Eczema

Dear Lisa,

I have eczema and now my baby's skin is becoming very dry. What are the chances that my baby will get eczema too? Is there anything that I can do to prevent my baby from getting it?

“Don’t want eczema in N.J.’’

Dear “Don’t want eczema in N.J.”

Atopic dermatitis (AD) or eczema is hereditary. “80% of the offspring of two parents with AD will develop AD, 60% will develop the disease if one parent has AD and the other parent has respiratory allergies and 50% will develop AD if one parent has AD”.(1) Therefore there is nothing that you can do to prevent your child from getting eczema because it is genetically determined who will most likely develop the disease. There are things you can do to control the factors that exacerbate Atopic Dermatitis.

With the correct environmental conditions you may help control your child’s symptoms. To avoid a flare up of the disease, you should eliminate anything that is irritating to your baby’s skin such as tight fitting clothing or clothing with rough textures. It is best to dress your baby in soft, loose fitting cotton clothes and avoid clothes made from wool, corduroy, jeans or items filled with decorations that rub at the skin.

The clothes that a caregiver wears are also important. A baby’s face and hands frequently rub against its caregiver's clothing during handling and feeding. Therefore you should avoid wearing fabrics with rough textures when handling your baby.

Avoid scented soaps, shampoos or bath gels or products that contain colored dyes or preservatives. A non-drying soap such as Dove is recommended because it adds moisture and it doesn’t contain additives which may trigger a flare of eczema symptoms. I recommend Dove liquid soap as a shampoo for babies because shampoos on the scalp may irritate the skin of the baby’s face as well as the rest of the body.

When you dry your baby after a bath, you should pat the skin instead of rubbing it. Within three minutes of bathing an emollient should be applied to your baby's skin . Vaseline Petroleum jelly or Aquaphor are both good moisturizers. It is a good idea to avoid moisturizers containing preservatives such as parabens because such agents could result in a flare up of eczema.(2) Newborn babies do not need to be bathed daily, bathing twice per week is enough. Otherwise the frequent bathing can strip the skin of its natural oils and lead to over drying which is a risk factor for a flare up of Atopic Dermatitis.

Lastly, certain foods may be linked to the development of atopic dermatitis. When introducing new foods, watch closely for sensitivities which may result in a worsening of your child’s skin condition. It is a good idea to avoid highly allergic foods such as milk, eggs, fish, and nuts until a child is older.

References:
(1) Rosenthal, M. Pediatricians treating more patients with atopic dermatitis. Infectious Diseases in Children. 2006; April:56.
(2) Connelly, E., Eichenfield, L, Treatment Pearls for Managing Atopic Dermatitis. Children’s Hospital, San Diego and University of California, San Diego. Pediatric Skin Care. 2004:16-18.

Lisa Kelly R.N., P.N.P.,C.
Certified Pediatric Nurse Practitioner

Pediatric Advice for Parents

Campylobacter

Dear Lisa,

My neighbor’s child developed Campylobacter. What is Campylobacter and can my son catch it? How can I prevent my son from getting it?

“Need info about Campylobacter”

Dear “Need info about Campylobacter”,

Campylobacter is a diarrhea illness caused by the organism Campylobacter jejuni. It lives in the gastrointestinal tract of domestic and wild birds and animals. The symptoms of campylobacter include; diarrhea (usually bloody in nature), abdominal pain, fever and overall feeling of discomfort. Transmission occurs when a child ingests contaminated food or by direct contact with stool of an infected animal or person. Improperly cooked poultry, untreated water and unpasteurized milk are the main sources. Many times the infection is linked to travel outside the United States, living in a home with a sick pet, or a trip to a dairy farm where children drank unpasteurized milk.

Recent research showed infants and children developed Campylobacter after drinking well water, eating fruits and vegetables prepared in the home and riding in a shopping cart next to meat or poultry. (1) The cross-contamination is thought to occur when food infected with Campylobacter contaminates a surface such as a kitchen counter or shopping cart. Raw Poultry containing Campylobacter can contaminate the countertop during food preparation. Transmission may occur when a child’s food, such as uncooked fruit and vegetables is prepared on the same countertop or surface and then fed to the child. Contamination in the supermarket occurs when shoppers pick out poultry from the meat section and then touch the handle of shopping carts. Children sitting in the front of the shopping cart have direct access to the handle through touching or by putting their mouth on the handle.A child can catch Campylobacter if he comes into direct contact with another child’s infected stool, if he ingests contaminated food or comes into contact with items exposed to the Campylobacter germ.

You can prevent transmission by properly cleaning surfaces and utensils when cooking and preparing meat and poultry. Wash your hands with warm soapy water after cooking and before touching your child. Surfaces that come into contact with raw meat should be washed with warm soapy water or a chlorine based product. When shopping at the supermarket with young children, you can clean off shopping cart handles with disinfectant wipes or purchase a seat or cover which is designed to prevent young children from coming into contact with the cart. Your child should not have contact with a child with Campylobacter who is still in diapers or not potty trained.

(1) Rusk, J. New exposures linked to Campylobacter infections among infants. Infectious Disease in Children. 2006; March: 36.

Lisa Kelly R.N., P.N.P., C.
Certified Pediatric Nurse Practitioner

Pediatric Advice About Preventing Infections