Reader request: baby eczema tips

baby eczema routine prevention

For more posts with baby-related tips, see our: series on traveling / flying with an infant, favorite places to buy practical baby clothes, and starting solid foods (sorry I got derailed from publishing Part 2!).

Eczema…the pesky skin condition that plagues so many of us and our little ones. We’ve been battling it on Nori since she was a few months old, and everyone says most babies will outgrow it, but Nick is a prime example of an adult who’s been trying to manage eczema his whole life.

Now that we’re in the midst of dry winter conditions, I’ve been getting a lot of questions from concerned mamas on what’s worked for us. So I’m sharing our fairly standard eczema-mitigating routine as recommended by Nori’s dermatologists and allergists. This is just what we do, so as always, please consult your doctors for any medical advice!

moisturization & bathtime routine

We’ve tried countless eczema products that people have recommended such as Tubby Todd, Eczema Honey, Mustela (Nick is the product tester for Nori). For us there have been no miracle products, rather a continuous daily routine of keeping the skin protected and moisturized.

  • Bathe / shower regularly in lukewarm water for around 10 minutes. We used to be told those with dry skin should bathe less frequently, but now our docs all suggest at least daily baths, with the keys being:
    • lukewarm temperatures – around body temperature or below, which we check using a kitchen thermometer
    • not too long in duration, which can strip the skin of natural oils; and
    • sealing in moisture immediately afterwards (see 3rd bullet below)
    • test for water hardness as hard water may contribute to eczema
  • Use diluted bleach baths or cLn wash regularly to limit bacteria on skin. I was very hesitant to do this, but it’s supposedly more gentle than chlorine in a pool and every doc kept instructing us to do it. Nori had some bad patches of eczema that got infected and was prescribed antibiotics more than once, and we were told regular bleach baths may help prevent this. Knowing the potential association between antibiotics in infancy and allergies, I would’ve tried everything the docs recommended to prevent bacterial infection.
  • Seal in the moisture after bathing. I feel this has been really key in our daily routine. After your little one gets out of the bath or shower, gently pat off water drops then immediately pat (not rub) a layer of moisturizer on damp skin to “seal in” the moisture. This should be done within 2 to 3 minutes of getting out of the bath.
  • Moisturize during every diaper change, if possible. This isn’t practical for us but we aim to moisturize 2-3x a day (always a battle with a scratchy, squirmy little one) and we ask her caretakers to do the same.
  • Topical steroid use. We do use prescribed steroids during flare ups. But by following this daily routine and everything else in this post, we have not had to use it much anymore. I have gotten a lot of reader recommendations to look into Dr. Richard Aron’s eczema regimen (involves topical steroids), so wanted to pass that along.
  • Wet wraps if needed. We have not done this since it’s cold in our house in the winter, but our docs strongly suggested this and several mamas say it works well.

baby eczema routine preventing flare ups

Aquaphor, Vanicream, Scratch me not sleeves with silk mitts, soft bamboo towel, favorite diaper balm + butt paddle (a non eczema related must have ; )

Favorite products in our routine

We’ve been told that minimally dyed 100% cotton, bamboo, and silk are recommended fabrics for eczema prone skin. In my experience, bamboo and silk have been more gentle on Nori’s skin than standard cotton.

  • Fragrance-free gentle cleansers and moisturizers. We usually do not use soap at bath time, except for Honest fragrance free shampoo / body wash once every few days. For moisturizing, we’ll use an unscented lotion like Vanicream, Hydrolatum or Cerave. After trying SO many different and newer products, Nick has found that good ole Vanicream and Aquaphor sting the least on his inflamed skin, so we’ve stuck with these.
  • Scratch me not sleeves. These were a recommendation from you guys and have been a GODSEND (we have 5+ pairs). It’s a stretchy shrug with gentle silk mittens that can be flipped either open or shut to minimize scratching and irritating eczema flare ups. We put these on Nori as part of bedtime routine and worry less about waking up to bloody patches like we used to. For adults, I’ve also seen eczema gloves to help prevent subconscious scratching overnight.
  • Zipper onesies with flip over mitts and footies, so you can cover a hand or foot, if needed. The foldover covers are more common in infant onesies but are getting hard to find in bigger toddler sizes! Here’s my 2 favorite brands that each also feature double zippers for easy diaper changes:
    • Lil Sleepies bamboo zippies – super soft, stretchy, and lightweight so are especially nice in the summer. At first I thought these would be too thin for winter, but I LOVE them and we just layer if necessary. Only sizes up to 12-18 months have the foldover covers, which I’m bummed about as Nori is just about to outgrow that size. Due to the fabric, these are the only flipover mitts that she cannot break free from!
    • Kids Tales cotton blend zipper rompers – medium to thicker weight fabric. Nori lives in these at home and I love them for travel. Tag is on the outside so you need to trim it off. I’ve been very happy with these (favorites are the pineapple and watermelon print), but FYI I have found a little fabric feel inconsistency and had to return one due to a broken zipper. Nori can break free from these foldover mitts overnight (so for bed time, I keep them open but layer a Scratch Me Not over it), however they work temporarily if I need her to stop scratching during a diaper change.
  • Bamboo hooded towel + washcloths. These are so soft, and the towel is a generous size.
  • Electric gentle nail file to help keep sharp nails from doing too much damage.
  • Silk crib sheets: A total luxury and splurge product (that mama doesn’t even get to indulge in), but we have 1 silk crib sheet that’s extra nice and gentle on her face and scalp, especially when Nori would rub her head back and forth against cotton sheets til it was raw and bloody during bad eczema flare ups.

