Every mother wants to see her baby as smiling and rosy-cheeked, as in beautiful pictures in advertising, in magazines and on the Internet. In reality, everything looks somewhat different - at the toddler, with enviable constancy, red spots appear on the cheeks, then an incomprehensible rash appears on the priest. Diathesis, grandmothers sigh in unison. And the whole family begins to think about how to treat this condition. There is no time for advertising beauty.
The well-known children's doctor Yevgeny Komarovsky spoke about why babies develop atopic dermatitis and how to deal with it, repeatedly in his television programs, in books and articles. We tried to summarize the information in one article.
And here is actually the issue of Dr. Komarovsky dedicated to atopic dermatitis in children.
About the disease
Atopic dermatitis is a fairly common disease. According to medical statistics, every third baby under the age of six months suffers from this ailment. This disease is very insidious, since it tends to mutate. Over the past 10 years, children have begun to be diagnosed with this diagnosis 5 times more often, since the disease itself has become more severe.
Parents mistakenly consider him a skin ailment, this is not true. Since atopic eczema (this is the second name of the disease) is initially an allergic reaction.
Most often, the disease occurs in children with a genetic predisposition to a reaction to one or another allergen... At birth, the genome of a child contains information about which antigen to react in what way.
Geneticists have come up with an interesting pattern: in families where mom and dad are not allergic, only 10% of children are prone to allergic dermatitis at birth. If one of the parents suffers from some type of allergy, then the probability of having a baby with the same problem is 40-50%, and if both parents sneeze in the spring and eat packs of antihistamines and do not tolerate oranges and cats, then from 80% - They are more likely to have offspring that will suffer from atopic dermatitis and, most likely, some other types of allergies.
Symptoms
The main symptom of allergic dermatitis is a rash. It can be red, pink, with or without watery heads, solid and sparse. Most often, the disease manifests itself on the baby's face, neck, arms and legs, in rare cases - on the stomach and chest. Such allergic eczema differs from others, including skin diseases, by a strong, sometimes intolerable itching, which does not allow the child to sleep, eat, and stay awake normally. The temperature rarely rises. If you notice a high jump in body temperature (up to 38.0), then we are probably talking about a completely different diagnosis in your case.
So, if the rash is concentrated under the armpits, in the folds of the skin, then, most likely, we are talking about diaper dermatitis. And if the baby has a rash with a white coating on the head (as an option, yellow crusts on the scalp) or on the body in areas where the sebaceous glands are especially active, then seborrheic dermatitis will have to be treated. In some cases, doctors diagnose atypical dermatitis in children, it is very similar to atopic dermatitis and, in fact, is a type of this disease.
According to doctors' observations, atopic dermatitis most often occurs in children of the first year of life. For most of them, it goes away over time on its own, the path from remission to complete recovery can take several years.
Komarovsky about the problem
Evgeny Komarovsky, speaking about atopic dermatitis, always starts by teaching parents to correctly name the diagnosis. Moms and dads say "diathesis". There is no such disease, the doctor corrects. There is atopic dermatitis or childhood eczema.
There is a definite relationship between the occurrence of redness on the skin and itching and the work of the intestines, says Komarovsky, but it is not the main cause of the disease, as many district pediatricians like to imagine. If two children are given the same product, one will develop allergies and the other will not. It's all about the state of immunity. The weaker it is, the higher the genetic predisposition to an unhealthy reaction, the more likely an allergy is.
Treatment according to Komarovsky
The widespread practice of treating atopic dermatitis "through the intestines" is not entirely correct, the doctor said. That is why treatment often does not bring the desired result. Dermatitis subsides, and after a while flares up with renewed vigor.
Komarovsky advises to approach the treatment of the disease from a position of knowledge, namely, from an understanding of what is happening with the child's body. Foreign antigens, getting to the baby with food, with pollen, with irritating substances from household chemicals, cosmetics, can leave it only in three ways - through the skin (sweat), through the kidneys (urine) and through the lungs. In the event of dermatitis, the skin reacts to the allergen leaving the child. But again, such sweat is not in itself toxic, but only in combination with some kind of allergen outside.
And in this issue you will find interesting information on the treatment of atopic dermatitis.
For example, mom washes the floor with chlorine-containing products. Sweat reacts with chlorine molecules and the baby becomes covered with a bright rash.
Although it is impossible to completely abandon the opinion that atopic eczema is associated with digestive disorders. Komarovsky assures that in his practice he has not yet seen a single thin child who would suffer from this ailment. But there are plenty of plump and loose babies with a red rash up to scabs on the cheeks and butt. Therefore, in order to reduce the likelihood of an allergic reaction to a particular protein-antigen, it is better not to overfeed the child, says Komarovsky.
Artificialists are more likely to suffer from childhood eczema than infants. This is due to the fact that babies always eat more from the bottle than they are able to digest and assimilate. After all, breastfeeding is more difficult, and the feeling of fullness, as you know, always comes after a meal in 10 minutes.
