One teaspoon is recommended for adults, so not to be given in excess to children
– Not to be given to babies below one year old (some links recommend 2 year old)
Update: View this post in 2014 with a compilation of studies on honey’s effect on eczema
Limited evidence (there's still some evidence) of protective effect of partially hydrolyzed formula for high risk babies
Partial Hydrolysed Milk sold in Singapore
Partially hydrolyzed milk formula, such as Enfalac HA and NAN HA, was recommended to my baby girl Marcie when her eczema was diagnosed by the paediatrician at one month old. It was a nightmare getting her to drink the less tasty milk formula and each bottle feed dropped from 85ml to 20ml! It seemed to improve when we made the switch from NAN HA to Enfalac HA but you never know if it was due to the milk or that the reflux or gassiness got better.
The irony is that when I brought Marcie for a skin prick test when she was seven month old, she isn’t actually allergic to cow’s milk! The paediatrician had assumed that Marcie’s eczema was caused by food allergy, when it was intrinsic. So, I began to google whether HA milk was worth the money and whether I should let my next baby have hydrolyzed milk from the start.
So, here’s what I’ve found on this:
1. Partially hydrolyzed milk is non-hypoallergenic
This really confused me since the label clearly stated hypoallergenic. However, it seems like unlike extensively hydrolysed milk (which is not available in supermarket), only part of the cow’s milk protein is broken into smaller pieces.
2. Partially hydrolysed milk is proven to reduce risk of food allergy
So far research suggests that partially hydrolysed milk reduced the risk of food allergy, but it is not recommended for babies which has a firm food allergy. That is, if your child is already tested allergic to milk, giving partially hydrolysed milk can still give rise to allergic reaction.
3. Everyone says the best is breast milk
Naturally, it is cited on all labels that WHO recommends breast feeding for first six months. Problem is, parents like you and I, who are already stressed out with dealing with babies with eczema are unlikely to have the rest or the time to drink fluid or have proper nutrition, to produce enough breast milk! Easy to say, but we all know the effort required to produce breast milk.
I think, given that eczema is hereditary and to spare myself from the trauma of switching baby’s formula from a normal sweeter one to a partially hydrolysed one (should my next baby also has eczema), I would just start off him or her with HA milk.
Update: I’ve interviewed nutritionist Judy Converse on partially hydrolyzed milk about 2 years from this post (time flies!) and click here to read her explanation. Also check out this post in 2015 that compiled the significant studies on partially hydrolysed milk’s preventive effect for eczema high-risk infants.
Since last Friday when my baby girl Marcie’s teachers called to say they suspected that she has hand-foot-and-mouth disease (“HFMD”), my life, my hubby’s and Marcie’s have been miserable. Today is the 6th day of her HFMD, counting from Friday, 1st day where red bumps showed up on her hands and in her mouth. Here are some quick questions answered on HFMD, especially what happens when a baby with eczema has it (btw, Marcie is 17th month old).
1. How do you know if your baby has HFMD? Will it be confused with eczema rash?
When I brought Marcie to the doctor to verify if she has HFMD, the doctor did seem to take longer to check but made the diagnosis of HFMD when he saw ulcers in the mouth. Below are some pictures taken from the Singapore’s Health Promotion Board’s website, provided by KK Women’s and Children’s hospital.
HFMD on non-eczema child
2. What is the difference when HFMD happens to a baby with eczema?
In Marcie’s case, it didn’t look much like the above but instead the HFMD red bumps appear where she has been scratching most frequently, like her hand and her foot. I’m not sure if the degree of ulcers got to do with the immune system of the baby, but Marcie, fortunately, did not get red sores on her tongue but her tongue seems to be swollen and she drooled a lot.
HFMD on baby’s eczema foot
3. Did the scratching get worse on the eczema skin patches?
It didn’t for Marcie and instead got less scratching, until when the red HFMD bumps subsided, she started scratching again.
4. Will a parent get the HFMD from the child?
Yes! Especially as I co-sleep with my baby, I actually got flu (fever, sore throat, running nose) a day before the ulcers showed up on my baby.
5. What food does a baby take given there’s ulcers in the mouth?
Hydration is key as a baby drool a lot when the mouth has ulcers. If you google, every child seems to have their own preference in times of HFMD. It was traumatic to come up with ten different meals/food just to get Marcie to eat some, here’s what she did eat if it helps:
a. Hard-boiled egg
b. Steamed bun
c. Yoghurt (she only ate when I let her explore the fridge!)
d. Noodle
e. Baby rice cereal with strawberry sorbet (even then the trick didn’t work after 2 meals)
She did drink her favorite pear juice, some chocolate milk and Vitagen. For the past 6 days, she lost 1 kg, and I’ve lost 2kgs taking care of her!