baby toddler eczema soft pajamas with feet and hand covers

Left: Kids Tales cotton blend zippies in size 90 // Right: Lil Sleepies bamboo zippies in size 12-18m

Outside of our bathing and bedtime “maintenance” routine, below are other steps we take to help prevent and mitigate eczema flare ups in the family.

gut health and FOOD allergies
  • Probiotics. Many have suggested a linkage between eczema and gut health, and the importance of probiotics. I don’t have anything special to recommend as we just give Nori standard kids probiotics by Culturelle. She was put on antibiotics twice as a newborn which I really tried to avoid (but had no good alternative), as they likely wiped out a lot of her healthy gut bacteria.
  • Eliminating cow’s milk from mom’s diet while breastfeeding. I feel like this is a common blanket suggestion that docs give breastfeeding moms for issues ranging from reflux to eczema to general fussiness. I did not notice any difference after eliminating dairy from my own diet, but have heard from fellow moms who noticed a big difference. Just make sure you’re getting your calcium in other ways so you don’t become calcium deficient.
  • Testing for food allergies prior to starting baby on solids. Current American pediatric guidelines encourage introducing babies to common food allergens once they start solid foods (allergens include egg, dairy, peanut, tree nut, fish, shellfish). But if your baby already has eczema, your doc may suggest allergy testing first, in case these foods will worsen their skin condition.
  • Our pediatrician had Nori do a blood allergy test when she was 6 months old (and again at 1 year old) which both came back positive for nuts, dairy, egg, soy, and sesame allergies. Some of these allergies have proven to be real on her, while a few like soy and sesame may have been false positives. Most doctors believe babies will outgrow dairy and egg allergies (less hopeful for nuts), so we are currently doing an egg ladder challenge and will hopefully tackle dairy next – see example egg & dairy challenge instructions.
  • Also, I’ve heard a lot of great things about the SoCal Food Allergy Institute (currently has a patient waitlist) from readers far and wide, so just wanted to mention them for anyone dealing with severe food allergies.
  • Foods that allegedly worsen itchiness. These supposedly include some of Nori’s favorite foods (avocados, tomatoes, grapes, citrus) which I still give to her. But again, some mamas say their babies have a noticeable reaction, so I just wanted to share.
  • Nori does develop a skin rash on her hand and mouth after eating certain foods but it usually goes away after we wash the areas with water. Our allergist suggested applying a layer of vaseline around your little one’s mouth prior to eating potential allergy or itchy foods, to minimize contact-related skin irritations.
Environmental factors
  • Reduce indoor allergens and dust by vacuuming and cleaning regularly around the house, including washing dust mite-trapping objects like stuffed animals and bed linens. We got rid of our big fluffy rugs that couldn’t easily be cleaned. Also this is a given to some, but keep your windows closed during high pollen seasons.
  • Keep humidity levels around 50% and make sure to clean your humidifier (it’s a pain, I know). We run a cool mist humidifier only when our heater is on, because excess humidity can then contribute to mold. When we travel, it’s pretty noticeable how Nick’s (and now Nori’s) eczema changes in different climates, to the point that we’ve considered moving for this purpose.
  • Keep temperatures cool but comfortable to avoid sweat. Sweat immediately triggers Nori’s flare ups, including if her back gets a little too warm sitting in a stroller or carseat, or if she’s wearing too many layers. We keep our home temperature around 68 degrees and it’s been trial and error on how warmly to dress her overnight.

winter carseat cover

Trying to get cozy without being sweaty (one of Nori’s flare up triggers) // carseat cover by JJ Cole

