Baby & Toddler / 11 September, 2023 / Dr. Nauf AlBendar
It can be so hard to watch your little one suffer with baby eczema and it can be especially worrying when you’ve tried everything and can’t seem to clear it up. If you’re looking for baby eczema treatments, and ways to soothe your little one, medical scientist and founder of The Womb Effect, Dr Nauf AlBendar, is here to tell you everything you need to know.
Baby eczema or infantile eczema usually refers to the inflammatory skin condition that is atopic eczema (atopic dermatitis). It is the most common form of eczema, with it affecting up to 20% of children in developed countries.
The usual age of onset of atopic eczema is typically 3–6 months. It is characterized by chronic itchy, scaly, dry rashes as well as frequent skin infections and sleep interruptions.
It is most prominent on the cheeks, forehead, scalp and extremities of a baby within the first few months of life.
Other types of baby eczema include contact dermatitis, dyshidrotic eczema (foot-and-hand eczema), and seborrheic dermatitis, or scalp eczema (known as cradle cap). Eczema is not contagious.
Researchers do not know exactly what causes baby eczema, but it is clear that it is multifactorial. There is a combination of genetic predisposition and environmental factors.
Infants are more likely to develop eczema if family members have a history of eczema, hay fever, or asthma.
Many babies with eczema go on to develop food allergies, asthma and hay fever as the cracks caused by eczema weaken the skin barrier, allowing external allergens or microbes to penetrate the skin and cause a sequence of allergic diseases, which experts call the ‘atopic march.’
The occurrence of eczema in the first 2 or 3 months of life has been associated with food allergies at 1 and 3 years of age.
The striking increase in the prevalence of baby eczema over the past 30 years suggests that environmental factors play an important part.
The symptoms of baby eczema have often certain triggers, such as soaps, cleaning products that contain irritants, scented products, clothing made of wool or synthetic fibres, cigarette smoke, excessive heat or dryness, sweating, air pollutants and the weather.
Below are other triggers that may not be common knowledge:
Water hardness (levels of calcium carbonate) and chlorine in household water. In the UK, domestic water tends to be harder in the south compared to the north, and the prevalence of eczema follows the same gradient. Living in a hard water area was associated with an 87% increased risk of eczema at 3 months old. The risk tends to be higher in children with a genetic predisposition to eczema.
The use of antibiotics at birth or in children under the age of 2 creates a greater risk for eczema as well as childhood-onset asthma, respiratory allergies, celiac disease, obesity and attention deficit hyperactivity disorder.
A baby’s weight, (please refer to my previous article on the importance of birth weight), for each additional kilogram on the average birth weight there was a 17% increased risk in baby eczema.
Emotional factors. Children have a higher risk of developing eczema if their mothers experienced chronic stress and anxiety during pregnancy. Maternal depression in the postnatal period, and even beyond, is also associated with the development of eczema throughout childhood and adolescence.
Below are some preventative measures that parents can take and the best baby eczema treatments that can provide relief:
Fatty fish & fish oil supplements: Fish consumption helps reduce eczema. Fatty fish like mackerel, sardines, salmon and anchovies are rich in omega3’s and can be added to baby’s diet when weaning.
Studies have shown that taking fish oil supplements while pregnant and during the first three to four months of breastfeeding decreases the risk of eczema in infants and children by 16%.
Vitamin B3: Infants whose mothers had a higher level of vitamin B3 during pregnancy had a 30% lower chance of developing atopic eczema at 12 months.
Vitamin B3 is found in many foods including yeast, meat, fish, chicken, mushrooms, nuts and eggs. It is also found in vitamin B complex supplements and is important for the body’s immune responses, skin lipid barrier, oxidative stress and energy metabolism.
Early research shows that applying a cream containing 2% niacinamide (a form of vitamin B3) eases symptoms of eczema and similar conditions.
Vitamin D: There is a link between vitamin D status and eczema outcomes with lower vitamin D levels being associated with the increased incidence and severity of eczema symptoms.
>90% of vitamin D is from sunlight exposure. Food-based dietary sources of vitamin D are limited but include deep-sea fish and cod liver oil.
It is essential to supplement with vitamin D during pregnancy and breastfeeding. Infants who have limited sun exposure can also be given oral vitamin D supplementation directly.
Probiotics & Fermented foods: Mothers who took a probiotic supplement during and after pregnancy were able to cut the incidence of eczema in their children by almost half.
Introducing fermented foods like cultured vegetables, kefir and yoghurt when weaning can help promote “good” bacteria and decreases gut and skin imbalance, which is one of the causes of baby eczema.
Barrier Moisturisers: The lipids and ceramides found in skin barrier moisturizers form a protective layer on the skin to help lock in moisture while keeping out impurities and some may even be healing.
There are several dedicated moisturisers to baby eczema in the market but some versions that are worth trying can include extra virgin coconut oil, tamanu oil, tallow balm, black seed oil, avocado oil, calendula cream, 5% dilution magnesium creams and topical vitamin B12 creams.
Salt: Epsom and Dead Sea salts baths have shown to bring some relief to eczema-prone skins with numerous anecdotal evidence of parents seeing an improvement in their child’s eczema when they swam in the sea on holiday.
Halotherapy is a popular treatment in Eastern Europe and Russia, where high-grade salt micro-crystals are diffused into the air of the treatment rooms which decreases skin’s itching and irritation and can result in a marked improvement in eczema symptoms.
Baths: A recent study has found that bathing an infant more than once a week can significantly increase their chance of having eczema.
Higher bathing frequency was associated with an increase in skin barrier dysfunction and a greater prevalence of eczema at 3 months old.
The dysfunction was seen in 14.6% in once-a-week bathers, 26.4% in 2-4 times a week bathers, 30.4% in 5-6 times a week bathers and 44 % in those that bathed daily.
When bathing it is important to make sure to have a bath filter or vitamin C tablets added to the bath to neutralize chlorine. As mentioned previously, water hardness and chlorine are significant triggers of baby eczema.
Another bath additive to consider is oats. By adding colloidal oats to the bathwater, eczema symptoms are reduced by reducing inflammation and normalising the skin’s PH.
Humidifiers: As mentioned previously, eczema can be triggered by dry air. To prevent this, a humidifier can be used to produce moisture and increase humidity especially during the winter months or when using indoor heaters.
It is important to remember that humidity indoors should be between 40% – 60% for ideal health benefits. Higher than 60%, increases the risk of mould and fungal growth.
Pets: Studies have shown that children who grow up with a pet are less likely to have eczema as an adult. This is particularly true for dogs, as babies born in a home with a dog during pregnancy may receive protection from baby eczema.
Most infants who have mild eczema will grow out of it. But for some, eczema will be a lifelong problem.
Always contact your GP if you are concerned about your baby’s skin and consult him or her right away if the eczema seems to be infected, have blisters or pus.
There is some evidence that breastfed babies may be less likely prone to eczema. Babies whose mothers had received support to breastfeed exclusively for a sustained period from birth have a 54% lower risk of eczema at the age of 16.
The UK has one of the lowest rates of breastfeeding in the world. Only one in three UK-born babies have received any breast milk and just 1% are exclusively breastfed for six months.
Article by Dr Nauf AlBendar, medical scientist and expert in foetal origins of disease. Founder of The Womb Effect, an educational platform for aspiring and expecting parents.