Wednesday, March 31, 2010

Eczema

Let me let you in a little secret if you haven't already figured this out. Recommendations from the medical profession change, and change often. Just think back over things like when to introduce solids and if babies should sleep on backs or tummies.

 
Advice for how to best treat eczema is no different. There is "traditional" advice, and then there is the more "contemporary" advice that not all doctors have even really been updated on yet.

 
This post contains information on how to help treat eczema. I will share all the advice I know, and some of it will be conflicting. What works for one baby will not work for another.

 
WHAT IS ECZEMA?
The term eczema covers a broad spectrum of things. Basically, it is skin irriation. With eczema, no matter the cause, the skin will get irritation, inflamed, and often has a rash. Skin is often dry. It can blister, crack, and bleed. Eczema is typically itchy. Eczema is itchy before the rash appears. I found this picture on Wikipedia. It states this is mild:

 

 
WHAT CAUSES ECZEMA?
There are lots of theories on what causes Eczema, and the exact cause isn't exactly known.
  • Eczema is itchy before it rashes. The rash comes out after it has been itched, rubbed, or irritated.
  • It might be caused by the body overreacting to some trigger.
  • For some, it is an allergic reaction. Many times, this happens in families where asthma and hay fever are common. It can be a reaction to a food allergy or another allergen.
  • For some, it is caused by an irritant like the type of laundry detergent used.
  • Dry weather can have an affect.
With McKenna, I think the dry weather has a negative impact on her skin. I also have noticed that skin that gets rubbed a lot flares up. Her forearms get it now that she crawls. Before she was a crawler, it was her back.

HOW DO I TREAT ECZEMA?
First of all, Eczema is not contagious. Second of all, it cannot be cured, which is why I titled this section how to "treat." The problem with eczema is that it is itchy and sometimes painful. If the person with eczema is capable of scratching, she can scratch to the point of causing an infection in the skin. Let's take the treatment one section at a time.

 
BATHING
The "traditional" advice on bathing is to bathe as little as possible. The idea is that it dries the skin out and makes everything worse.

 
The modern advice is to bathe as often as possible--at least once a day. I have read articles that say dermatologists will tell you to bath daily, while many pediatricians are still saying bath as few times as possible.

A study published nearly a year ago used diluted bleach water each day. Half of the group used bleach and half a placebo. The bleach worked so effectively that they terminated the study early in order to provide the other half the relief.

 
So how do you decide what to do? I think you just need to experiment and see what works best. I created an Eczema spreadsheet to help me track things. It is available through the Chronicles Yahoo! Group in the Files section.

 
For about the first six months of McKenna's life, we bathed every day. That has always been my routine with my children. Around 6 months it got to be a challenge on school days, so we went down to bathing four days a week.

 
When she was about 8 months old, she developed Eczema. This was around the time of year it got cold and the heater came on a lot more. We live in a dry climate.

 
On days she has a bath, her skin is amazing and much better than on days she doesn't. So for us, I believe bathing at least every other day is best, and I plan to try out every day soon. I have dry skin. It isn't eczema, but it is really dry. My skin gets really bad if I don't shower every day--even if I apply lotion. Putting lotion on damp skin is much more effective than putting it on dry skin.

 
Another thing to consider with the bath is the temperature of the water. You don't want it too hot or too cold. Luke warm is pretty universally suggested.

 
I think the best thing to do is to try out different intervals of bath and see what works best.

 
Of course, you need the right soaps and such for bath time or else you will irritate the skin more.

 
Soaps/Body Washes
First, note that true "soap" is not a good idea. It is drying. Body washes/creams/cleansers are what you are after. There are a lot of soaps out there. A lot. And they are expensive. Unless you have a lot of money floating around, it is hard to figure out which one is "best" for your child. For that reason, I created the polls on which worked best.

