For babies predisposed to atopic dermatitis—also known as “eczema”—skin can quickly turn from slightly itchy to a red, dry, scaly mess, putting your baby at risk for infection. The condition affects an estimated 1 in 10 U.S. children; 65 percent develop symptoms by their first birthday, and 85 percent by age five. For many sufferers, eczema is a lifelong condition, but flare-ups typically occur off and on. Although the cause of eczema is unclear, likely culprits include environmental, genetic, and autoimmune factors.
While the search for a cause continues, researchers do agree on one thing—consistent use of moisturizers is the best prevention strategy. Establishing and maintaining healthy skin is key to reducing the number and severity of eczema outbreaks. Daily application of a fragrance-free moisturizer to the face and body (except for the scalp) can calm eczema and minimize flare-ups. During severe outbreaks, prescription medication may be needed, and can be recommended by your child’s health care provider.
In its latest report—“Atopic Dermatitis: Skin-Directed Management”—the American Academy of Pediatrics (AAP) recommends parents and health care providers use four strategies in caring for children with eczema:
- repair and maintain healthy skin
- apply topical anti-inflammatory medications
- control the itch
- manage triggers and recognize/treat flare-ups
Since the symptoms and severity of eczema can vary, you may want to discuss with your child’s pediatrician (or, ideally, a pediatric dermatologist) a plan for meeting your child’s individual needs. Action plans should include:
- Baths lasting no more than 10–15 minutes in lukewarm water.
- After bathing, pat (don't rub) skin mostly dry so the skin still feels slightly damp.
- Apply fragrance-free ointment immediately after bathing and more often if needed.
- During flare-ups, use appropriate topical medications recommended by your child's health care provider.
Even if your child doesn’t have eczema, applying a moisturizer after her bath can help to maintain healthy skin and prevent skin problems. The time spent applying a moisturizer may not seem as taxing if you make it part of your child’s daily routine. Given parent reports that children with eczema are prone not only to skin irritation but also sleep problems and mood changes, any strategy for preventing flare-ups is worth the effort.
Aside from moisturizers, studies have identified few strategies for preventing eczema. Some early studies suggested that breastfeeding might help to delay the onset and reduce the severity of eczema, but more recent studies have not produced the same results. Still, experts agree that the benefits of breastfeeding (for your health, as well as your baby’s) make it worth the investment. Genetics are thought to play a key role in the development of eczema, given the high incidence of eczema in children with a family history of the disease. Although you can’t change your child’s genetic makeup, you can keep your child as healthy as possible by breastfeeding your child for at least one year, vaccinating your child according to the recommended schedule, and taking your child to his health care provider for regular check-ups. For more on eczema, click here.