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The sun is really important in the creation of essential Vitamin D, which is essential to the health of our skin. However, the sun can also emit harmful UV rays and children with eczema are even more vulnerable to the sun’s damaging rays. The sun can also dry out the skin, making eczema more prone to flaring up and the inevitable scratching can open up old (or new!) wounds.

That’s why it is very important to put on sunscreen on your child – even if they have bad eczema!

It can be stressful picking a sunscreen because eczema can react to many chemicals and the reaction can cause flare-ups, sleepless nights and miserable days. Here are some tips on how to choose a sunscreen for your child with eczema:

• Some sunscreens are made with minerals, such as zinc oxide or titanium dioxide, that act as a physical sunblock. They reflect UV rays so that they aren’t able to penetrate the skin. Some sunscreens are made with organic chemicals, such as avobenzone or oxybenzone, that absorb UV radiation through their chemical bonds and release heat.
• The key difference between mineral and chemical sunscreens is that chemical sunscreens are absorbed into the skin whilst those containing minerals sit on the skin and act as a barrier. The mineral formulations often work better for eczema kids as the active ingredient aren’t absorbed into the skin so have less opportunity to irritate. In addition, the mineral formulation reflect the light rather than converting it into heat, so they are often much more comfortable for kids whose eczema is aggravated by heat.
• It’s best to choose a product that has been given the National Eczema Association’s Seal of Acceptance. This seal gives you the assurance that the product does not contain known eczema triggers and meets the following criteria:

• Mineral based sunscreen ingredients: Titanium Dioxide (TiO2) and Zinc Oxide (ZnO)
• Alcohol free
• SPF 30 or greater
• “Broad-spectrum” protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays

Sunscreen can also be a way to restore skin moisture at the same time as protecting your child from the sun. But remember that the sunscreen is not a moisturizer. Always remember to put on moisturizing, give it a minute to absorb and then put on the sunscreen. This will ensure your child’s skin is properly moisturized.

Finally, as with all things eczema, you should patch-test new sunscreens in a small area for 24 hours before using them on the whole body.

Recommended sunscreens for eczema:

Proper skincare for babies is most critical in the first few months of a baby’s life.

Baby skin is about 30% thinner than adult skin. Therefore babies, especially those with a defective skin barrier, are prone to skin sensitivities like eczema.

Babies with a defective skin barrier are especially sensitive because they are not able to effectively retain water in the skin, thereby allowing cracks to open and allergens and irritants to enter through the skin. The allergens and irritants enter the baby’s immune system, which is immature and still developing and are generally less capable of eliminating toxins. Eczema is linked to an overactive response by the body's immune system to toxins.

In order to properly care for your baby’s skin, use as much natural products as possible. Many so-called baby products today contain soap and other detergents that deteriorate the skin barrier that is still developing.

Also, be careful of the body wash they give you at the hospital! Sometimes, they are not products recommended by doctors but just products given to the hospitals as samples! Nobody warned me about this. I really wish I knew this and packed my own baby products in my hospital bag.

Even the best and highly rated baby products contain some synthetic ingredient. In my opinion, the best option is to stick with natural, nourishing and edible ingredients such as shea butter, olive oil or coconut oil. When you using natural products with no preservatives (parabens) added, be sure to use it up within six months or so (depends on the product) because it can oxidize or be contaminated when exposed to air.

Here is a list of chemical ingredients you want to avoid in your baby care products:

1. Fragrance
Look for on label: fragrance, parfum

Yes, it may smell nice, but the medical journal Dermatitis pronounced fragrance as the allergen of the year. Of the more than 2500 fragrance ingredients (and it takes hundreds of chemicals to produce one fragrance), more than 100 are known allergens.  All those chemicals can lead to contact allergies.

2. Mineral oil
Look for on label: mineral oil, petrolatum, paraffinum, parrafinum liquididum

Mineral oil is a cheap petroleum by-product used is many creams, moisturizers, hair products and oils. In baby products, you may find mineral oil in diaper creams, baby wipes, oils and lotions. Big cosmetic companies like to use mineral oils as a base for their products because of the cost and it is praised for it’s lubricating action. Unfortunately, mineral oil acts as a coating on your skin and thereby blocks your pores and the skin’s natural breathing process. A lot of the well-known brands make baby oil from nothing more than mineral oil with synthetic fragrance…not exactly what you want to put on your baby’s skin.