 
I think there are a lot of products because different products work for different children. If there was an overall bad product out there, it wouldn't be long before it was out of business. But seeing a poll might give you a good starting point. For bath wash I did the following poll on which bath wash worked best:

 
Aquaphor: 42 votes (24%)

 
Aveeno: 62 votes (36%)

 
Burt's Bees: 3 votes (1%)

 
California Baby: 9 votes (5%)

 
Cerave: 7 votes (4%)

 
Dove Soap: 14 votes (8%)

 
Other bar soap: 2 votes (1%)

 
Other: 30 votes (17%)

 
Total of 169 votes

 
I highlighted the top two vote getters. We have Aveeno, Aquaphor, and Burt's Bees. Those are the products we have tried thus far. Aveeno works best for McKenna, but I think Aquaphor works fine, too. I don't see problems with Burt's Bees, either.

 
This is my opinion about the soaps. I think so long as you get something that is fragrance free, you should be fine. I think of all the products, the soap is the least critical so long as it is fragrance free. I also think you don't necessarily need to wash your child with soap every time they take a bath unless they are actually dirty.

 
Shampoo
If your child has eczema, she might also have dry scalp, dandruff, cradle cap, etc. While I don't think the soaps matter much, the shampoos do.
 
Aveeno: 68 votes (25%)

Aquaphor: 26 votes (10%)

 
Burt's Bees: 15 votes (6%)

 
California Baby: 24 votes (9%)

 
Coconut Oil: 6 votes (2%)

 
Dermamed: 1 votes (0%)

 
Gentle Naturals: 7 votes (3%)

 
Head & Shoulders: 30 votes (11%)

 
Olive Oil: 23 votes (8%)

 
Other Oil: 17 votes (6%)

 
Other: 51 votes (19%)

 
Cerave: 4 votes (1%)

 
Total of 272 votes

I highlighted the top two vote getters--other than the "other" since that doesn't give you anything concrete. My vote on this poll was for Burt's Bees. We had tried Head & Shoulders and Burt's Bees at the time. After seeing the results to this poll, I decided to try Aquaphor and Aveeno.

 
Burt's Bees prevented her scalp from getting worse. It didn't get better, but it also didn't get worse. I would brush her head with a stiff bristle brush before the bath and use Burt's Bees and we kept things as they were.

 
But the Aveeno did the trick! Aveeno is my new vote, hands down. I no longer brush her head and the dryness is 100% gone.

Another thing to consider with baths is the softness of the water. We got soft water about a month after McKenna's symptoms showed up. It made a huge difference! It has gone out since, and when it did, her skin got much worse, then improved when it was fixed. With the water softener, I only have to lotion her once a day. With hard water, I need to lotion her twice a day.

 
Post Bath
I wrap McKenna in a towel and just pat her dry. Do not rub. Make sure the towel is washed in appropriate laundry detergent, as discussed below.

This is how I do post bath. I lay her on her towel and wrap her up. Then I carry her in a cradle hold. As I walk to her room, I rub her head to dry her hair. Once we are in her room, I pat her diaper area dry. Then I put her diaper on. Then I start the lotioning. I don't need to dry any other area of the skin.

 
LOTIONING

 
Creams/Steroids/Antibiotics
Medicated Creams, steroids, and antibiotics need to go on before you apply any lotions. When McKenna has a flare up, I use Hydrocortisone Cream. I don't use it every day, but do when she needs it.

 
Lotions
Once your creams and steroids and all that (as needed) have had a minute or two to set in, start the lotioning.
With lotions, choosing the right product is important.

 
Aquaphor: 67 votes (26%)

Aveeno: 56 votes (21%)

 
Burt's Bees: 11 votes (4%)

 
Calforina Baby: 15 votes (5%)

 
Cerave: 7 votes (2%)

 
Deramed: 0 votes (0%)

 
Eucerin: 26 votes (10%)

 
Prescription: 17 votes (6%)

 
Other: 57 votes (22%)

 
Total of 256 votes

 
I have used Aquaphor and Aveeno on McKenna. They work so well that I haven't gone any further. I use both. I first load up the Aquaphor, then follow up with the Aveeno. If I could only buy one, I would use the Aquaphor. I should mention that I have read to not put any sort of lotion over something like Aquaphor, but I have had great success with it, so I do it. Take this into consideration as you figure out what works best for your baby.

