Are Eczema/Allergies Preventable in Children?

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Life threatening diseases like meningitis, sepsis, and dehydration are mostly a thing of the past for babies and children in 21st century America. Thank goodness! But instead of these acute illnesses that have been so prevalent in the past, now children are battling chronic illnesses like asthma, food allergy, and the topic of today’s talk, eczema. If you search the Portable Practical Pediatrics archives, you will see that we have talked about eczema on many, many occasions– but today I thought I would bring you some new information that recent research has uncovered. If this research is correct, it looks like eczema may be, in  a large number of children, preventable. So stay with me to find out more about how you might be able to prevent the debilitating skin disease known as eczema in your children.

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The Heartache of Eczema

You may be asking yourself, why is Doc Smo spending so much time on a relatively rare skin condition? What’s the big deal with a few children having dry skin? The reason is obvious to most older pediatricians; eczema is a growing debilitating problem in children. Estimates vary but as many but some estimate that 20% of young children have eczema during their childhoods. Many of these children have relentless itching that forces them to scratch until their skin bleeds, endure recurrent staph infections, and suffer countless sleepless nights due to constant rubbing and scratching. Children with severe eczema truly suffer.

What is eczema?

What is eczema you might be asking yourself? The word eczema itself means bubbling up.  The original idea that led to the name eczema was that inflammation in the child’s skin, deep in their skin, literally bubbled up from the deeper parts of the skin thus damaging the surface outside layer. Well today, this model of eczema has changed. Today, many dermatologist feel that the basic problem with eczema is a that the surface “barrier” of the skin, the part that keeps the outside world outside, gets damaged with cracks. The barrier in these children just isn’t very strong. These cracks expose the nerve endings in the child’s skin (hence the intense itch) and allow substances from the outside world to touch the deeper parts of the skin provoking allergic reactions. We now believe that rather than bubbling up, the cracked barrier lets the outside world percolate in!

Is eczema preventable?

Ok, so eczema is hard on kids and is fairly common but can it be prevented? To a large degree, yes. This is where two new exciting pieces to the eczema puzzle come into play. Firstly, there is a growing body of evidence that a mother’s intestinal bacteria-yes you heard me right, the bacteria in Mom’s poop, tweaks and fine tunes her new baby’s immune system.  If that bacteria is healthy and diverse, allergy genes get turned off and eczema in her baby is much less likely. Expectant Moms can promote and build that healthy gut micro biome by eating cultured foods and taking a probiotic, especially in the last trimester of pregnancy. In my practice, I strongly encourage Moms who have previous children with eczema to take probiotics during their pregnancy, possibly turning off the allergy genes in her new baby.

The second new piece of information that might be helpful in avoiding eczema in your children is a new study out of Northwestern Medical center that concluded that putting a daily moisturizer on babies at high risk of developing eczema, during the first six months of life, cut these babies rate of developing eczema in half. And it didn’t seem to make much difference which moisturizer was used, even vaseline worked. They concluded that by putting a protective barrier on top of the babies delicately thin skin, avoided the cracking and damage that leads to eczema. No cracks, no allergy, preventing these children from becoming allergic to things that they touch.

Could it really be this simple?  Could we turn the tides on eczema by having mom changing her diet and by oiling babies like mom’s have done for centuries? Read the studies that I have linked in my Smo notes and decide for yourself. For now, I am encouraging the mom’s of my patients to take those probiotics and grease up those little ones that they care for.

Well, as always, thanks for joining me today to explore what’s new in pediatric health. My goal is to make you one of the smartest parents in the room–always. If you enjoy learning about child health with pedcasts, take a moment to subscribe to my podcast on iTunes or on my website, If you have insights or comments about any topic I cover, feel free to leave a comment at my blog. This is Doc Smo, broadcasting from studio 1E, hoping that all your little kin, will have healthy glowing skin. Until next time.

Smo Notes:

1.Eczema-soak and smear

2.Daily Bathing for children with Eczema?

3.Protecting babies from eczema with low-cost Vaseline

4.Cost-effectiveness of Prophylactic Moisturization for Atopic Dermatitis

5.Atopic Dermatitis: Global Epidemiology and Risk Factors

6.Petroleum Jelly May Reduce Risk of Eczema