how to help baby eczema

How can I help my baby’s eczema? Practical tips for parents

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Anyone who has dealt with eczema in babies and young children knows how relentless it can be – constant vigilance is required to keep it under control. Trying to slather a wriggly young baby with emollient and steroid creams whilst attempting to keep it off their flailing hands (and inevitably going straight into their mouth) requires some pretty impressive ninja style skills. At least it is good practice for when they turn into toddlers and can actually run away from you. Trying to catch a half moisturised child and make them stay still is akin to trying to grab a slippery eel…

Eczema has affected both my children, but has particularly been a problem for my eldest. The main trigger for him is his food allergens (dairy, eggs, soy and previously wheat), but even strictly staying away from those his eczema has persevered with unexplained flare ups and occasional infections.

After 5 years, with lots of perseverance, trial and error, medical appointments and – most helpfully – learning from other parents, we’ve now finally got to a point where it is pretty much under control. So, here is what I’ve learned over the years; no medical advice (I’ll leave that to the professionals), just lifestyle and practical tips. Of course, it will be different for every child, but these are things I wish I had known to try earlier.

  • Keep going until you find an emollient cream that works for your child, and for you. Emollient creams are not all equal, and different things work for different people – we tried at least five before settling on one which worked for my son. But bear in mind that it needs to work for you too, as you will be applying it A LOT. During the quest to find a good cream, we were prescribed an incredibly oily ointment. It was so thick and slippery that my baby was then impossible to pick up, it never fully soaked in, and it marked everything it came into contact with. No matter how well it cleared up the eczema (not very well for him as it happens), if it’s not practical to apply then it won’t work.
  • Staying on the theme of emollient creams, good advice on how to apply it is not always given. A quick smear is not enough, you need to apply a good thick layer and make sure you get into all skin folds and creases (behind ear/knees/armpits etc. can be eczema hot spots). Emollients should be applied every day, regardless of whether the eczema is active or not. Our standard is twice a day (morning and evening), but during a flare up it can be multiple times a day. If you are using any other prescribed creams make sure to ask how your GP how much of a gap to leave after moisturising. If we need to apply steroid then we leave at least 15 minutes to let the emollient sink in, but some creams will go on before the emollient. When the kids were babies I would put scratch mitts on them while waiting to put the next creams on, as otherwise the cream would get all over their hands and straight into their mouths! The Itchy Sneezy Wheezy site has some videos about how to effectively apply emollient.
  • Laundry powders can be a big irritant for children even with the mildest eczema. You can get detergents designed for sensitive skins (we use Surcare) but the most important thing is to make sure whatever you are using is non-bio. Whichever detergent you are using, running an extra rinse cycle at the end of every wash helps to get rid of any residue. It’s also worth asking anyone the kids spend a lot of time with to switch to non-bio – particularly if it is someone who gives them lots of cuddles or somewhere they nap/sleep over.
  • On his first skin prick test my son had shown a slight reaction to dust mites, but not enough to reach an allergy threshold. Given all the other triggers we were dealing with, it wasn’t something I gave much thought to. Then as he got older, the eczema on his face (particularly around his eyes and cheeks), became much more of a problem. His specialist suggested this may be a dust mite issue and, as predicted, his next skin prick test showed the reaction to dust mites had become worse. At first I panicked that I would be spending every waking minute hoovering and dusting, but actually putting in place some other really simple measures made a big difference (I’m afraid the hoovering is still important – and don’t forget under the bed – but you don’t need to go into overdrive with it). We started using specialist allergy-barrier mattress and pillow protectors, and washing all sheets, pillows and duvets regularly at 60 degrees to kill off the mites. For us that was enough, but you can find information about further steps to take on this Allergy UK fact sheet.
  • At age 3 my son had a bad eczema relapse, with loads of unexplained flare ups and multiple infections. I went into overdrive thinking that he must have developed further food allergies and drove myself crazy trying to work it out . A few months and another skin prick test later, it became clear that he had developed a pretty big reaction to early tree pollen. The skin flare ups were his main reaction, and hay fever never occurred to me because I always associated it with sore eyes and stuffy noses. He now takes daily antihistamine for early tree pollen season – late Feb to May. We also use Haymax barrier cream on his nose, keep windows closed in the mornings when pollen levels are highest and don’t line dry any clothes over these months. It is does feel wrong using the tumble drier when the sun is shining, but we noticed this causing flare ups even when he had anti histamine. Finally you can check the pollen forecast on the met office website so you can plan accordingly.
