Atopic dermatitis is the most common disease that pediatric dermatologists only encounter in their daily practice. In 65% of children, manifestations of dermatitis are observed in the first year of life, 90% of babies experience similar symptoms before the age of five. Most babies completely stop bothering a skin rash by the age of four, but in some it goes into other allergic diseases. Dryness and hypersensitivity of the skin can persist in adolescence, in rare cases - for life.
Causes of Atopic Dermatitis
The basis of the mechanism of the appearance of atopic dermatitis in an infant is sensitization, that is, an increased sensitivity of the immune system to certain substances. “Atopy” means a hereditary predisposition of the newborn’s immune system to the formation of special immunoglobulins (lgE), that is, it is transmitted “by inheritance” from parents and close relatives not the allergic reaction to a particular product, but only an increased likelihood of getting sick.
The cause of atopic dermatitis in infants is a low ability to adapt. This is one of the transitional (physiological, borderline, transient) states of the child. After the birth of a newborn falls into a completely different environment. The way of breathing and receiving food is changing, gravity, a lot of tactile, acoustic and other stimuli appear. It takes a child time to adapt to the outside world.
At birth, the baby receives a thermal burn, because it passes from the intrauterine cavity, where the temperature is 36-37 degrees Celsius, on Wednesday, where a temperature of about 22 degrees is considered normal for newborns. As a result, reddening of the skin occurs, then peeling appears. This is typical for almost all newborns in the first week of life. However, atopic dermatitis is not a transient condition, although the clinical picture is very similar.
Dermatitis is allergic in nature. Disruptions in the composition of the intestinal microflora can provoke an adverse reaction of the body. Most often, the reaction appears on food. With artificial feeding, this may be a certain mixture. Parents need to be careful: atopic dermatitis in a baby can occur when feeding an expensive imported mixture, but there will be no reaction from cheaper food from a domestic manufacturer. This is normal. You need to try and look for what is suitable for a particular newborn.
The same story applies to diapers, skin care products, detergents and so on. Anything that comes into contact with the baby’s skin can cause an allergic reaction. Rashes may occur if the wrong product is used to wash children's items. Here you need to remember that to care for a newborn you need to choose only products labeled "0+", and not just "for children." If the reaction appears on the diaper, then you first need to try using a different brand, and not smear the baby with creams and oils to reduce allergy symptoms.
With breastfeeding, atopic dermatitis in a newborn can also appear. In this case, the problem lies in the diet of a nursing mother. The development of an allergic reaction in a child is also facilitated by various complications of pregnancy (threatened termination, placental insufficiency, fetal hypoxia, intrauterine infection, and so on), poor nutrition during pregnancy or a uniform food, food rich in food allergens.
According to many practicing pediatricians (including the famous doctor Komarovsky), atopic dermatitis in newborns who are constantly overeating occurs more often than thin children. If a child develops an intestinal disorder, then the symptoms of dermatitis are significantly weakened. According to Komarovsky, atopic dermatitis in infants with HB is a phenomenon as common as a rash from an artificial milk mixture.
The mechanism of the appearance of an atopic rash
The mechanism of development of atopic dermatitis is quite simple. Some substances that enter the body are not absorbed. This can occur due to the immaturity of the digestive system (the newborn only learns to properly digest and assimilate food), when it comes into contact with the allergen during breathing, or when it comes to contact with the skin. As a result of certain processes in the body, these substances acquire the properties of antigens and cause the active production of antibodies. So the immune system normally works. Antibodies provoke a rash.
With any contact with allergens, which are foreign to this organism (sources of allergies), a rash appears in the future. So, any rashes on the skin are the result, and the reason lies in contact with the irritant. A substance alien to its immunity can enter the child’s body in three natural ways: during eating or drinking (food allergy is the most common), when the skin comes in contact with an allergen (for example, after washing children's clothes with an inappropriate detergent), and when breathing (respiratory allergy) .
Symptoms of atopic dermatitis in infants
What does atopic dermatitis look like in infants? The photo below shows that this is a common allergic rash. Rashes can be noticed after the introduction of cow's milk (artificial mixtures), citrus fruits, eggs, strawberries, oatmeal and other cereals into the diet. With breastfeeding, diathesis may appear due to the use of these products by a nursing mother. Less commonly, a rash occurs due to skin care products for an infant or powder, but it happens that an adverse reaction is manifested in a particular brand of diapers. So, you need to pay attention to the appearance on the child’s skin of redness or peeling - this may be atopic dermatitis.
The initial stage in the baby (in the photo it looks like a slight redness) usually does not cause significant concern. But if you do not immediately identify an allergen and do not stop contact with it, then the child may even have a fever. Dermatological manifestations are the first and most important sign of an allergy, which you must definitely pay attention to and take appropriate measures.
Atopic dermatitis in infants (photos will help young mothers understand how the rash may look) is characterized by periods of remission and exacerbation. Exacerbations can be triggered by concomitant diseases, eating disorders, a sharp change in weather, vaccination, dysbiosis and so on. At the same time, a trip, for example, to the sea can significantly improve the condition of an allergic child.
