Miss E is 6 months old and has eczema on her face. I'm really struggling with her sleep as she is constantly scratching herself (sometimes to a bloody mess) and waking through the night. Her case is actually pretty mild compared to others and I started wondering if this is so hard already, what it's like dealing with a baby with severe eczema? So came the idea to start interviewing other mums on their experiences in a particular area of motherhood and/or life I want to know more about.
This interview is with a mum who has an 1.5-year-old daughter who has severe eczema (on 90% of her body at its worst point). Obviously all kids are different and have different backgrounds, triggers, reactions to treatments, allergies etc, so please consult your doctor for professional advice. This is simply one mum's experience and I thought it would provide some interesting insight.
Does eczema run in the family?
No it doesn't. But my husband suffers from asthma which was worse as a kid. So he is considered atopic. (Apparently if one parent is atopic the chances of eczema is 60% and if both are then the chances are 80%)– Note this is verbal information relayed by a doctor
When did it first start appearing?
Some time between 3 and 4 months old.
At what point did you think it was time to go to the doctor's to get it checked out and get a diagnosis?
We went to the GP (general practitioner) 2 or 3 times from the moment I noticed it (who weren't of much help really) then consulted the MCHN (Maternal Child Health Nurse) at her 6 month appointment, who suggested we get a referral to the RCH (Royal Children's Hospital in Melbourne) ezcema nurse. Things got really bad by 6 or 7 months. We got an appointment at the RCH around 8 months old.
What was her skincare regimen as recommended by the RCH (Royal Children's Hospital in Melbourne)?
Initially it was Advantan Cortisone (steroid cream) full body, hydrocortisone for face, then QV cream (moisturiser) whole body and wet wrap twice a day for a week. Then it was Advantan to affected areas only and wet wrap affected area once a day as required. Moisturise with QV cream 5 times a day or every nappy change. Bleach bath daily for 2 months then gradually weaned over 4 or 5 months.
When did it start getting manageable?
That's a tough question. We always have to keep her moisturised and cool (it got worse in winter because of the dry heater and over dressing). But we've had to learn from lots of mistakes. On the whole it got better around her 1st birthday. By her 1st birthday it would only appear in patches but before that it was 90% all over her body.
Did any foods make it worse in her case?
No not in her case. Nothing that we noticed and we were told not to abstain from any foods. In fact to keep giving her foods that many might have allergic reactions to. So we had to keep giving her peanut butter and egg etc- Note this was professional advice given in their individual case
Did she react to the water in swimming pools?
Not the chemicals in the water. She had bleach baths daily anyway. It was more that the warm pool flared up her eczema. Anything more than 32 degrees Celsius would flare up her eczema.
Do you think it affected her sleep/mood?
Yes I think it did. It's hard to tell but I do think she slept better after treating it. It was hard in those early months with a baby who slept very lightly anyway. I have to say at the start having to wet wrap and follow the whole regimen was very hard but with regular practice we got very efficient with knowing what to do.
Coping with a healthy infant is hard enough, how was the emotional toll of having to cope with this added problem?
Yes it's hard. But having support and reinforcement that I'm doing the right thing really helped. I'm blessed with a husband who is a pharmacist who knew a few things. I think the other thing I felt was "mummy guilt" that I couldn't get rid of it and that she was just so itchy and I felt upset for her. The guilt was that she was just so focused on being itchy that she wasn't progressing in other aspects ie physical milestones. Do talk to your doctor or MCHN if you need as I can see how this can make post-natal depression a lot worse.
Any further words of advice for parents with kids suffering from eczema or anything I haven't touched upon that you think might help other parents to know?
I think the best thing to do would be to keep them cool, never overdress them, and only lukewarm baths. Even in winter, all she wears is a single long sleeve cotton layer when indoors (minimal heating on). Don't worry about cold extremities as long as their core is warm, they're all good. Moisturise moisturise moisturise. I would highly recommend to go to a ezcema specialist if it's uncontrollable. The idea is that if you keep it under control, the higher the chance it will be that they will eventually grow out of it.
I think one more thing to mention is about cortisone use. No parent wants to have to use cortisone and everyone seems scared to use it so they just use the smallest amount or the lowest concentration but for long periods. But the theory is that we need to get the skin back to baseline and the only way is to use the high strength (ie Advantan) for a short period rather than continuously using the lower strength for long periods. Dont be afraid of having to use cortisone. Again always be guided by your eczema specialist or your paedatrician.
Please consult your doctor for a proper diagnosis and professional advice. For more information you can look up the Royal Children's Hospital's resources:
Clinical guideline (which is apparently currently under review)
Knowing Your Child's Eczema (a long booklet)
Wet dressings for eczema
Formula for an eczema bath