3. Parabens
Look for on label: Ethylparaben, butylparaben, methylparaben, propylparaben, other ingredients ending in –paraben

Parabens prohibit the growth of microbes and are therefore widely used as preservatives in the food and cosmetics industry. Parabens can irritate your baby’s skin. However, the biggest concern is that they are known to disrupt hormone function. An effect that is linked to increased risk of breast cancer and reproductive toxicity. Since a baby’s hormone system is not yet mature, parabens can cause irreparable damage to the developing endocrine system.

4. Phenoxyethanol
Look for on label: phenoxyethanol

 A preservative often also used by products that claim to be “all-natural” as an alterative to parabens. Phenoxyethanol is not completely uncontroversial as it may have impact on the nervous system and has been even restricted in Japanese cosmetics. It is known to be an irritant to the skin and may cause vomiting and diarrhea if exposed at high enough concentrations. In 2008, the FDA published a warning for nursing mothers against Mommy’s Blisse Nipple cream that contained both phenoxyethanol and chlorpenisin (another preservative known to impact the central nervous system).

5. Sodium lauryl (ether) sulfate
Look for on label: SLS, SLES, sodium dodecyl sulfate, sodium PEG lauryl sulfate,

This synthetic substance is used in shampoos and wash products for its detergent and foam-building abilities. Also often used in baby products. Although this makes products nice and foamy you can better avoid this ingredient. SLS / SLES can cause eye irritation, skin rash, hair loss, scalp scurf similar to dandruff, and allergic (reactions?). It is a known skin irritant that is easily absorbed through our biological shields

6. Polyethylene glycol
Look for on label: PEG- followed by a number. The lower the number, the more easily the compound is absorbed into the skin.

PEG is a class of ethylene glycol polymers that moisturizes, keeps products stable, and enhances the penetration of other ingredients, both good and bad. PEG’s can irritate the sensitive baby skin. In addition, they help traffic all sorts of chemicals they may be contaminated with across your epidermis.

For more information on chemicals in baby products: http://www.treehugger.com/health/7-chemicals-and-toxins-avoid-when-buying-baby-products.html

Recommended skincare products for babies with sensitive skin:

Recommended baby washes for babies: 

There is a lot of debate about whether steroid creams are safe for babies. When used properly, I feel they are safe. Tips for safe application include:

• Use only on affected skin and avoid normal skin
• Avoid skinfolds (e.g. armpits, groin, thighs) and eyelids as much as possible
• Use no more than two times a day or as per prescription

Steroid cream can be used as a preventative treatment. When the eczema is mild, you may be able to keep it under control by just regularly applying moisturizer, using a humidifier and avoiding irritants. When eczema is more severe, you can try turning on the humidifier more often and applying thicker layers of cream. If you’ve tried all possible measures and your child continuously rashes and itches then a steroid cream on a daily basis can help improve the condition and help stop the itch-scratch-itch cycle. The issue with scratching is that it can cause an infection – and you don’t want that!

Steroid cream can be used as a treatment during flare-ups. Almost all children with eczema will experience a flare-up. An eczema flare-up is when some areas of the skin become more irritated and look raised, red and have slightly oozing patches. It happens when the skin is very dry, it comes in contact with irritating substances or allergic triggers, or when the skin is infected. During a flare-up your child will itch more. Remember you want to avoid an infection at all causes! Use a steroid cream to keep it under control and continue until the rash is less inflamed and more comfortable.  

How much should I apply?

I have always found it difficult to judge how much steroid cream to apply. On one hand, I didn’t want to overapply and risk the thinning of my baby’s soft skin. On the other hand, I didn’t want to apply so little that it has no effect on his eczema.

Through research, I’ve learned three methods to determine the right amount to apply:

1. Apply enough so that the skin feel tacky immediately after application.
2. Apply enough so that the skin glistens.
3. A Finger Tip Unit (FTU) - One finger tip unit is the amount of cream that can be gently squeezed in a thin line onto the last joint of an adult index finger. One FTU is enough to cover an area of skin the size of two adult flat palms. Different parts of the body require different amounts of topical steroid.