The most common manifestations of atopic dermatitis in newborns are redness of the skin, dryness and peeling. Redness may completely disappear or diminish when it goes cold, and then reappear. Usually in babies prone to allergic reactions, from birth dry skin is noted in the perineum and buttocks, in folds, diaper rash.
“Milk crusts” may form on the scalp. These are scales that stick together with the secret of the sebaceous glands. Such crusts cannot be wiped off or torn off. After bathing, it is enough to brush them several times easily with a special brush, and then grease them with oil. Crusts will not be removed all at once. Also, the child may appear nodules with transparent contents or wet skin areas.
By the end of the second year of life, the manifestations of dermatitis in babies soften or completely disappear, but in some children they can go into serious allergic diseases, for example, bronchial asthma or allergic rhinitis. Therefore, the correct treatment of dermatological problems is very important even at the stage when adverse reactions appear in the baby.
The basic principles of the treatment of dermatitis
Treatment of atopic dermatitis in infants is carried out under the supervision of a pediatrician. It is necessary to show the child to the doctor even with minor manifestations of allergies. In severe cases, pediatricians prescribe pills and injections of antihistamines, corticosteroid ointments, which can quickly relieve inflammation and itching. In some cases, UV radiation is prescribed. Be sure to show a special therapeutic diet for the mother (if the baby is breastfeeding) with atopic dermatitis in newborns. For artificial feeding, it is recommended to change the milk mixture, in some cases, the child is allowed to feed only goat milk, not cow.
Non-drug treatment
Non-drug treatment of atopic dermatitis in infants with minor allergy manifestations brings quick positive results. Parents need to identify the allergen and limit contact with it as much as possible. Usually, atopic dermatitis in newborns on the face occurs in response to food irritants, and if irritation is observed in the genitals and buttocks, then this is a reaction to inappropriate skin care products or diapers. A comfortable environment and proper care should also be provided.
Diet for atopic dermatitis in a baby
The basis for the treatment of atopic dermatitis in newborns is the identification and elimination of a food allergen. When breastfeeding, a young mother should review her diet and exclude foods that can cause allergies. First, you can switch to a hypoallergenic diet, and after the disappearance of the symptoms of dermatitis, start introducing new products one at a time. This will allow you to track the reaction of the baby and accurately determine the allergen.
It is advisable to discuss nutrition with a pediatrician, allergist, or pediatric dermatologist. Specialists will give qualified recommendations on the organization of a nutritious diet during lactation and suggest ways to deal with constipation, which can also provoke an allergic reaction. Glycerin suppositories are commonly used to restore regular stool. It is also necessary to observe the correct drinking regime, enrich the diet with dairy products and foods rich in fiber.
If the baby is breast-fed, an adverse reaction to cow's milk proteins should be ruled out. Such a baby is transferred to soy milk formulas: Nutrilak Soya, Nutrilon Soya, Similak Izomil, Humana SL, Frisosa, Bellakt Soya. If the child's condition has not stabilized, it is recommended to try hypoallergenic mixtures. Adapted mixtures with goat milk (Nanny or Cabrit) can be used. Hypoallergenic are “NAS GA”, “Nutrilon GA”, “Frisolak GA”, “Similak GA”, “Bellact GA”, “HiPP Combiotic”, “Humana GA”.
Atopic dermatitis in a baby (photo rash does not differ) developed after the introduction of complementary foods? In this case, you need to look for an allergen among the foods that the baby has already tried. Possible allergens must be excluded from the diet in turn. Most often, an adverse reaction of the body occurs on cereals, chicken, fish, eggs. At the same time, you need to make sure that the child does not overeat, but also does not eat, drank a sufficient amount of fluid, had regular stool. Sweets are completely contraindicated in children with atopic dermatitis, because carbohydrates increase the absorption of food allergens.
Favorable environmental conditions
The skin of a child is very sensitive to external conditions. The room needs daily wet cleaning and airing. The optimum temperature is about 22 degrees Celsius. Humidity should be at least 50 degrees. Cool and humid air in the room will prevent overdrying of the skin of the child, increased sweating, irritation. Clothing must be suitable for the weather.
In order to maintain optimal humidity in a city apartment in winter, when central heating is working, you need to regularly carry out wet cleaning. You should remove soft toys and eliminate the maximum number of other sources of dust (these are upholstered furniture, curtains, decorative pillows and trinkets). Washable children's toys should be washed regularly with hot water. It is important to exclude the contact of the baby with pets and toys that cannot be washed.
To avoid contact with allergenic detergents, all clothing and linen should be washed with baby powder and rinsed very well in clean water. The baby’s dishes should be washed without detergents or hypoallergenic. All items of clothing for the child and bed should be sewn from natural materials. It is advisable to minimize the close contact of smoking family members with the baby.
Skin Care for an Allergic Child
Atopic dermatitis in newborns (a photo of a rash will help young mothers to recognize malaise on time) requires special attention to the skin both during an exacerbation and during remission of the disease. Be sure to bathe daily in settled and filtered water. Water must be defended to evaporate the chlorine, which dries the skin.
