Is it Time for a New Approach to Paediatric Eczema?

I have specialised in working with babies and children with eczema – and other skin conditions – for the past 10 years. first as a research analyst in a large Pharmaceutical company – working with off licence immuno suppressive drugs and latterly as a homeopath, slight change of career there!!

It was never something I intended to do, rather something I fell into and found profoundly interesting. I think as mum to four young children myself lots of parents resonated with me so when I set up my own homeopathic clinic and drew in my first patient – a 1yr old suffering with severe eczema – word spread and I quickly became known as “the lady that treats childhood skin problems” and have seen a steady stream of baby eczema referrals ever since over the years. One thing I have learnt is how stressful living with a baby with eczema can be. Sore, itchy skin can cause havoc with a baby’s sleep, feeding and general mood throughout the day, I feel so much more for babies suffering with eczema as they cannot even tell us when they are uncomfortable.

 

At homeopathic college we always laughed at what we called the TEETH phenomenon – aka: “Tried Everything Else Try Homeopathy”, certainly the babies and children I saw all came to me with armfuls of doublebase, diprobase, E45, aqueous cream, betaderm, Dermovate, Eumovate, wet wrap bandages and more. The mums had two concerns 1) the conventional treatment wasn’t working very well and 2) they were worried about the effects the treatments had on the skin. Indeed clinical evidence is not all that persuasive when it comes to the effectiveness of the lotions, potions and techniques used – e.g: a study by  Hindley, Galloway and Murray  in Arch Dis Child (2006) found that Wet wrap bandages for 4 weeks did not differ from topical ointments but increased skin infections in paediatric atopic eczema.

In terms of side effects, something I was particularly conscious of having worked in pharmacovigilance (drug safety) reporting for 4 years previously, steroid creams have a particularly bad record. The most well known side efffect of steroid creams being thinning of the skin (atrophy) which can often result in permanent marks (striae). The fine blood vessels under the skin can swell and become permanently prominent (telangiectasia) and pigment can be temporarily lost in the areas of skin treated. Children can even be allergic to the cream which results in making the eczema worse. The skin might bruise more easily and become more susceptible to infection which in turn can damage the skin even more! (is this ringing any bells of the classic “cascade of intervention” for any birthy peeps?). That’s just effects on the skin itself though, steroid use can have far reaching effects on the whole body (systemic) and has been known to cause growth suppression or adrenal suppression (and illnesses such as Cushing’s syndrome). Children are at a greater risk of systemic side effects than adults, yet it is often in childhood that we start smothering them in steriodal creams.

Many parents remove cow’s milk from their child’s diet in the hopes that this will cure their baby’s eczema, however evidence for this approach is lacking at best, with some studies refuting any benefit at all. Bath-Hextall, Delamere and Williams found no change in eczema after removing (cows) milk from the infant’s diet in a review of 9 studies, published in 2008.

 

 

So, what can make a difference? without nasty side effects?

 

1) Removal of Processed Foods from the diet.

A study by Lee, Jin, Noh and Lee in 2011 found a significant improvement in the eczema suffered by children who had had all processed foods (particularly MSG) removed from their diet, after 1 week.

 

 

2) Addition of Omega Fatty Acid supplement

Although the study by Popa et al in 2011 was a veterinary study  the results showed a promising effect on skin lipids on the skin of atopic dogs. Hopefully this research will be continued into humans. There is already much research showing the benefit of Omega oils for child behaviour and brain development and even as an effective prevention for pre-eclampsia.

 

 

3) Prevention before birth?

A study by Kalliokomaki in the Lancet in 2001 studied babies at risk for atopic disease, by giving the pregnant mother an oral administration of Lactobacillus GG (LGG), the results found that given prenatally and postnatally the LGG significantly reduced the occurrence of atopic eczema in babies and children up to 2 years of age.

 

 

 

4) Coconut Oil

100% pure coconut oil is a highly saturated fat expressed from the kernels of the coconut.  Coconut oil has long been famed for its gentle moisturising properties. It is an incredibly light, easily absorbed oil that is very similar to skin’s natural moisturiser – sebum. Coconut oil has been used for thousands of years as a skin conditioner around the world and is particularly known for its gentle healing effect on eczema. For this reason coconut oil is the one thing I recommend to all parents of babies suffering from eczema. The best way to use it is when the skin is slightly damp, just having got out of a bath is great, even better if a massage is included! Very often parents comment to me that the results are better than their prescription creams!

A lovely range containing coconut oil is Weleda’s Baby Derma range, specifically formulated for eczema prone skin.

 

5) Chamomile and Calendula

Both wonderfully useful for calming and soothing itchy and irritated eczema. I commonly recommend parents by a little tin of Badger Baby Balm to keep at hand for middle of the night itches and always have some on standby for general cuts and grazes and nappy rash.

 

6) Removal of Non-Organic products with no SLS, Parabens and Minerals

Perhaps one of the worst things we can do for a child with eczema or irritated skin is to bath them in commercial products containing the above, for a detailed explanation of why these nasties should be avoided by everyone, not just children and babies with sensitive skin, see THIS POST.

7) Oats

Pure organic oats can work absolute wonders for sore itchy skin, not just for babies and toddlers with eczema, but for those suffering from chicken pox. The easiest way to use oats is to cut the foot and leg off of a pair of old (clean!) tights, fill with organic  oats and tie around the tap in a running bath. Once the bath is run squeeze out the milky liquid into the bath. The “sock” can even be rubbed over the skin as a form of soap.

8) Be careful with sunscreen!

Very often I will see a flare in one of my young patient’s eczema after a sunny spell, the cause is almost always suncream, it’s very hard to find an organic, additive and synthetic ingredient free suncream for babies, parents seem to assume that because a cream is marketed on the high street for babies and children that it is gentle – which is usually not the case! my favourite suncream for all babies, not just those with sensitive skin is Badger Baby Sunscreen.

9) Eczema friendly clothing

Organic cotton with silver can work wonders for babies who scratch at night, they are not cheap – but you can’t put a price on a good night’s sleep – you can get a wide range of products, such as this babygro with silver.

Sarah 

About SarahOckwell-Smith

Sarah Ockwell-Smith, Parenting author and mother to four.
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