eczema in babies: what it is, how to treat it, and how it can impact their sleep
As a sleep expert specializing in infants and children, I often encounter parents grappling with the challenges of painful, itchy rashes like eczema in their little ones. This common skin condition not only affects the child’s skin but can also disrupt their sleep patterns, leading to additional stress for both the child and their caregivers.
In this post:
What is Eczema?
Eczema is a group of conditions that cause the skin to be itchy, inflamed, or rash-like. Eczema is often inherited, and infants with parents who have allergies or asthma are at highest risk for development. It commonly appears in infants and young children, often before the age of five. According to a study published in the "Journal of Allergy and Clinical Immunology," approximately 10-20% of children worldwide are affected by eczema (Silverberg, 2021), though some children grow out of it.
Eczema can be “graded” as mild, moderate, or severe. The way you get diagnosed and the way you will manage your child’s eczema may depend on the severity, or grade. To read more about this, visit Dr. Anjuli’s blog post here.
What Causes eczema?
The exact cause of eczema is still unknown and is likely multifactorial. The cause for your baby’s eczema may be different from the cause of another baby’s eczema. While the exact cause of eczema is not fully understood, but it is believed to result from a combination of genetic and environmental factors. Here are some key contributors:
Genetics: Children with a family history of eczema, asthma, or hay fever are more likely to develop the condition. Research indicates that specific gene mutations affecting the skin barrier can predispose children to eczema (Leung & Guttman-Yassky, 2020).
Immune System: An overactive immune response to allergens or irritants can trigger eczema flare-ups. This is supported by studies that highlight the role of immune system dysregulation in eczema (Weidinger & Novak, 2016). If you’re concerned about potential allergies in your baby, check out this episode all about food/ breastmilk/ formula intolerances and allergies.
Environmental Factors: Exposure to certain environmental factors such as pollen, dust mites, pet dander, fragrances and harsh soaps can exacerbate eczema symptoms. A study in the "Journal of Investigative Dermatology" links increased pollution levels with higher eczema prevalence (Kim et al., 2017).
Skin Barrier Dysfunction: Eczema patients often have a defective skin barrier, which allows moisture to escape and irritants to enter, leading to dry and sensitive skin. This barrier dysfunction is a critical factor in the development of eczema (Cork et al., 2006).
How does eczema impact sleep?
Eczema can significantly disrupt a child’s sleep due to the intense itching and discomfort it causes. Sleep disturbances in children with eczema are well-documented and can lead to various issues, including:
Nighttime Itching: Itching tends to worsen at night, making it difficult for children to fall asleep and stay asleep. A study published in "Sleep Medicine Reviews" found that children with eczema experience more frequent awakenings and shorter total sleep time compared to their peers (Yosipovitch et al., 2010).
Daytime Fatigue: Poor sleep quality overnight can result in daytime fatigue, irritability, and difficulty concentrating, impacting the child’s overall well-being and development.
Parental Stress: The sleep disturbances caused by eczema can also affect parents, leading to increased stress and fatigue, which can further impact the family dynamic (Cohen et al., 2014).
Tips to help manage your child’s symptoms
To help children with eczema get better sleep, consider the following strategies:
Barrier Creams at Mealtime: Before and after eating foods that may trigger eczema (allergens or very wet or acidic foods), apply a thick cream like Vaseline or Aquaphor to areas of the body that come into direct contact with the food, like the hands or cheeks.
Establish a Bedtime Routine: A consistent and calming bedtime routine can signal to the child that it is time to wind down and prepare for sleep. Bedtime routines are shown to positively impact sleep in young children and can be helpful for parents to avoid stress as well. If you’re struggling with establishing a bedtime routine, scroll up and head to “courses” to find the best solution for your child’s age and stage.
Include a Bath in the Routine: Keeping the skin moisturized is key for managing eczema. Give your child a 10-15 minute bath in warm water, limiting soap (which can be drying). After the bath, wrap them in a towel and while the skin is still damp, add any prescription treatments and moisturize with gentle lotion. Wait for the lotion to soak into the skin before dressing them in pajamas. Also look into Wet Wrap Therapy: This involves applying wet bandages over moisturized skin to enhance hydration and absorption of topical medications. A study in "Pediatric Dermatology" showed that wet wrap therapy can provide quick relief from severe eczema symptoms (Devillers et al., 2002).
Keep the Bedroom Cool and Humidified: Maintaining a cool and slightly humid environment can prevent skin from drying out and reduce itching. This humidifier is a great option!
Dress in Soft, Breathable Fabrics: Choose sleepwear made from soft, natural fibers like cotton to minimize skin irritation. Avoid hot or itchy fabrics and synthetic fibers like polyester and fleece.
Consider Prescriptions: If recommended by a healthcare provider, antihistamines, steroids etc. can help reduce itching and promote better sleep.
Limit Irritants in the Home Environment: Things like cigarettes or vapes in the home, fragrances and candles, and certain cleaning and laundry products can make eczema flare ups worse. Be sure the air in your home is clean and that you are using natural, unscented products wherever possible. Keep your child’s room clean, dusted and vacuumed.
For more on eczema treatment options and how to determine what professional you should seek to diagnose and help treat your child’s eczema, check out this great blog post from Dr. Anjuli and see her highlights on Instagram @resilientrascals