You need to bathe your child without a washcloth; baby soap and shampoos are allowed to be used no more than once a week. After the procedure, the skin should be wet (do not need to be wiped) with a soft towel. Then you can lubricate the problem areas with a special cream, oil or lotion. Means should be applied to the skin with such a frequency that it does not dry out, but is not constantly oily.
On the recommendation of a doctor, you can add decoctions of herbs to the bathing water. It is often recommended a series of atopic dermatitis in infants. The broth should be done in a separate container, and then added to the bathing water. You can also add decoctions of nettle, oak bark, burdock root, infusion of birch buds. Drying herbs are allowed.
Well moisturize the skin of the child care products, which include urea. This is a natural component of the skin and a physiological moisturizing factor that does not cause an adverse reaction in the form of an allergic rash. Any moisturizers should be applied only to problem areas. During the day of cleaning these areas, it is better not to use water, but to use wet wipes.
Drug therapy
If all of the above measures do not help improve the condition of the child, then doctors prescribe medications, which include glucocorticoids. Cream for atopic dermatitis in newborns can be prescribed only by a pediatric dermatologist or pediatrician. The use of such serious drugs (the products contain hormones of the adrenal cortex and steroids) must be strictly according to the scheme recommended by the doctor.
You need to cancel the drug correctly. Immediately after the appearance of improvements, do not stop rubbing the skin with the prescribed cream if the doctor recommends continuing the therapy. Cancellation is carried out within a few days. The dose of the drug used or the concentration decreases gradually until it is completely withdrawn.
Creams and ointments, which contain hormones, are necessarily used together with drugs that restore the protective functions of the skin. Good reviews were earned by the Swiss Excipial M lotion from Spirig Pharma. The tool increases the effectiveness of treatment, reduces the duration of therapy and reduce the load on the baby's body. The risk of side effects is also significantly reduced. Lotion is not a hormonal drug. With a mild form of dermatitis, inflammation can be removed only with its help (without the need for hormonal ointment).
To moisturize the skin during the period of remission, “Excipial M Hydrolotion” is often used. The composition of the lotion allows the skin to breathe and fully perform all functions, and this is very important for small patients. The drug begins to exert a moisturizing effect within five minutes after application.The feeling of tightness of the skin disappears, the itching decreases, there is a feeling of relief. Excipial M Hydrolotion can be used from the first days of life as prescribed by the pediatrician.
? « ». . . , , . « » .
The regular use of lotions (if necessary) will prevent the transition of allergies from infants to an older age, as well as reduce the frequency of relapses. Apply the product on the skin two or three times a day (in the morning, before bedtime and within three minutes after bathing). During the period of exacerbation, it is recommended to use ointments with the frequency that is necessary to constantly maintain the skin in a moist state.
In severe atopic dermatitis in newborns, a combined therapy regimen is prescribed. Ointments for local exposure are supplemented with calcium preparations, antihistamines. According to indications, immunomodulators, antibiotics, as well as antigen-specific therapy can be recommended. After normalizing the condition of the child, long walks in the fresh air, day and night sleep, a normal atmosphere at home are mandatory. In some cases, physiotherapy is needed to stabilize the nervous processes.
Possible effects of dermatitis
In the absence of adequate therapy, atopic dermatitis in newborns (in the photo the late-stage rash resembles manifestations of a very serious dermatological disease) can develop into other allergic diseases. Often, all skin reactions disappear in children, and at four to five years old bronchial asthma or allergic rhinitis is diagnosed. When an infection is attached, ulcers, purulent lesions, abscesses can occur.
A small reminder for parents
Atopic dermatitis in newborns can be prevented if simple preventive measures are followed and the baby is properly looked after. New foods should be introduced gradually into the diet. After the introduction of the next product, you need to wait a week to track a possible reaction. If no reaction has occurred, then the next product can be given. When a child is on GV mom, you need to exclude salty, smoked, spicy, limit sugar, honey, chocolate.
Children with a tendency to allergic skin reactions often need to change diapers and diapers. Oilcloths, woolen and synthetic underwear are contraindicated. Clothing should be made of natural materials, allow air to pass through well and not over-press. Sweat can be the cause of irritation, so you need to control the physical activity of the baby and change it more often.
Baths with decoctions of medicinal herbs are also recommended as prevention. In equal quantities, you can brew a string, plantain leaves, oak bark, calamus root, chamomile in equal quantities (one tablespoon per liter of water). A weak and potassium permanganate solution has a drying and antibacterial effect. Crystals should first be completely dissolved in a small amount of water, and then added to the bathing water. It is better that the bath is light, because it will help control the color of the resulting solution.
It is necessary to ensure that the apartment has a microclimate comfortable for the child. Indicators of 20-22 degrees Celsius are considered optimal temperature, suitable humidity is 40-50%. Children with allergies are more likely to suffer from colds, so hardening is especially important for them. To begin with, it is enough to leave the child at least 10-20 minutes without clothes. In summer, you can take air and sun baths. It is advisable to spend more time in the air, but not during epidemics.