 
If your baby's skin has a rash, I suggest you lotion morning and night until it is gone. If there is currently no rash, try lotioning only once per day and see if that controls it.

 
This stuff is expensive, yes. Here is the good news. As I write this, McKenna has been using it for over four months. She is still on her first tubes of these items (all of them). I used the lotioning stuff twice a day for two months. So it does last a long time. A baby's body is small :)

 
DAILY LIVING
There is definitely more to do beyond the bathing and lotioning.

 
Diapers
If your child has eczema, you will find some diaper rash creams/ointments definitely work better than others. There are a whole lot of options out there, and you will notice that there are not really a high concentration of votes like in the other polls:

 
A&D Ointment: 14 votes (5%)

 
Amolin: 2 votes (0%)

 
Aquaphor: 62 votes (24%)

 
Arbonne Herbal: 7 votes (2%)

 
Avalon Organics: 1 votes (0%)

 
Badger Diaper Cream: 0 votes (0%)

 
Balmex: 6 votes (2%)

 
Bepanthen Ointment: 0 votes (0%)

 
Boudreaux's Butt Paste: 27 votes (10%)

 
Burt's Bees: 11 votes (4%)

 
California Baby: 16 votes (6%)

 
Desitin: 21 votes (8%)

 
Desitin Extra Strength: 6 votes (2%)

 
Dr. Smith's: 2 votes (0%)

 
Grandma El's: 0 votes (0%)

 
Hydrocortizone Cream: 19 votes (7%)

 
Lansinoh Diaper Cream: 1 votes (0%)

 
Method Sqeaky Clean: 1 votes (0%)

 
Northern Essence: 2 votes (0%)

 
Other: 23 votes (9%)

 
Paladin Soothing Relief: 1 votes (0%)

 
Triple Paste: 18 votes (7%)

 
Vasoline: 7 votes (2%)

 
Weleda: 6 votes (2%)

 
I think this result just adds to the value in purchasing Aquaphor. Something to consider with this choice is how you diaper. Some of these are much better for clothe diapering than others (so I am told :) ).

 
I have never used Aquaphor on the bottom, but I am thinking I should try it.

 
I have used Balmex and don't like it at all. I would never pay money for it.

 
I love Butt Paste. It was so fabulous for Brayden and Kaitlyn; however, it did not work at all for McKenna.

 
Burt''s Bees is our current use for McKenna. I really like it. It works well.

 
I LOVE the Lansinoh. Really love. It is impossible to find where I live, so I need to order it online. The next time we need to buy diaper ointment for McKenna, I think I will try Lansinoh and try it in the context of eczema. I have not complaints about Burt's Bees, but I want to see if I like Lansinoh better.

 
I have to put diaper ointment on at every diaper change.

 
You should probably also watch the brand of diapers you use. Some will be more irritating to your baby than others.

 
Laundry
When you do laundry, make sure you wash your child's clothes, sheets, towels, etc. in "free" detergents. There is All Free and Clear. I use Dreft for McKenna and that has been fine--no problems. I have also used All Baby for McKenna with no problems.

 
If you want to use a fabric softener, you can use Bounce Free.

 
For my babies, I always use a baby-friendly detergent. I wash their clothes separately for the most part, though I will add pinks and reds to the girl's pinks and reds. I typically do this for the first year, but for McKenna, I will extend it as long as she has eczema. If she continues to have eczema (many stop having issues around 18 months), then I will switch the family over to All Free and Clear.

 
I just don't use fabric softener for my baby clothes, but I am thinking the Bounce Free sounds like a good  idea.

 
Dressing
When dressing your child, try to use 100% cotton clothing. It breathes better. It is a natural fabric. Avoid scratchy materials like wool. You also want to avoid overheating your child.

 
Humidifier
Use a humidifier if you live in a dry climate.

Supplements
There are supplements you can try. One is fish oil. You can take fish oil supplements if you are breastfeeding and it will transfer through your milk. It is fat soluble, so it will take a couple of weeks to make it through. If you are not breastfeeding, you can try adding it to bottles or food, but be sure to consult with a doctor first. You can also feed your child fish if she is old enough. Studies have found children who eat fish do better with eczema.