Contact factors

Being married to someone who has dealt with allergies, asthma and eczema most of his life, this is the norm in our household:

  • Laundry:
    • Use a small amount of free & clear, fragrance free detergent. Note that unscented is not the same as fragrance free, as sometimes unscented products still have fragrances in them to neutralize odors. I found this article on laundry by a fellow eczema mama to be a helpful read.
    • Machine wash laundry with an extra rinse cycle.
  • No / minimal perfumes or fragranced products on us or in the home including soap, lotion, etc. We ask this of house guests and caretakers in our home too since both Nick and Nori are sensitive.
  • Clothing and bedding in cotton, silk, or bamboo as mentioned above under our favorite products.

We have gotten a lot of tips and advice from you guys (like the Scratch me not!), so please feel free to share other things and products that have worked for you and / or your little ones!

 

25 thoughts on “Reader request: baby eczema tips

  • Reply Anonymous December 30, 2019 at 6:14 am

    I cannot speak of brands as we live in different parts of the world, but I think you might also find an oil/lotion/moisturizer in spray form to be used when changing diapers in the US? It might make it less of an battle.

  • Reply Liz December 30, 2019 at 10:49 am

    Thank you for sharing this, Jean! It’s super helpful!!

    • Reply Leslie December 30, 2019 at 1:02 pm

      I’m curious if you’ve tried the BabyBum Monoi coconut balm? It’s working really well on my girls’ arms and bottoms, much I easier to use than straight coconut oil. And I can’t say enough good things about Kate Quinn Organics for cotton and bamboo knits – I’ve gotten really picky after 5 years of dealing with eczema!

  • Reply Lia December 30, 2019 at 10:54 am

    Awesome post! Thanks for the rundown and recommendations – it’s always good to hear what other people are doing for their eczema. Has Nick considered trying Dupixent? I’m not sure it’s approved for kids yet, but it was a game changer for me.

  • Reply Christine December 30, 2019 at 12:34 pm

    Wonderful post, Jean! My baby and hubby struggle with eczema and food allergies too. Everything you recommended is spot on – we are both docs (family medicine and allergy), but the struggle is still real. You’re a great mommy. Keep up the hard work, hope our babies outgrow it soon.

  • Reply Jenn December 30, 2019 at 12:49 pm

    Thanks so much for sharing this post!! Very helpful insights and recommendations! I know it’s not easy sharing these kind of things sometimes with the world. Is there anything you’ve used to moisturize Nori’s scalp that helps with the itching? Again, awesome read! Love all your posts ❤️

  • Reply Emily December 30, 2019 at 1:29 pm

    I have had eczema issues my entire life. Bleach baths and vanicream have been a god send! Also, I found cutting avocados and bananas out of my diet helped a lot. It seemed like one day or meal was fine but if I ate them for multiple days I would have a flare up. I just try to avoid that whole family of food as much as I can.

    • Reply Ruby December 30, 2019 at 8:55 pm

      Very thorough! My child had eczema & has nut allergies , and though they said she was allergic to eggs, she does eat them without a problem. Eczema thankfully got better over time. Your daughter is lucky to have parents who are so aware! I must ask what type of climates alleviated the eczema?

  • Reply Emily S. December 30, 2019 at 2:13 pm

    I feel Nick and Nori’s pain! I’ve had eczema since infancy. The thing that makes the biggest difference for me is my bedding, because I’m very sensitive to dust mites. For people whose eczema is worst in the morning, that’s often a major cause of the problem. I always travel with a dust-mite-proof pillowcase, which helps a lot, but I wish I could bring all my hypoallergenic bedding with me.

    I’ve tried several brands of dust-mite-proof bedding, and the brand I’ve found to be the best by far is Mission Allergy, a small company based in Newtown, CT. Their products are very soft and silky and have an extremely tight weave. Their dust-mite-proof comforter has been a lifesaver: I used to have to wash all my bedding in hot water weekly to kill dust mites, and comforters are a pain to wash. Now I just wash my sheets.

    I also rely on Vanicream products. I used Aquaphor for years, but last month I switched from Aquaphor to Vanicream’s version of it (sometimes called Vaniply, sometimes called Vanicream Ointment), and I prefer it. It is as thick and soothing as Aquaphor, but it works into the skin better: when my face is red and raw, I can put it on and go out without fear of looking totally shiny and weird. Most importantly, it seems to be slightly more effective at taming my eczema.

    I didn’t know about the gut health connection. Thanks for the tip!

