Eczema is a condition that runs in families, so if anyone in the family has eczema, asthma or hay fever, your children are, unfortunately, at higher risk of developing it as well.
How does that work?
Eczema is all about the way the body’s immune system reacts (or overreacts!) to triggers; why that happens is complicated, but people with eczema also seem to have a faulty skin barrier, so their skin is more susceptible to those triggers in the first place. That’s where the genetic component of eczema comes in, as there’s a gene that affects how much a substance called filaggrin your body has, and filaggrin is crucial to maintaining a strong skin barrier function in order to prevent the ingress of allergen.
So people can be born with a predisposition towards eczema, because with less filaggrin available, their skin is more vulnerable to allergens and to being sensitised by irritants from the start.
But there are many other pieces of the puzzle to consider! A baby born with that genetic trait won’t necessarily develop full-blown childhood eczema.
What can you do to help your baby?
First of all, we want to acknowledge that there are so many demands on a mother to do everything perfectly, so many experts telling her to do this or do that, that motherhood can be absolutely overloaded with guilt and stress. That doesn’t help at all!
If your baby develops eczema it is not your fault.
You cannot eliminate the risk entirely and the reasons behind why one baby flares up constantly and another doesn’t are incredibly complex and difficult to pinpoint. Please do not blame yourself; think of the following list as practical things you can do which might make a difference; even if they don’t prevent eczema, they certainly will not hurt. They’re all good practice anyway, as much for your own well-being as your baby’s.
Do what feels manageable: your health and happiness are important too.
Here’s what research has shown can help:
- Eat well in pregnancy: feed your own body and your developing baby’s body with all the nutrients needed to be healthy: omega-rich oils, fresh green leafy vegetables, and prebiotics are all important for growing babies and have been shown to reduce the risk of a baby developing eczema. It’s now thought that eliminating potential allergens such as eggs, peanuts or dairy from your diet during pregnancy is actually counterproductive, so eat well and widely!
- Breastfeed for as long as possible: there’s really sound evidence that formula-fed babies are more likely to develop eczema than breastfed ones; breastfeeding is advised for 4-6 months.
- Delay weaning until your baby is ready for solid food, which is likely to be around 6 months, and when you do introduce new foods, add them carefully and gradually. It’s a good idea to keep a food diary during this process. See our blog about weaning babies with eczema here.
- Keep away from soap! Avoid soap, body washes, shampoos and detergents such as SLS/SLES for the first year of life, if at all possible! Newborn skin is especially susceptible to lasting damage from soaps that strip the natural oils from their delicate skin, leading to dryness and damage. Once the skin barrier is damaged then it can let in allergens which can cause long-term sensitivities. See our blog about bathing babies with eczema here.
- Moisturise: if your baby has a predisposition to dry skin or eczema, it’s important to support the skin barrier function with emollients. Always use oil or ointments immediately after washing or bathing. There’s evidence to suggest that applying non-irritant emollients all over, every day, can make a real difference to how healthy and resilient the skin barrier is.
- Patch test: it’s really important to patch test anything you’re putting on your baby’s skin to reduce the risk of them getting sensitised to ingredients. See our blog about patch testing here.
- Reduce household triggers: be aware of common household triggers such as laundry detergent, house dust mites, household cleaners, and swap out for hypo-allergenic or natural versions.
- Don’t be too clean! The immune system needs challenges in order to develop healthily; in practice this means not going overboard on the cleaning and sterilising of everything your baby comes into contact with! A famous study showed that babies who grow up in super-clean houses have higher rates of eczema, asthma and hay fever than kids who grow up on farms.
- Get a dog! Yes, really! A study published in the Journal of Pediatrics* showed that for children at risk of developing eczema, having a dog in the family home before the child’s first birthday dramatically reduced the child’s risk of developing eczema by age four. (Cats do not have the same effect, unfortunately for cat lovers.)
*Epstein TG, Bernstein DI, et al. “Opposing effects of cat and dog ownership and allergic sensitization on eczema in an atopic birth cohort.” J Pediatr. 2011; 158:265-71.