Everything that is eaten in excess of the norm is poorly digested, rots in the intestines, and is partially excreted by the liver. However, it is this organ, according to Komarovsky, that is the most vulnerable in babies. Hence the reaction on the skin. Hence the explanation of why atopic dermatitis can go away on its own over time - after all, as the liver grows older, it improves, becomes more mature and is able to neutralize more harmful compounds.
Komarovsky suggests treating atopic dermatitis in three stages:
- Decrease in the amount of antigens “inside” (with food, liquid, drugs, etc.).
- Reducing sweating.
- Elimination of external antigens (which are in the environment of the baby).
The "internal" stage should include monitoring the state of the intestine. The child should regularly go to the toilet "in a big way." In case of constipation, mild laxatives may be given. If the baby is breastfed, the mother also needs to make sure that her bowel movements are regular.
It is desirable that the baby eat slowly. An artificial person should be given a nipple with a small hole, you can also make a mixture of a less saturated concentration, pour it less than indicated in the instructions. And you should always adhere to the rule "It is better not to finish eating than to overeat."
Reducing sweating is easy enough, says Evgeny Olegovich. To do this, you need not to entangle the baby, and also monitor the air temperature in the room - it should not exceed 18-19 degrees. A baby with allergic dermatitis needs to be paid off with warm water several times a day, while remembering that the chlorine contained in tap water is very aggressive.
Therefore, it is better to boil the water that you plan to rinse the baby after the bath and cool it to a warm state so that the chlorine used to disinfect it at the station evaporates.
As we have already found out, antigens are released not only with sweat, but also with urine. Therefore, it is important to reduce the amount of fluid consumed during treatment. However, it is not necessary to deprive the baby of drinking at all. Measure is good in everything.
"External" stimuli should be minimized decisively and without hesitation. First of all, in the apartment where the baby with atopic dermatitis lives, you need to ventilate, make sure that dust does not accumulate, there should be no furry pets in the house - cats and dogs. Mom should give up household chemicals with chlorine, and all cosmetics should be hypoallergenic, devoid of perfumery fragrance.
For bathing, you need to use baby products, and wash the baby's linen with a special powder. If the family practices co-sleeping, the parents' bedding should also be washed with baby powder. For guests who like to cuddle your allergic toddler, it is necessary to have special robes, washed with children's products, in order to exclude any contact of the child with possible antigens on the clothes of strangers.
Do you need medication?
Often not needed, says Komarovsky... There is no universal pill for this disease. Treatment is not a specific drug, but a set of measures that parents must take.
However, in some situations, the attending physician may recommend certain medications, and such prescriptions should not be neglected, says Komarovsky, since the doctor most likely has good reasons for this:
- With a severe course of atopic dermatitis, medicine advises to start taking antihistamines, which are Suprastin, Tavegil and others. These drugs, Komarovsky recalls, dry mucous membranes. They help to cope with sweating, but they have a number of significant disadvantages. Therefore, they should be resorted to in extreme cases.
- A well-known pediatrician recommends that all children with atopic dermatitis take calcium supplements. Its deficiency increases the symptoms of the disease.
- The rash does not need to be cauterized or squeezed out. But if a dry crust (scab) has already formed, Evgeny Komarovsky advises to process it several times a day with Bepanten. In some cases, it is permissible to smear such places with local antihistamines - "Fenistil-gel", for example.
- If the rash greatly bothers the baby, he itches, cries, almost cannot fall asleep due to constant itching, hormonal drugs (corticosteroid) will help. Komarovsky notes Elokom and Advantan as the least harmful and effective.
Doctor Komarovsky's advice
- Treatment will be faster and more effective if accompanied by a hypoallergenic diet. Cow's milk, chicken eggs, nuts, especially peanuts, factory-made sweets should be excluded or minimized from the diet. Sugar is best replaced with fructose. For babies, it is important to reduce the fat content of mother's milk, for this a woman needs to consume less fat (sour cream, lard, butter). For babies who are artificially fed, it is better to give hypoallergenic mixtures during treatment. They are more expensive than usual, but the result will not be long in coming.
- Your baby will sweat less if the humidity level is maintained in the house. Komarovsky advises starting an aquarium, placing basins of water in the corners, hanging wet towels. All these measures are good if there is no special device - a humidifier. If present, additional moisture is not required.
- When bathing a child with childhood eczema, you should know that the places with the greatest accumulation of rashes should not be thoroughly and diligently washed. It is better to avoid this, and after bathing, wipe separately with wet wipes (naturally, without aromatic additives).
- Do not buy bright clothes of unknown manufacturers for your baby. It is better to take white clothes, as a sweating baby can become covered with a rash due to contact of sweat with fabric dyes. Ideally, if things are crumbs made of linen or cotton.
- The same ban applies to cheap toys made in an unknown Chinese clandestine factory. Stuffed toys, even good and solid ones, should be removed altogether or given to neighbors. They are a real "piggy bank" of various antigens from the outside, and therefore are dangerous for crumbs with atopic dermatitis.