A recent study suggests that Vitamin D3 helps improve skin. This vitamin is found in the sun, so during the winter, many people will not get enough. Again, if you are breastfeeding, you can take about 2000 IUs a day. It is also fat solubleso expect two weeks before seeing improvement. One of my best friends growing up had eczema, and her skin always got better if it had some exposure to the sun, so I believe this has some validity to it. If your child is not breastfeeding, talk to you pediatrician about ways to get more D3 into your child in the winter.

SUMMARY
As a summary, to treat eczema:
  • Figure out the best way to bath baby and which products to use.
  • Figure out which creams and lotions are best. Use steroids if needed (as discussed with a doctor).
  • Find the best diapers for your baby.
  • Figure out the best diaper rash ointment for baby. You will likely need to use it at every diaper change.
  • Do laundry in a "free" detergent.
  • Dress in cotton as much as possible.
  • Use a humidifier if needed.
  • Try to find the cause of the eczema. If it is caused by an allergy, then you can greatly diminish if not eliminate eczema. Most babies with eczema just have eczema, but some have it because of allergies.
  • Take supplements as desired
Please feel free to share what works and doesn't work for your child on this post. Like I said, there are many things that work for some and not for others and the more info moms have, the more likely they will be able to find what works.

I will be taking all previous comments from readers on eczema and putting them into their own post, so if you have posted your tips before, don't feel like you have to do it here. You are welcome to, it won't bother me in the least, but you don't need to.

There is also a lot of great info in this group on Babycenter. You don't need an account to read the info, just to post questions/comments.

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Tuesday, March 30, 2010

McKenna Baby Summary: Week 52


Okay, first of all, I didn't skip a week. I have been thinking for the last month that things seemed off with my week numbers. I went back and looked and indeed, I had messed up. I did week 47 two weeks in a row. So, this is week 52. I went back and fixed the others.

McKenna's last week as a baby! *Sniff Sniff*

NURSING
A few days into this week, McKenna bit me and drew blood. Umm...yeah, that hurt. My husband proclaimed nursing over, but I was only 5 days away from her birthday and I just really wanted to make it. I told him I didn't nurse through the yeast infection recently just to give up five days early. Yes, I am stubborn...or is it goal-oriented? Either way, I continued nursing! Yes. I made it to one year. Then we stopped. But that is a topic for next weeks summary...her pre-toddler summary.

BLANKET TIME
We had a significant breakthrough this week. I can now get up and do things and she stays on quite well. We still do 10 minutes. I think McKenna is not totally sure what isn't allowed. She might think she can't move in the least. It will take time for her to fully get that it is okay to move but she must stay on the blanket. When she wants a toy, she reaches and reaches and then goes right back to her spot. I think it is cute to see her trying so hard to do what she believes is what I want.

TEETHING
McKenna had a tooth come through this week, taking her total to 5 with one pressing hard. The good news here is that she has turned into a great teether. Her first three teeth were hard for her, but the last two have been fine.

PICTURES
McKenna had her one year photos taken this week. At first, she cried and cried, which is very unusual for her. She has never done that. It took some time to get her calmed down, but we eventually did and got some darling photos.

Well, that does it. That completes her first year. It is such a bittersweet moment. I am really excited to get to the fun of toddler life--I just love toddlers and Kaitlyn is about to leave toddlerhood. But it is sad that my little baby is no longer a baby! Her first year has really flown by. I honestly feel like it has been only a few weeks since I wrote her first newborn summary. She is such a joy to our whole family and we just adore her.

LOOKING FORWARD
I will be doing a pre-toddler summary next week for sure because a whole lot seems to happen that first week of a one year old. I am looking for input on how to go forward from there. I was thinking that maybe a summary every two weeks would be good? So a 12 month old, 12.5 month old, 13 month old, etc. Things just don't change as quickly from this point forward, so a weekly summary might be quite boring sometimes--and I have lots of other posts waiting to be written.