    • Reply Emily S. December 30, 2019 at 2:15 pm

      P.S. Another laundry tip: wash linens in hot water (with fragrance free detergent as you mentioned) to kill dust mites. I wash most of my clothes in cold water but always do sheets in hot.

  • Reply Tes December 30, 2019 at 2:55 pm

    Please try Good Stuff Botanical Gypsy Cream Healing Moisturizer which was featured in last weekend’s Boston Globe travel section. They have great reviews for eczema / psoriasis. It has anti-bacterial properties as well so, hopefully, antibiotics will not be needed. I would love to hear if it worked for baby.

  • Reply Tia December 30, 2019 at 3:07 pm

    We’ve been dealing with eczema since Reid was 3ish months old (now 9 months). We tried all the creams as well as eliminating dairy, soy, eggs, tree nuts, nuts, gluten, and seafood but none of it seemed to help. We are on a months long waiting list to see an allergist, but recently, his skin has cleared up a lot despite the Chicago winter. I think it might be due to daily apple cider vinegar baths, and increasing his Vitamin D3 intake. I’ve also started taking Vitamin B12 (I’m nursing). There are a lot of articles out there that say Vitamin D3 and B12 deficiencies can exacerbate eczema, so we thought it was worth a shot!

  • Reply Kim December 30, 2019 at 4:45 pm

    Abby Lai’s eBooks on how she got rid of her eczema worked for me in 2017. For many months it was a frustrating, three-steps-forward/two-steps-back process, but now I only start to see a rash if I’ve consumed a trigger food for too many days in a row (mine are coffee, tomatoes, and too much gluten). Very best wishes to Nick and Nori.

    • Reply Dee December 30, 2019 at 10:53 pm

      Thanks for sharing! I’ve battled eczema for years now. A wash with Hibiclens (chlorhexidine gluconate) is a good alternative to bleach baths. I’ve heard good things about Dupixent, as Lia mentioned, but it can’t be used on babies.

    • Reply S January 1, 2020 at 11:50 pm

      Spot on a lot of your comments. My Lo also had an extremely bad case of cradle cap which turned into a dairy sensitivity (amongst other tested IgE allergies) and horrible eczema. We also saw a pediatric dermatologist and allergist and agree with a lot of what you said. I am glad to hear that your doctors recommended daily bathing. No one else believes me when I try to explain that if the skin isn’t clean, how will it properly absorb all the lotions and ointments that are needed to treat?! We also prescribe in a double moisturizing immediately following bath: Cerave baby cream followed by good ole petroleum jelly. She’s super shiny and sticky but her skin stays good! I found Aquaphor a little drying since there is trace amounts of alcohol in its ingredient list. It does get better! Mine is 2 and still occasionally gets a little eczema but mostly manageable now since we don’t stray away from her daily bath routine.

  • Reply Candi Crown January 1, 2020 at 8:49 pm

    Thank you for this post! I did not realize so many struggle with allergies and eczema. My 3 year old grandson has both as well. I’d like to see if silk bedding will help. Any recommendations?

  • Reply Sonia January 1, 2020 at 11:09 pm

    Hi Jean- I really appreciate how thorough your posts are when it comes to baby items/issues. My daughter has Eczema and one of my favorite creams is Mustela replenishing balm.
    Would you consider posting or discussing any sleep training methods you’ve tried, absolutely wouldn’t try, or any tips/tricks that have worked for you in the baby sleep department? I’ve done so much research myself and I’d love to hear input from one thorough mom to another! TIA

  • Reply Christine January 2, 2020 at 4:12 pm

    Hi Jean! I used Poofy Organics Skin Hero Lotion (Ciao Eczema) on my baby’s skin when she had an eczema flare up. I still use this lotion when her skin gets very very dry and irritated. This combined with Cerave body cream really helped clear up my baby’s skin. I even use it on her head to help relieve the itchiness from her cradle cap. What I love about this lotion is that it is made from clean ingredients, and you can use the lotion as frequently as you like. Unfortunately, there is a wheat-like smell from the lotion (which I am not really fond it especially since I don’t like to use scented moisturizers in general), but you do get used it after awhile. I’ve linked the lotion below if interested.

    https://www.poofyorganics.com/products/1097-skin-hero-lotion-ciao-eczema.aspx

  • Reply Karen January 2, 2020 at 5:12 pm

    I second the recommendation to ask a doctor about Dupixent (for Nick)! My husband has had bad eczema all his life as well, and recently after months of increasingly bad flare-ups, we went to a dermatologist who recommended Dupixent. Due to insurance + Dupixent’s co-pay program, we are able to get it without charge. It made a huge difference almost instantly, and we see continual improvement (he’s been on it for maybe 3-4 months now)!