If you still feel unsure that the amount of cream you applied, bring your bottle of steroid cream to your doctor at the next visit and verify with your doctor. This really helped reassure me that I wasn’t doing anything wrong.

Other application tips:

• Moisturizer should always be applied over the steroid cream
• Wait about 15 minutes before you apply moisturizer on top of the steroid cream to avoid diluting the topical steroid with the emollient and spreading it to areas that don’t need it
• Ask your doctor about an anti-itch cream or adding add an anti-itch component to your steroid cream
• The period of time a steroid may be used depends upon the severity of the eczema and the potency of the topical steroid so don’t be afraid to use it for days or even weeks – your doctor will advise you on this

The biggest side effects of a steroid cream are scarring and thinning of the skin. However, there is no evidence that this is permanent. And for me, the benefits outweigh the risks. Without the steroids, my baby was not able to break the itch-scratch-itch cycle and it obviously impacted his sleep and growth.

Still, I refused to use steroids in the beginning and the constant scratching eventually caused an infection. My poor baby’s eczema was bleeding and a crust was developing over his weeping skin. 

We were prescribed an antibiotic cream at first. When that didn’t work, we were prescribed an oral antibiotic. Waking my baby up every 6 hours and hearing him cry when I forced him to take the oral antibiotics was so heartbreaking. I hope other moms don’t have to experience this ever. Good luck on your journey!

Recommended skincare products for babies with sensitive skin:

Recommended baby washes for babies: 

Most of the doctors, naturopaths and dermatologists have told me that baby eczema is mostly due to genes. The inheritance is not only limited to the baby's parents but can also be from anyone blood related such as aunts or uncles or cousins who has eczema, hay fever or asthma. Great... that pretty much means every baby has a good chance of having eczema due to genetic reasons!

Aside from genes, some babies also have eczema for other reasons. The exact causes of eczema are not known and can be different for every child. 

For my baby, I don't know of any eczema, hay fever or asthma conditions in our family history. But who knows... maybe Uncle John had an eczema patch at some point in his life...

Anyway, through many rounds of trial and error, I learned that my son flares up with he is overdressed and when I ate soy (he was breastfed). 

Do you know what irritants make your baby's eczema symptoms worse? Consider and pay attention to these possible irritants:

• Soaps and detergents
• Cigarette smoke
• Pets (cats and dogs)
• Dust
• Heat
• Sweat
• Stress 
• Wool and synthetic fibres

If you think your baby may be allergic to food, go on an elimination diet where your baby eliminates certain foods for a period of time, usually one or two weeks, then slowly reintroduce specific foods and monitor symptoms for possible reactions. If you are breastfeeding, you will go on the elimination diet yourself. Keeping a diary that lists all the food and reactions is a good idea to identify patterns and triggers.

When you or your child go on the elimination diet, you may want to start trying these foods that are typically associated with eczema causes:

• Dairy products
• Eggs
• Nuts and seeds
• Soy products
• Wheat

Many parents assume that a particular food or irritant is the cause of their child’s eczema. Unfortunately, the answer is rarely that simple. 

Although I've identified some things that make my child's eczema worse, I still haven't found out what causes it and it continues to be a daily battle. To avoid other possible irritants, I've switched to chemical-free detergent for all my laundry. I vacuumed two times a week and changed beddings weekly to try to keep my home as dust-free as possible. I've also switched his mini wardrobe to all 100% cotton clothing and sometimes 100% organic bamboo or organic cotton when I can find them. Organic bamboo and organic cotton is hard to find but they are the softest and most natural fabric for your child. GAP carries a organic cotton baby line and it's available at their bigger stores or online.

So should you do an allergy test? My dermatologist told me that most eczema is not related to diet, and because current allergy tests do not accurately predict eczema triggers, allergy testing is not recommended. However, if the child gets a rash after contact with a specific thing or eating a specific food then allergy testing might be considered. 