OUR SCHEDULE
8:30 AM--wake, nurse, solids (prunes or peaches/apricots and oatmeal). This is when we do a bath (four days a week) and independent playtime. We then do sibling playtime.
10:30 AM--nap.
12:30 PM--wake, nurse, solids (green veggie and applesauce. Sometimes mix with blueberries or cherries). She then "helps" me put Brayden in rest time (which just means telling him to go) and Kaitlyn down for her nap. We then do blanket time followed by free play with me in the same room.
2:30 PM--nap
4:30 PM--wake, formula (sort of), solids (yellow veggie and bananas or pears). Then time with Daddy.
5:30ish PM--dinner with family. Finger foods and what we are having. Then time with family.
7:15-7:30 PM--nurse, PJs, story, prayers, bed.

GOOD BOOKS/WEBSITES

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Monday, March 29, 2010

Ask and Tell


Ask and Tell is a notion that wise parents use often. By wise parents, I don't just mean "Babywise" parents, but wise parents. It is an age-old trick. I have found that many of the moms I respect most around me, who have very wonderful children, use this tool.

So what is Ask and Tell? Ask and Tell is found in On Becoming Preschool Wise starting on page 179. This is the same idea as training in times of non-conflict. Before you leave your home to go somewhere (church, shopping, out to dinner, etc), you get down on your child's eye level. You then explain where you are going and what is expected. Explain the rules for this outing.

Over time, your child will come to understand the rules and won't need the rundown each time. Instead, you can ask. Ask what the rules are for church. You can start with questions like, "Do we run in the church?" As your child continues to get better, you just ask for the list of rules. This works well because people don't like to be lectured about something they understand well. The five year old does not need the rules spouted off to him when he has been hearing them for the last two years. He will tune out. But if you ask him questions, he will be involved, and he will know that you recognize he has progressed beyond the three year old level of understanding and behavior.

You can also use Ask and Tell for teaching about greeting people. Perhaps you are going to visit a relative you don't see often and you know your child is a bit shy around new people. You can teach him before you leave that your great aunt will say hello and he needs to say hello back. You can also say that she will likely tell him how cute he is, and that he should reply with gratitude.

Some children will also greatly benefit and need some role-playing. You can tell your child to show you how to walk in the church, or how to shake hands politely, etc.

I have also used it to avoid the meltdown when it is time to leave somewhere fun. Brayden has a hard time leaving places. This problem seems to be the worst the first time we go to the park after winter is over. So I will tell him that we are going to the park, and when it is time to leave, I don't want any fits or any crying. I know it is fun and he wants to stay forever, but we can't. I also know he is sad to leave, and that is fine to be sad, but that doesn't mean he can or should throw a fit. If he can't leave without throwing a fit, then we won't be going back. I lay it all out there. It produces the results I want.

As you use this skill, your child will come to understand and employ proper behavior and social courtesies.

I am not always great at utilizing this skill. I often find myself expecting my children to just know how to act in different situations. If you think about it, that is rather silly. Why would a child just know if he hasn't been taught? The times I remember to do this, things go much more smoothly.

I think I have shared this in the past, but this it illustrates this very well. We have some friends who had no children, but were great with kids. They loved kids and kids loved them. My children enjoyed their attention immensely.

They adopted a little baby boy. We went to visit them the day they came home from the hospital. For some reason, I didn't really think about the fact that my children would need to act differently than they were used to acting in their home. I knew they need to, but I didn't realize that they wouldn't know they needed to.

So we went over and our kid were kind of crazy. They were noisy and they wanted to have the attention they were used to. Of course our friends were new parents and enamored by their precious, long-awaited for baby.

I was shocked at their behavior at first, but as I thought about it, I realized the fault was with me.

We went back a few days later to bring them dinner. They wanted us to eat with them. Before we left, I sat my children down (they were 3.5 and 19 months at the time) and told them the rules. I explained there was a new baby and they needed to be quite and respectful.

They were fabulous! Poor Brayden was afraid to speak above a whisper at first because he didn't want to disturb the baby. It was a much better experience--and all it took was a few minutes of our time before we left the house. It was as simple as that.

This is something I am adding to my list of things I need to be better at. I have used it and I know it works. I need to make it a part of my habit before we leave the house. Try it! I promise you will like it.

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