  • Reply Petite Picks January 2, 2020 at 5:43 pm

    I feel for you guys! I’ve never found a miracle product either unfortunately. I agree this is such a great post that will no doubt help a lot of people! What works is probably different for everyone and it’s probably extra tough in the early years when they can’t tell you with words if something is making them itch. I’ve heard a lot of people age out of it so hopefully she does. I have found a lot of things you’ve mentioned in your post helpful over the years. In particular: avoiding all synthetic fragrance (especially in detergent and bath products), avoiding synthetic fabrics especially lower priced synthetic fabrics for some reason (they do not breathe as well and can be itchy, I’m looking at you, polyester fleece!), avoiding sweating a lot, finding a moisturizer that is not irritating (maybe a high quality aloe gel or the plant itself will be helpful to Nori since it has a cooling effect; also one quality that I think would be helpful is if it absorbs quickly and does not sit on the skin for too long), and avoiding soaps and bath products that are drying. Moisturizing is important, but you also want a gentle soap that doesn’t strip the skin of everything. I’ve discovered over the years that a lot of soaps are quite harsh! You might also try a high quality organic cotton percale sheet since percale (when done properly) can have a cooling feel. I recently tried Honest Shampoo+Body Wash in the lavender scent as a shampoo and it made me super itchy (did not try as body wash). I do like their bubble bath however. I’m sure it is different for everyone. I like Desert Essence shampoo now, and they do have a fragrance free one. I think you just have to keep trying different products until you find a mix of ingredients that works and doesn’t cause irritation. Good luck to you and welcome to the Itchy & Scratchy Club!

  • Reply Cate January 3, 2020 at 10:44 am

    As a mom to an older teen who has dealt since infancy with eczema, skin and allergy/food sensitivities, I wish I had a list like this when we were trying to figure out where to start. I really wish I had done more to help repair his gut flora in his young life, because like your daughter he was born via c-section and on a couple of courses of antibiotics early on in life and his gut health was extremely compromised, but I was learning as we went. In addition to supplements like Culturelle (which we used too), probiotic-rich foods are another excellent way to help repopulate/rebalance the gut flora – foods such as kefir (add to smoothies or drink straight, has more probiotics than yogurt) and fermented vegetables (cabbage/sauerkraut, cucumber/pickles – really almost any vegetable can be pickled), miso, kimchi, apple cider vinegar with the “mother”, kombucha for older kids and adults. Also, adding additional probiotic supplements made for kids, because we have so many different types of gut bacteria, using just one type of supplement sometimes isn’t enough. A few excellent books on this subject are The Good Gut, I Contain Multitudes, and Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues. I hope Nori outgrows her eczema and allergies – I know how stressful it can be as a parent to deal with!

  • Reply Vi January 3, 2020 at 4:44 pm

    We did wet wraps last winter with our toddler and were totally blown away by how effective it was. She wasn’t even cold, even in a room that was around 66 degrees overnight. We used carter’s snug fit cotton pajamas as the inner layer (wet with warm water) and then gap fleece pajamas on the outside. We were prepared to take off the wet pajamas after an hour but she was perfectly happy to sleep through the night with them on and they dried out overnight. We did it for a week or so, and then have only had to do it again once or twice in the past year.

  • Reply Kris January 4, 2020 at 11:26 am

    Jean
    I love your blog
    You always post such relevant and cool topics!
    Wish there were more blogs like yours. My eczema s still not controlled and I’m in my 30s. For my son I did Vaseline and when it was mad I mixed the Vaseline and Burt’s bees immediately after drying him off. It helped more than all the meds. Another alternative is Eucrissa (PDE-4 inhibitor). I’ve seen many allergy and eczema kids respond well to this. I look forward to following your blog in 2020! Would love to know if you’ve considered speaking at conferences or the live webinars etc.

  • Reply Trace January 9, 2020 at 5:53 pm

    +1 for eucrisa. But you have to play the manufacturer’s co-pay card game to get it to $10 or $70. The sticker price is like $500.

  • Reply Bea January 10, 2020 at 12:18 pm

    Hello all, the product that has helped my baby with her eczema is Aveeno Baby Eczema Therapy Nighttime Balm. It’s a thick moisturizer that comes in a tub. It was recommended by our pediatrician and after trying out many other products and bath routines, this has helped the most. After baby’s nighttime bath, we generously cover her in this cream. This was the one change that has helped her the most. The tub lasts a long time too.

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