Baby eczema tips and suggestions

Eczema…the pesky skin condition that plagues so many of us and our little ones. We’ve been battling it on Nori since she was a few months old, and everyone says most babies will outgrow it, but Nick is a prime example of an adult who’s been trying to manage eczema his whole life.

Now that we’re in the midst of dry winter conditions, I’ve been getting a lot of questions from concerned mamas on what’s worked for us. So I’m sharing our fairly standard eczema-mitigating routine as recommended by Nori’s dermatologists and allergists, but the same things may not work for everyone (and there are so many different triggers for eczema). This is just what we do, and as always, please consult your doctors for any medical advice!

moisturization & bathtime routine

We’ve tried countless eczema products that people have recommended such as Tubby Todd, Eczema Honey, Mustela (Nick is the product tester for Nori). For us there have been no miracle products, rather a continuous daily routine of keeping the skin protected and moisturized.

• Bathe / shower regularly in lukewarm water for around 10 minutes. Nick used to be told that those with dry skin should bathe less frequently, but now our docs all suggest at least daily baths, with the keys being:
  • lukewarm temperatures – around body temperature or a few degrees below, which we check using a kitchen thermometer
  • not too long in duration, which can strip the skin of natural oils; and
  • sealing in moisture immediately afterwards (see 4th bullet point below)
• Use diluted bleach baths or cLn wash regularly to limit bacteria on skin. Definitely consult with your own doc first. I was very hesitant to do this, but it’s supposedly more gentle than chlorine in a pool and every doc kept instructing us to do it. Nori had a few bad patches of eczema that got infected and had to go on antibiotics, and we were told regular bleach baths may have helped prevent this. Knowing the potential association between antibiotics in infancy and subsequent allergies that develop, I would’ve tried everything possible to prevent infection and the need for antibiotics.
• Seal in the moisture after bathing. I feel this has been really key in our daily routine. After your little one gets out of the bath or shower, gently pat off excess water then immediately pat a layer of moisturizer or Aquaphor on still damp skin to “seal in” the moisture. This should be done within 2 to 3 minutes of getting out of the bath.
• Moisturize regularly throughout the day when possible. We’re told to moisturize her thoroughly at every diaper change, but it’s not practical. We aim to moisturize 2-3x a day (always a battle with a scratchy, squirmy little one) and we ask her caretakers to do the same.
• Topical steroid use. We do use prescribed steroids during flare ups. But by following this daily routine and everything else in this post, these days we have not had to use it much. I have gotten a lot of global reader recommendations to look into Dr. Richard Aron’s eczema regimen (involves topical steroids), so wanted to pass that along.
• Wet wraps if needed. We have not done this since it’s cold in our house in the winter, but our docs strongly suggested this and several mamas say it works well.

Aquaphor, Vanicream, Scratch me not sleeves with silk mitts, soft bamboo towel, favorite diaper balm + butt paddle (a must-have ; )

Favorite products in our routine

We were told that minimally dyed 100% cotton, bamboo, and silk are recommended fabrics for eczema prone skin. In my experience, bamboo and silk have been more gentle on Nori’s skin than standard cotton.

• Fragrance-free gentle cleansers and moisturizers. We usually do not use soap at bath time, except for Honest fragrance free shampoo / body wash once every few days. For sealing in the moisture post bath time, in the winter we need the thickness of Aquaphor (her docs all suggest simple white petroleum jelly, despite mixed opinions on that product). For regular moisturizing throughout the day, we’ll use an unscented lotion like Vanicream, Hydrolatum or Cerave. After trying SO many products, Nick has found that good ole Vanicream and Aquaphor sting the least on his inflamed skin, so we’ve stuck with these.
• Scratch me not sleeves (runs a little big – Nori is 16 months and wears the 12m size). These were a recommendation from you guys and have been a GODSEND (we have 5+ pairs). It’s a stretchy shrug with gentle silk mittens that can be flipped either open or shut to minimize scratching and irritating eczema flare ups. We put these on Nori as part of bedtime routine and worry less about waking up to bloody patches like we used to. For adults, I’ve also seen eczema gloves to help prevent subconscious scratching overnight.
• Zipper onesies with flip over mitts and footies, so you can cover a hand or foot, if needed. The foldover covers are more common in infant onesies but are getting hard to find in bigger toddler sizes! Here’s my 2 favorite brands that each also feature double zippers for easy diaper changes:
  • Lil Sleepies bamboo zippies – super soft, stretchy, and lightweight so are especially nice in the summer. At first I thought these would be too thin for winter, but I LOVE them and we just layer if necessary. Only sizes up to 12-18 months have the foldover covers, which I’m bummed about as Nori is just about to outgrow that size. Due to the thinness of the fabric, these are the only flipover mitts that she cannot break free from!
  • Kids Tales cotton blend zipper rompers – medium to thicker weight fabric. Nori lives in these at home and I love them for travel. Tag is on the outside so you need to trim it off. I’ve been very happy with these (favorites are the pineapple and watermelon print), but FYI I have found a little fabric feel inconsistency  and had to return one due to a broken zipper. Nori can break free from these foldover mitts overnight (so for bed time, I keep them open but put a Scratch Me Not over it), however they work temporarily if I need her to stop scratching during a diaper change.
• Bamboo hooded towel + washcloths. These are so soft, and the towel is a generous size.
• Electric gentle nail file to help keep sharp nails from doing too much damage.
• Silk crib sheets: A total luxury and splurge product (that mama doesn’t even get to indulge in), but we have 1 silk crib sheet that’s extra nice and gentle on her face and scalp, especially when Nori would rub her head back and forth against cotton sheets til it was raw and bloody during bad eczema flare ups.

