Vol.2 Reader’s Queries on Eczema, Low Weight and Eating Habits of Baby

A reader asks : My baby boy is 8 months old. He is my first  baby.

1. He has eczema (not very severe) since he was just 2 months. Doctors said that it can be treated only by steroids and that is obviously not good for such a small baby. Can you suggest any thing for that. 2. Second thing is his weight. He is not a good eater, even not take milk properly. Is there anything to increase his appetite. I already gave him ghee, olive oil, bananas etc but weight gain is not good. (He has severe egg allergy) 3. Can I give him cheese. I’m hesitant because of his eczema, because there are chances of food allergies in such babies. Which type of cheese is best? Dr.Nitin Deshpande’s Answer : Dear Anxious mom,

Your 9 / 10 months old baby has Eczema. ‘INFANTILE ECZEMA‘ ( also known as ATOPIC DERMATITIS), is a very common skin disorder, affecting 10 to 20 % of all infants and children.

It is an allergic condition, seen more prominently in the 1st year of life. The severity of the disease is known to wax & wane (increase and decrease ), for the initial 4 to 5 years of age. Most of the cases of ‘ Atopic Eczema ‘  gradually regress as the child grows older.

Various triggers can flare up episodes of Eczema in children. These irritants / triggers are:

• Dry Air
• Winter
•  Pets
•  Dust mites
•  Wool
•  Cigarette smoke
•  Perfumes
•  Laundry detergent
• Air freshener
• Contact with saliva
• Certain foods ( Cow’s milk )
• Detergents in Bubble baths
• Detergents in Shampoo

SYMPTOMS OF ECZEMA:

   Dry, itchy, red skin, in patches, seen mainly on the checks, scalp; but it may affect other areas of the body as well.

TREATMENT OPTIONS FOR ECZEMA:

•  Emollients/ Moisturizers
•  Steroids
•  Anti-histaminics
•  Anti-allergics
•  Disease modifying agents.

Emollients & Steroids are the mainstay of therapy of Atopic Eczema. The best option is to use emollients on a regular basis and to use Steroids during flare-ups or acute increase in symptoms.

There are a wide variety of steroids, that can be used in Paediatric Eczema. Your Paediatrician can guide you regarding using a steroid, which is potent enough, but has lesser side effects. One cannot completely avoid the use of steroids in Atopic Dermatitis, in children.

BATH:

Bathe your baby with a Syndet soap, whose pH is close to our skin pH. Soaps such as DAFFY, or TEDIBAR can be used on a regular basis. CETAPHIL CLEANSING LOTION, is relatively mild and is a good option to use for bathing the baby.

AVOID:

• Talcum powders
• Creams or lotions with a strong fragrance
• Massaging with Gram flour( Besan ) / Irritant oils.

PART B) of the same question:

As far as your baby’s weight is concerned, try giving him a wide variety of foods such as:

• Rice Dal
• Khichadi
• Kheer / Porridge
• Mashed fruits
• Mashed Potatoes
• Ragi
• Veg Soups
• Non Veg Soups
• Fresh Curds/ Butter milk / Lassi
• Chapati soaked in Dal/ Milk
• Daliya/ Upma/ Sooji/Sheera
• Milk
• Idli/ Dhokla / Dosa / Thepla / Paratha
• Oats Porridge
•  Kelloggs + Milk

   As well as many other traditional food options.

PART 3 of the same question:

CHEESE

   Yes, you can give your baby Cheese. Cottage cheese or Paneer is a good option. Fresh Paneer with salt and pepper can be given.

Cow’s milk allergy usually decreases in severity after the 1st year of life. So, after your baby’s 1st birthday, you may try any cheese. Goat cheese has lesser allergic potential.

You should try giving your baby both Indian and foreign commercially available cheese, & observe for any problems. If you find increase in severity of Eczema, then you may avoid it. Do not put your baby on a cheese free diet, without trying it out first. Kids often outgrow allergy to milk products, as they grow older.