  • Once we realised that airborne allergens (dust and pollen) were eczema triggers for my son, then we started using an air purifier in his room at night. It’s a bit difficult to tell how much difference this makes, but my feeling is that as part of the range of measures we are taking it is worth doing. If you decide to buy an air purifier check out the specification carefully to make sure they are effective at trapping the particular allergen you need to avoid. After checking out LOTS of reviews we have gone with a Levoit.
  • I’m afraid you will need to step away from the lovely smelling bubble baths in favour of something a bit blander; bath time can be a minefield for eczema sufferers. When the kids were younger. we stuck to using their prescribed emollient as a soap substitute, as well as a prescribed bath oil. This does not give you a sweet smelling baby but really is the best solution whilst trying get eczema under control. It should be applied before bath time, but beware that this makes babies really slippy – I found that using a flannel to lift in and out, plus a good baby bath support, helped. Once eczema is well managed you can try something a bit more adventurous, but stick to the really gentle products. As my kids have got older, I have started to use some other products, but have found anything containing SLS can be irritating, and this can be found even in products marketed as being for sensitive baby skin. Weleda and Burts Bees are both SLS free and work well for us, but they are on the more expensive side so use sparingly and look out for offers. Other options I know have worked well for others are dead sea salt (which can help relieve itching), Oilatum and Child’s farm (we can use the shampoo but not the bubble bath).
  • If you find that your child’s eczema is particularly persistent on their face then it is worth politely asking any heavily perfumed relatives to lay off when they see you. Strong perfumes and cosmetics can be irritating to sensitive skins, and some skin creams can even contain milk, soy and other allergens, so it’s always worth checking.
  • Messy play at nursery and school can give eczema parents major headaches, especially if food allergies are a trigger for your child. If you can’t work out why your child is having flare ups it’s worth talking to the teachers about what they have been using – I once found that my egg allergic son had been playing with egg noodles! I suggested some easy switches they could make (e.g. rice noodles) and they were very happy to do so.
  • Unfortunately, a lot of children with eczema will occasionally get skin infections. If your child’s eczema is not responding to usual treatments or is looking different to usual (for example particularly angry, or crusty/weeping) then it’s definitely worth seeing a GP as soon as possible. Make sure you keep your children’s fingernails short and smooth to minimise risk of skin being broken when they itch, as this makes it susceptible to getting infected. You can get bath oils (e.g. Dermol 600) which have an antimicrobial in them.
  • Until we found a good sun cream for the kids, my heart sank every time the sun started shining. Even sunscreens marketed at sensitive skin seemed to bring on a reaction. This seems to be a common issue, and unfortunately it is very personalised which means the whole thing involves a bit of trial and error. If you are struggling with this, check out my post about the most frequently recommended sunscreens by parents of children with eczema.
  • Whether or not the sun is out, keeping cool is important to help the eczema itch – particularly at night. Using light sheets and duvets, and choosing pyjamas in natural breathable fabrics can really help with a good nights sleep. It is possible to get specialist sleepwear for eczema sufferers, including scratch sleeves which cover children’s hands and help them to stop itching in their sleep. We’ve never had to use these, but I know they’ve been a lifesaver for some – worth looking in to if itching at night is a problem.

These are the things which have worked for us, and I hope you find it helpful. I was keen not to accidentally stray into giving medical advice, so I haven’t said exactly which prescribed creams we use, although I will say that we use twice daily emollients, a combination of steroids as needed (kept to a minimum, but they really are a life saver for getting things back under control) and anti-histamine during tree pollen season.

It’s no exaggeration to say that managing eczema in small children is a daily battle, and at times it can feel overwhelming. There are some great Facebook support groups around (my favourite is UK Kids with eczema – parents support chat) and I really recommend joining one of these for help, advice and recommendations of specific creams.

Have I missed any tips or tricks that you have found helpful for managing eczema? Please share your experiences in the comments below!

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