Left: Kids Tales cotton blend zippies in size 90 // Right: Lil Sleepies bamboo zippies in size 12-18m

Outside of our bathing and bedtime “maintenance” routine, below are other steps we take to help prevent and mitigate eczema flare ups in the family.

gut health and FOOD allergies

• Probiotics. Many have suggested that eczema stems from gut health and the importance of probiotics. I don’t have anything special to recommend as we just give Nori standard kids probiotics by Culturelle. She had to go on antibiotics twice as a newborn which I really tried to avoid (but had no choice), as they likely wiped out a lot of her healthy gut bacteria and may be linked to her allergies.
• Eliminating cow’s milk from mom’s diet while breastfeeding. I feel like this is a common blanket suggestion that docs give breastfeeding moms for issues ranging from reflux to eczema to general fussiness. I did not notice any difference after eliminating dairy from my own diet, but have heard from fellow moms who noticed a big difference. Just make sure you’re getting your calcium in other ways so you don’t become calcium deficient.
• Testing for food allergies prior to starting baby on solids. Current American pediatric guidelines encourage introducing babies to common food allergens once they start solid foods (this includes egg, dairy, peanut, tree nut, fish, shellfish). But if your baby already has eczema, your doc may suggest allergy testing first, in case these foods will exacerbate the skin condition.
• Our pediatrician had Nori do a blood allergy test when she was 6 months old and it came back positive for nut, dairy, egg, soy, and sesame allergies. Some of these allergies have proven to be real on her, while a few like soy and sesame seem like false positives. Most doctors believe babies will outgrow dairy and egg allergies (less hopeful for nuts), so we are currently doing an egg ladder challenge and will hopefully tackle dairy next (see example egg & dairy challenge instructions).
• Also, I’ve heard a lot of great things about the SoCal Food Allergy Institute (currently has a patient waitlist) from readers far and wide, so just wanted to mention them for anyone dealing with severe food allergies.
  
• Foods that allegedly worsen itchiness. These supposedly include some of Nori’s favorite foods (avocados, grapes, citrus) that I still give to her. But again, some mamas say their babies have a noticeable reaction, so I just wanted to share. Our allergist recommends applying a layer of vaseline around your little one’s lips and mouth prior to eating potential allergy or itchy foods, to avoid contact-related skin irritations.

Environmental factors

• Reduce indoor allergens and dust by vacuuming and cleaning regularly around the house, including washing dust mite-trapping objects like stuffed animals and bed linens. We got rid of our big fluffy rugs that couldn’t easily be cleaned. Also this is a given to some, but keep your windows closed during high pollen seasons.
• Keep humidity levels around 50% and make sure to clean your humidifier (it’s a pain, I know). We run a cool mist humidifier only when our heater is on, because excess humidity can then contribute to mold. When we travel, it’s pretty noticeable how Nick’s (and now Nori’s) eczema changes in different climates, to the point that we’ve considered moving for this purpose.
• Keep temperatures cool but comfortable to avoid sweat. Sweat immediately triggers Nori’s flare ups, including if her back gets a little too warm sitting in a stroller or carseat, or if she’s wearing too many layers. We keep our home temperature around 68 degrees and it’s been trial and error on how warmly to dress her overnight.

Trying to get cozy without being sweaty (one of Nori’s flare up triggers) // carseat cover by JJ Cole

Contact factors

Being married to someone who has dealt with allergies, asthma and eczema most of his life, this is the norm in our household:

• Laundry:
  • Use a small amount of free & clear, fragrance free detergent. Note that unscented is not the same as fragrance free, as sometimes unscented products still have fragrances in them to neutralize odors. I found this article on laundry by a fellow eczema mama to be a helpful read.
  • Machine wash laundry with an extra rinse cycle.
• No / minimal perfumes or fragranced products on us or in the home including soap, lotion, etc. We ask this of house guests and caretakers in our home too since both Nick and Nori are sensitive.
• Clothing and bedding in cotton, silk, or bamboo as mentioned above under our favorite products.

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