Lastly, remember to test all the moisturizers you buy on a small test area of your baby's skin to see if it causes any problems. You never know what reaction he or she may have.

A key part of managing eczema is nourishing the skin with a good moisturizer. So naturally the most common question asked by parents is what moisturizer to use on their babies. 

Moisturizers help reduce the itch and protect the skin from infection and dehydration. There are many creams on the market. Aveeno, Lipikar Baume, Castor Oil, Coconut Oil, Shea Butter, Calendula Cream, Cetaphil, Triple Cream, Emu Oil, Vitamin E, Chickweed Cream, Pure Potion, Curel Itch Defense, Charism Baby Balm and many others are all good moisturizers. Unfortunately, there is no one single product that works well for all babies. It is a personal preference and a game of trial and error. Some creams may feel too thick or sticky and uncomfortable for your baby. Also remember that more expensive creams may not be better -- so find a good one that fits your budget. 

After trying many creams on my baby, I personally found that Tekadis's Shea Butter and Le Roche Posay's Lipikar Baume (which I later found out is also made from shea butter!) works the best. It reduces the redness immediately and spaces out the flare ups. The Lipikar Baume absorbs faster than the Shea Butter. However, my baby always screams with the Lipikar Baume when he has a bad flare up. Since I figured the Lipikar Baume stings him, I just use it on days when his skin condition is better.  

Always check the ingredients before you buy any moisturizer. Normally, the less ingredients the better because up to 60% of the ingredients can be absorbed into the body. More chemicals means more toxins for your baby's liver to filter. As well, if your baby have a reaction to the cream, less ingredients will make it easier to identify what is causing the allergy.

So unless your baby has a specific allergy, how you apply the moisturizer is probably more important than what type of moisturizer you apply. Here's how:

1. With clean hands, soften your moisturizer by by rubbing it between your hands.

2. Instead of rubbing, gently smooth the moisturizer on the skin to avoid causing irritations. Smooth onto the skin with downward strokes. 

3. Leave a thin film of moisturizer sitting on the skin surface. You can also add a layer of vaseline on top of your cream to lock in the moisture or if you will be going out in windy weather.

4. Repeat this process several times a day especially when the baby is itchy or after contact with water. Apply moisturizer at least 3 times daily. Remember that once you feel the baby's skin is dry, it is too late - keep it soft and hydrated at all times to prevent flare ups!

5. Don't waste your efforts. Protect your baby's skin by avoiding things that can dry it out -- such as soaps, exfoliants, coarse washcloths and hot water. 

Recommended skincare products for babies with sensitive skin:

As you probably have already done your research, you know that there are tons and tons of information about baby eczema on the internet. I've also spent endless hours reading blogs, forums and even research papers on the latest breakthroughs. I've tried countless amount of creams and natural remedies. The wackiest thing I tried was probably making an organic wintermelon mask to put on my baby. While none of the methods ended up curing my baby's eczema, I did learn a lot about what can make eczema worse and how to keep the flareups under control. 

One of the biggest thing I learned was that what works for one baby make not work for another. So I'm not going to give a solution here. Rather, I want to share some of the common questions and best resources I found to answer them. Under the "Helpful Links" section of my website, you will find these resources below updated periodically. If you know a great resource, please share it with me at info@ainibaby.ca. Good luck!

Can breastfeeding cause eczema? What foods should you avoid?
http://kellymom.com/health/baby-health/food-sensitivity/
http://www.cfp.ca/content/57/12/1403.full

What do dermatologists/pediatricians recommend for baby eczema?
http://www.eczemahelp.ca/en/treatment.html
http://www.aboutkidshealth.ca/En/HealthAZ/ConditionsandDiseases/Dermatology/Pages/Eczema-Atopic-Dermatitis.aspx
http://www.macpeds.com/documents/Eczema-howtotreat.pdf

What moisturizer should I use?
http://safemama.com/2012/02/24/natural-skincare-for-kids-with-eczema/
http://www.eczemahelp.ca/en/seal.html

What can be causing my baby's eczema?
https://nationaleczema.org/eczema/child-eczema/infants-toddlers/
http://vitalitymagazine.com/article/tcm-for-childhood-eczema/