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Wednesday, January 14, 2015

Managing Vivi's Baby Eczema

Vivi had appointments with all three of her doctors over the past month, and all three were amazed at how good her skin looks.  We finally have a good skin care routine going, and as a result, her eczema is under control.  

I've found that her eczema never truly goes away.  It's a lot like weeding a garden bed.  You can pull out all the unwanted plants, but three days later, those damn dandelions are back.  It's the same with laundry, and shaving my face, and all the other never-ending tasks that fill up our lives.

If I follow her skin-care regimen every day, we're able to keep her rashes to a minimum.  If I let things slide, it comes creeping right back, and she's an itchy, rash-y baby mess all over again.  Nobody wants that.  So here's what's been working for us:  

Frequent bathing
Frequent moisturizing
Avoiding irritants

It's pretty basic.  In fact, this is pretty much the same routine one would follow for any baby, eczema or no.  There are just a few extra considerations and tricks we use to keep her skin hydrated and clear.  

1. Frequent Bathing

Vivi needs a bath every day.

There are cold days, busy days, and cranky days when I think, "Meh, she's not that dirty...I'll wash her tomorrow."  When she was a tiny baby, she'd scream every time she saw the water, which also made me want to avoid washing her whenever possible.  But her skin really, really needs a daily soak.  I always notice a difference if we skip a day.    

I keep the water warm, but not hot.  We also keep her time in the tub short.  Baths that are too hot or too long irritate her skin.    

We don't use any bubbles, soaps, or shampoos because they also irritate her skin.

Twice a week we use Eucerin Baby Cleansing Relief to wash her body and hair.  It's the last thing I do before we take her out of the water so that she's not sitting in the suds for a long time.  

Sometimes she shares a bath with her sister, which means some of Maddie's shampoo is in the water.  Those baths are extra quick, and we haven't had any problems.

2) Moisturize, Moisturize, Moisturize

It took a long time to find a moisturizer that works for Vivi.  Every over-the-counter moisturizer we tried, even those recommended by the National Eczema Foundation, caused a horrible red rash all over her body.  For a long time, we used Vaseline, which worked okay but was horribly sticky.  

Then our doctor recommended Hydrolatum to us.  It's now our best friend.

It's odorless, hypoallergenic, fragrance free, yada, yada, yada.  It's thick, but not uncomfortable like the Vaseline was.   Best of all....it works!  Her skin has improved so much since we started using it.

You don't need a prescription for Hydrolatum, but the pharmacy keeps it behind the counter.  You might not see it browsing the shelves.  It comes in a gigantic tub that lasts us about two months.

I apply the Hydrolatum twice a day including directly after her bath while her skin is still damp to lock the moisture in.  And I mean liberally.  It's like rubbing a turkey with butter.  A lot of butter.  If her skin is looking dry, I apply the moisturizer more frequently.
(It's probably also wise to not let your child chew on the container, but I'm a horrible parent, so...)

We also have a prescription for topical hydrocortisone to use when needed.  The hydrocortisone is used only on the problem areas before we apply her moisturizer.

For a long time we were using the hydrocortisone every other week.  After five days the rash would clear, but as soon as I stopped using the cream, it would quickly return.  As she gets older, we're using it a lot less frequently.

Constant moisturizing has been the biggest help in keeping her skin healthy.  Plus, my hands are pretty soft too...

3. Avoid Possible Irritants

There has been a lot of trial and error in identifying what triggers Vivi's rashes.

Eczema and allergies are separate conditions.  Allergies do not cause eczema.  However, people with eczema are more likely to develop allergies.  There seems to be a lot of debate linking food allergies with eczema, and from what I've learned, most people with eczema can eat whatever they want.  

That being said, Vivi's skin has improved greatly since she stopped nursing.  It sucks.  Breast milk is THE BEST.  But in our case, switching to Nutramigen, and thereby eliminating all traces of of dairy, eggs, and peanuts from her system, has been a good thing.  If you need to switch to Nutramigen due to a cow's milk allergy, check with your insurance company.  Ours covered 100% of the cost.

And of course, now that she's eating more and more solids, we keep the foods she's allergic to away from her.

We've also noticed that Vivi is sensitive to certain fabrics.  Micro fleece seems to be the biggest problem, which is a bummer because A LOT of cozy baby clothes are made out of that material.  She wore a fleece hoodie yesterday, for example, and by the end of the day, the area where the hoodie meets her cheeks was all red and irritated.  

Once the garment is washed a few times, it's no longer a problem.  It's only when it's still new, soft, and fuzzy that it makes her itchy.  Back into the wash with that hoodie!  

We also use hypoallergenic detergent for all our laundry.

As already mentioned, lotions do not jive well with her.  If I'm freshly lotioned after a shower, I make sure she doesn't come in contact with my skin as we cuddle.

The weather also seems to make a huge difference in her skin.  While there's not much we can do about that, we make sure we take extra precautions for extreme cold and heat.  During the winter, we lotion more because the air is so dry.

During the summer, her skin was horrible.  The sweaty creases of her body were rubbed raw and bloody.  I had to make sure her nails were kept extra short to keep her from scratching.  Even though it was hot out, I'd pull leg warmers on her at night to keep her away from the back of her knees.  We don't want her skin getting infected.  Poor baby.  



The doctor tells us that her skin condition should improve as she gets older.  In the meantime, we just keep moisturizing and bathing and moisturizing and bathing....and more moisturizing.




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