Infant Eczema - Calming the Unstoppable Itch

Eczema (aka Atopic Dermatitis)  is very common, and it frequently first pops up infancy affecting anywhere from 5-20% of children.  I've seen many babies, some as young as 3-4 weeks with whole body eczema.  By the time I see them, Mom and Dad have often already tried everything - new detergent, more bathing, less bathing and every over the counter cream money can buy.  And, understandably they are hesitant to rely on hydrocortisone cream.What Causes EczemaWe know that eczema tends to run in families, and that having a family member with either eczema, asthma or allergies increases the risk. There area also some interesting  environmental associations, including mother's age and exposure to pollution.But, we also know that certain foods and chemicals can trigger eczema, or make it worse in susceptible children.  Watch for irritating ingredients in:

• laundry detergent & fabric softener
• bath soap
• shampoo
• parent's personal care products including perfume, deodorant, etc.

Make sure you choose skin care products that are free of:

• Fragrance, or "parfum"
• Sodium Laureth Sulphate
• Parabens

Food allergies (IgE mediated) are known to exacerbate eczema, but non-IgE mediated food sensitivites can also play a role in managing eczema.  An elimination diet is the best way to identify potential culprits. This is part of what we do as part of a naturopathic consultation.What About Gut Bacteria?The "microbiome" refers to the population of bacteria that live in our gut.  They play an important role in mediating the immune response, especially in regards to allergies and eczema.Once thought to only influence the bowel, we're learning about how important it is to establish a healthy population of gut bacteria early in life.

Gut bacterial balance affects many different areas of health, but one of the most important to consider is the establishment of healthy gut bacterial balance during infancy.

Several recent studies (such as this one) have found that children with eczema have a very different population of gut bacteria than those who don't.  And, this study found that infants with "low microbial diversity" at 1 month of age were more likely to develop eczema. So, what influences the establishment of gut bacteria?

• Vaginal vs. C-section birth:  Babies born to mothers via c-section do not get the mouthful of healthy bacteria that those born vaginally receive. Several studies have found increased risk of asthma, allergies and eczema, most of which are summarized in this good article.
• Antibiotic use
• Diet - Breastmilk is rich in probiotics and the skin-to-skin contact with Mom may also serve as a source of probiotic exposure. An infant's diet (once eating solid food) can also influence the population of bacteria, especially if it's high in sugar and simple carbohydrates.  This is one reason why I'm in favour of doing away with the white cereal recommendation as a first food.

How to Treat Eczema

1. Start by "cleaning house".  Get rid of any personal care products that may be irritating.  A quick stroll through the health food store or section at your grocery store and you will reveal a multitude of choices.  Also choose unscented laundry detergents, such as Nature Clean or Down East (for those of us in Atlantic Canada).
2. Keep the moisture in.  Add 1/2 tsp of coconut oil to the bath, and don't bathe too often.  Every other day is a good place to start.
3. Use a barrier cream (such as Live Clean's non-petroleum jelly) if needed to protect the skin from moisture or the elements.  Infants often flare up when they begin to drool, so a bit of this jelly will help.
4. If needed, try a non-medicated ointment such as Anointment's "Soothing Skin Ointment". It's a great all -purpose salve to have in the house and is the go-to in our practice for eczema.
5. Establish and maintain a healthy population of gut bacteria.  Talk to an ND about the best way to do this.