Don’t scratch that itch: when your baby has eczema
Babies with eczema are irritable, restless and don’t sleep very well thanks to their itchy skin. Childbirth educator, family wellness coach and specialist in childhood immunisations, Sister Louise Archary, tells you what you need to know about this condition.
If your child has eczema it can be distressing for you, as a parent. It’s not easy to see your child struggling with the discomfort and itchiness that eczema brings. But if you understand what you’re dealing with, it can help you to manage the condition better for your little one.
Eczema – also known as atopic dermatitis – is an inflammatory condition of the skin in which the skin’s natural barriers do not function as they should. As a result, the skin dries out a lot easier.
The word ‘atopic’ means that your child has inherited the tendency to develop this condition. Predisposition is a result of a family history of eczema, hay fever or asthma: in other words, one or both parents, or a close relative has one or all of the above conditions.
What causes eczema?
Medical experts don’t know the exact cause of eczema but it is thought to be linked to the body’s immune system having an overreaction to an irritant. It is this response that causes the symptoms seen in eczema.
Some babies may show symptoms or have flare-ups only when exposed to certain substances or environmental conditions. For example:
- Certain fabrics or
- rough materials
- Sudden changes in temperature – feeling too hot or too cold
- Certain household products like soaps or detergents
- Animal dander
- Upper respiratory tract infections or colds
- Cigarette smoke
- Allergens in foods (less frequent).
Signs and symptoms
Eczema usually appears in babies before the age of two years, and it typically comes and goes. The inflamed skin is dry, itchy, scaly, red and raised. Eczema is not contagious, but because of the intense itching, it is very uncomfortable.
This causes babies to scratch, which results in the affected skin cracking, oozing or bleeding, and then the skin can become infected. If eczema is left untreated and babies continue scratching, the skin later becomes thickened, darkened or scarred.
The most common areas for eczema to occur are on the baby’s hands, face, neck, the inside of elbows and the back of the knees. In some babies it may also spread to other areas of the body like the scalp, back and chest.
What can you do to treat eczema?
Taking good care of the skin and avoiding allergens or triggers can prevent flare-up episodes – it’s a condition you will need to manage. Your doctor will be able to tell you whether or not a medicated cream or ointment is indicated for your baby.
Bathing and moisturising
- Bath baby only once a day and be careful not to make the water too warm, as this may dry the skin out further. Use lukewarm water instead.
- Use a mild, fragrance-free, cream based soap, or a non-soap cleanser like aqueous cream for both body and scalp. Don’t let baby sit in the soapy water for too long. After taking baby out of the bath, pat dry the skin and don’t rub.
- Apply a generous amount of moisturiser while the skin is still damp, so as to ‘lock’ the moisture in. I would recommend the use of an emollient cream or ointment, as these are best for skin with eczema. Emollients seal in the skin’s own moisture and aid in restoring the skin’s protective barriers.
- Dress baby in natural, smooth fabrics like cotton and avoid scratchy materials like wool, which tend to irritate already sensitive skin. Do not overdress baby, as this will cause overheating and aggravate the condition. The general rule is for baby to have on one layer more than you would have on yourself.
- Also be mindful of detergents and soaps used to wash baby’s clothing and linen. Don’t use fabric softener. An alternative for fabric softener is white vinegar: one capful can be added to the rinsing water and can act as a disinfectant, as well as softening the fabric.
Try to prevent scratching by placing cotton mittens on your baby’s hands, as scratching just makes the condition worse. Also keep your baby’s nails short, and use soft cotton sheets in baby’s crib to avoid itching and irritation of the skin.
During a flare-up you can apply a cool, wet cloth followed by emollient to soothe the skin. For severe itching consult your doctor, who may prescribe an antihistamine or special ointment.
Try to identify and minimise any triggers that may cause flare-ups such as rapid changes in temperature – try not to let baby get to hot or too cold too quickly. Also keep your child away from cigarette smoke and ensure that smokers wash their hands and change their clothing before handling your baby.
You may want to consult an allergy specialist paediatrician for advice about dealing with eczema caused by environmental factors.
Although there is no way to predict whether your child will outgrow eczema or not, the good news is that most kids outgrow the condition and it does become less severe with age. Many children see a resolution by the time they are five, although some only see an improvement in adolescence.