For medical professionals only
May your baby's eczema be controlled smoothly and grow up happily and healthily!
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Usually, I pay the most attention to children's skin diseases, and almost every day I encounter the protection and treatment of babies with eczema (generally equivalent to "atopic dermatitis"). One of the most asked questions is whether the eczema baby needs to avoid eating? Need to change to deep hydrolyzed milk powder? Does your baby have food allergies? Do I need an allergen test? Does Mom need to avoid during lactation? Why is eczema avoided or not getting better?
Here, we collate and share the authoritative science from The Society for Pediatric Dermatology, "Eczema and Food Allergies", to answer these special concerns of eczema parents.
(Source: Screenshot of reference)
One
What is eczema?
Eczema is a common chronic skin disease.
Eczema predisposes to redness, itching and dryness of the skin.
Infantile eczema (Source: https://www.visualdx.com/)
Eczema is associated with skin barrier problems as well as inflammation. Even after treatment, eczema fluctuates, getting better and worsening recurs. In addition, for a single person, the trigger for eczema may be difficult to determine. Parents sometimes worry that food allergies can lead to eczema in their children.
So what is the actual situation? Let's get straight to the point and see what the American Children's Dermatology Society explains.
Two
What is a food allergy?
First, a food allergy is an abnormal immune response to a certain food.
An allergic reaction occurs when your child eats these foods for the first or second time. The symptoms of food allergies are not simply skin problems, but may be summed up with urticaria (commonly known as rubella lumps), skin flushing, diarrhea, vomiting, stomach pain, difficulty breathing, swollen lips or swelling of the face.
Urticaria (Source: https://www.visualdx.com/)
These symptoms may occur within minutes to hours of eating.
International statistics have found that the most common foods with allergies are: milk, peanuts, tree nuts, eggs, soybeans, wheat, shellfish, fish.
Three
What does eczema have to do with food allergies?
Food allergies are more common in children with eczema. The more severe the eczema, the more likely it is that your child will have food allergies. Although children with eczema may have food allergies, experts believe that allergies by themselves generally do not cause eczema.
Other allergy problems are also more common in children with eczema, such as environmental allergies and allergic asthma, but these allergies also do not cause eczema.
(Source: https://convenientmd.com/asthma/)
Four
How do parents know if their child has any food allergies?
We usually describe rashes caused by food allergic reactions as urticaria. This manifests itself in flat or bulging round, ring-red, patchy eruption of flat or raised, circular red eruptions on the skin after a few minutes to hours of eating food, which usually itch.
It should also be noted that some foods can cause rashes when they come into contact with your child's skin, but these rashes are often caused by direct irritation, rather than medical "allergies".
(Source: https://pixabay.com/illustrations/foods-food-healthy-vitamins-summer-3520938/)
Five
Should my child have eczema and should have a food allergy test?
It depends on the actual situation, so you should talk to a dermatologist.
If your child does not have an allergic reaction after eating food, a food allergy test is not needed.
In fact, a food allergy test may be "false positive," meaning that your child who does not have allergies and has a positive result may be labeled "food allergy."
If you do suspect or worry that your child has a food allergy, you should see a reliable dermatologist or allergist who can talk to you in detail about the problem and tell you about the allergy tests you may need to do.
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Food allergy tests include:
1. Skin prick test: The doctor will "stab" the chemical ingredient suspected of being allergic into the skin. If urticaria appears within 15 minutes of penetration, the verdict is positive.
2, blood test: detect the food IgE antibody, note, not IgG. IgG detection is deceptive.
3. Food stimulation test: The child eats a suspected food allergen under the close observation of the doctor, and then observes the reaction. This test is not done lightly.
Six
Should children with eczema or nursing mothers avoid certain foods?
In general, you should not blindly avoid eating.
Infants or children with eczema should not blindly avoid food. If the child does not eat enough and eats incorrectly, nutrition and growth problems may occur.
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However, if a child is diagnosed with a food allergy (rather than unfounded suspicion and concern about the allergy), the corresponding food should not be eaten.
In addition, giving children to avoid relatively common food allergens (such as eggs, peanuts, and milk) does not cure eczema. This means that avoiding the mouth does not treat eczema.
Similarly, deliberately avoiding milk, wheat, or eggs during pregnancy or breastfeeding will not prevent your child from developing eczema and food allergies. That is to say, the avoidance of mouth does not have the effect of preventing long eczema.
Seven
When can parents give their eczema babies solid food?
First of all, you can learn the basic knowledge of complementary food additions from channels such as pediatricians (such as pediatric nurses). Scientific studies have confirmed that eating foods with allergies at a younger age can help reduce the chances of food allergies.
Babies with mild to moderate eczema can eat peanuts (mainly peanut butter) and other "high allergy risk" foods at 6 months of age. Babies with severe eczema may need a peanut allergy test before trying peanut products for the first time. If they are not allergic to peanuts, they can start eating these foods when they are 4-6 months old. A reminder: this may not apply to children at home, as peanut allergies are more common abroad.
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It's also important to note that babies with severe eczema can try other "high allergy risk" foods when they are 4-6 months old without an allergy test.
Finally, to summarize: the incidence of eczema in infants and young children is getting higher and higher, and how to properly manage eczema babies is especially important. As a dermatologist, I especially hope that parents can use scientific, professional and reliable concepts to take care of eczema babies. Usually, you can ask more why, be wary of your own (or the people around you) misconceptions and stereotypes, and pay more attention to whether there is enough basis behind various views.
May the baby's eczema be smoothly controlled, so that the baby can grow up happily and healthily!
bibliography:
[1] Lalor L, Todd P. SPD patient handout: Food allergies and eczema. Pediatr Dermatol. 2020, 37(6): 1142-1143.
Source of this article: Medical Community Skin Channel
Author: Tang Jiaoqing
This article was reviewed by Tang Jiaoqing
Editor-in-Charge: CiCi