Mild eczema in infant - where to start?

[oscarwilde]

Baby (4.5 months) had mild eczema type patches her legs and on one cheekbone. GP at her 16 week vaccinations agreed that it looked like "a bit of eczema" and prescribed an emollient cream (steroid free). It's taken two weeks to get the cream from the pharmacy - have now discovered you can buy it on Amazon, no prescription actually necessary. . In the past two weeks though, her skin has gotten worse.
Patch on face is now very red and angry, she is clearly scratching it or rubbing it.
Creases behind knees and elbows are starting to look red and angry but it is still v small in area.
Her neck now has lots of patches of red, slightly raised bumpy skin.
It's all co-inciding with her getting a bit plumper, but also an increase in the amount of formula she is receiving. She has been mix fed from birth (Aptamil) and has gone from 150ml to circa 250ml in the past couple of weeks as I am back at work and have stopped expressing a feed.

It's new to me - I don't have or have ever had it. My husband gets it from stress, bio washing powders and processed foods, but he has a family member who is highly allergic to everything (dairy, fish, nuts, additives, wool etc) and he is freaking out. He is totally anti steroid / medication to control it which I am fine with but it is likely to be the first recourse of the GP to prescribe rather than look at my/DD's diet. My DH wants to switch to soya formula immediately.

Where would you start ?
Eliminate dairy from my diet? Change the formula to ?
Change washing powders (we use Persil non-bio and Comfort sensitive)
Just use the derma cream for a couple of weeks before changing anything?

[cathan]

My daughter had eczema from 6 weeks and eventually we had to use steroid cream to control it. That said, the first thing I would do is change your washing powder (Surcare is good) and stop using regular soap/shampoo which may also be irritating her red patches. Oilatum is good and they have a range of creams as well bath stuff, especially if lanolin makes things worst (which it often does and it's in many products like E45). Given that she has been having the formula from birth, this is probably not a trigger. If you are offering any solids though, you may want to do this very slowly and gradually, allowing time between each new food to watch for reactions. Also, do you have pets? We had cats and eventually had to have them re-homed (heartbreaking!) as they made her skin worse. Do go back to the GP if things get worse - I know steroids get a bad press but watching your child itch and scratch and suffer is worse, believe me! In short term bursts at the lowest possible dose, steroid cream was an absolute life-saver for us and it did no harm to our DD in the long term. Hope this helps!

[Pollaidh]

The first emollient cream advised is usually E45 (an identical cream can be bought as Boots own brand, more cheaply). If this fails then Oilatum children's cream is very good. You should apply it by wiping it on with your hand until absorbed, but not rubbing.

You should also put emollient in the baby's bath and stop using soap. Oilatum do a good (though pricy) children's bath stuff. You can get it prescribed too.

Eczema advice is sometimes to bathe often and sometimes rarely! We've found it depends on where you live - hard water areas seem to make eczema worse, so bathe rarely and use lots of emollient. In soft water areas you can bathe frequently, in fact going to a soft water area often clears up my child's eczema for a while.

If this doesn't work go back to doctor, you will work your way through various creams until you find one that works - some formulations trigger eczema in some children. Some of the stuff is like goose fat and plays hell with the plumbing.

Occasionally the eczema will require a short course of steroid cream. This usually clears it up and then you return to emollient. Using steroid cream for too long thins the skin and makes things worse.

We use Ecover liquid for washing clothes, but again I think you have to experiment (only changing one variable at a time of course).

As for formula - has she had a tummy bug recently? If so it can sometimes cause a (usually) temporary lactose intolerance causing runny poo and eczema. There's a lactose free formula called SMA-LF you can buy at pharmacies, though you're supposed to get a prescription. Some allergic children are allergic to soya too, so worth trying lactose-free first. When weaning there's a range of products called Lactose Free, available in supermarkets, including yoghurts, cheese, milk, ice cream. Not suitable for milk allergy sufferers though, which is a different kettle of fish.

[Pollaidh]

Forgot to say - eczema is often worse in winter (central heating dries air and the wind doesn't help), so it may well clear up in the summer unless she gets really hot and sweaty.

Shampoo - we use a creamy Neal's Yard baby hair and body wash on hair, and in the summer, on body too.

Our doctor said you need to apply the cream multiple times a day - the child should always be well creamed up, never let the skin dry out.

[Pobblewhohasnotoes]

You need a steroid to treat the red areas. GPs get a bit funny about prescribing steroids to little ones but it's perfectly safe and the only way to treat the inflammation. Our dermatologist was horrified that our GP had just suggested emollients to treat our DS's eczema at four months old.

Soya is not recommended nowadays for a dairy allergy as it still contains milk protein. You need something like Nutramigen where the protein is broken down or failing that Neocate which doesn't contain any cows milk protein. It has to be prescribed.

Steroids really aren't a bad thing, honestly. I had a chat about it with DS's allergy consultant. He said they get a bad press but shouldn't. It's not harmful to use them and infact he said that it was good that our DS's eczema could be controlled by steroids, it's the children that can't be that are the issue. Please don't dismiss them as a treatment, they really work.

[MERLYPUSS]

I you are really worried about steroids perhaps try putting a bit of honey on the cracked areas at night. It seems to heal quickly on my boys especially if you can get local honey.

[Pollaidh]

Should probably avoid the honey idea until the baby is older - there is a small risk of botulism, which you can get through wounds, as well as ingesting, from honey. Botulism is rare but can cause paralysis and be fatal. Honey shouldn't be given to babies of less than 1 year as their immune systems can't cope with botulism.

[MERLYPUSS]

Didn't read the age - thpought it said 4 1/2yrs