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Allergy Today: Eczema and Food Allergy

Eczema is a common skin condition affecting up to 25% of infants and young children. Some will have signs and symptoms from a few months of age, such as itching and rashes on the skin. The itchy skin is unsettling and can greatly disturb their sleep and that of their parents. Eczema is a challenging condition to manage, with flare-ups often happening for no known reason.iStock-1253390455-452 

There is no cure, but most eczema can be controlled with good skin care that includes regular (2-3 times a day) moisturising, using a soap substitute for washing, and applying topical steroids when required. Thankfully, most children will outgrow eczema with time.

It is not known what causes eczema, although inherited (genetic) and environmental factors play a part. Some children with eczema will also develop allergies.

It is understandable parents want to do anything they can to alleviate their baby’s distress, particularly when their eczema flares up. If the baby is breastfed, it is not uncommon for the mother to suspect food in her own diet as the culprit, and cut the food out to control the eczema in her baby.

However, cutting cow’s milk out in particular for any length of time could cause problems for the breastfeeding mother, due to lack of calcium. There is also now good evidence that food is only occasionally the cause of eczema flare-ups, and that eliminating certain foods (such as cow’s milk, soy, wheat, egg, peanuts, tree nuts and fish) from a baby’s diet can lead to an increased risk of developing allergy to that food, and potentially causing poor growth through lack of good nutrition.

It is strongly recommended trialling an elimination diet only with medical supervision or a trained allergy dietitian.

The Australasian Society of Clinical Immunology and Allergy (ASCIA) has just released “Eczema and Food Allergy Fast Facts” in response to the demand for information about the two conditions:

https://www.allergy.org.au/patients/fast-facts/eczema-and-food-allergy

The Prevent Allergies website also has advice on introducing foods as well as managing eczema:

https://preventallergies.org.au/eczema/

“Fast Facts on Cow’s Milk Allergy” is also available:

https://www.allergy.org.au/patients/fast-facts/cows-milk-dairy-allergy

In New Zealand, if you are concerned your baby’s eczema might be flaring up due to a food allergy, it is recommended that you see a doctor or nurse with recognised training in allergies. In the meantime, discuss the management of eczema with your GP or nurse, including a referral to a paediatric outpatient clinic or service for support if you need it.   

More information about managing eczema is available on Allergy New Zealand’s website:

http://www.allergy.org.nz/A-Z+Allergies/Eczema.html

This includes a video series made by the New Zealand Child and Youth Eczema Clinical Network:

https://www.youtube.com/watch?v=UbUMqDrkPBY&list=PLdaNr16wZI1Yx26W0KIQrgaRiqXhsgkKg

Kidshealth website:

Eczema Action Plan (link to) https://kidshealth.org.nz/eczema-care-plan-take-your-doctor

Bleach Bath Information Sheet (link to) https://kidshealth.org.nz/when-how-use-bleach-baths-your-child-eczema?language=en
 

Thanks to Pauline Brown, Nurse Practitioner

General Paediatrics/Community, Child Health Centre, Northland District Health Board