Archive for September, 2009

Itching for help with childhood eczema?

Monday, September 28th, 2009

toddlerscratchingDid you know eczema affects 10 to 20% of children? I see many children in my Pediatric practice who are suffering from its effects. Not only is eczema a common condition, but it’s distressing and prone to complications (such as infection and bleeding). Children with eczema (and their parents) will also know that it is often associated with other difficulties such as poor quality sleep due to constant itching, scratching and bleeding.

 

These issues make life difficult and I believe both the community and health professionals understate the impact of eczema on children and their families. Affected children often scratch at night and therefore sleep poorly. This in turn can lead to impaired growth, development, concentration, appetite and even learning.

 

Our management of childhood eczema has been somewhat ‘light on’. We tell each other that he’ll grow out of it or its ok she won’t develop any scars. While this is true, what we should also be doing is working hard to treat the condition effectively, and ensuring that sleep and lifestyle are minimally affected.

 

We know the following are triggering factors for an eczema flare up:

·         Overheating

·         Dryness

·         An illness, like the common cold or gastro

·         Emotional stress

·         Sleep deprivation

·         Secondary bacterial infection of the skin

·         Irritants (such as soaps or nylon)

·         In some children, exposure to certain allergens

       such as egg, cow’s milk, wheat

 

All children with eczema respond differently, however I always recommend the following treatment guidelines:

·         Moisturize, moisturize, moisturize…paraffin or sorbelene are good

·        Keep your child cool. Try not to over-clothe them and, where possible,  keep their environment cool

·         Use bath oil rather than soaps

·         Avoid or reduce exposure to allergens if you can

·         Treat secondary bacterial infection aggressively with antibiotics (infection is suggested if the lesions have become weepy)

·         Don’t be afraid to use corticosteroid ointments (rather than creams) prescribed by your doctor. Better to treat the condition aggressively from the outset and then complications and chronic problems less likely to occur. Continue steroid ointments for 3 days after resolution of eczema inflammation.

·         Consider using wet dressings at night to for severely affected areas to reduce inflammation. This will keep the skin cool, moist and protected from scratching

 

If you are a parent with a child who has eczema you’ll no doubt be familiar with many of these suggestions. Other useful information can be found here. You may even have some of your own strategies that you could share? I’d love to hear.

 

While the outlook for childhood eczema is variable (children with multiple allergies generally have more severe and longer lasting eczema) the good news is most infants and children grow out of eczema by primary school. Also, long-term complications (such as scarring) are rare indeed. So hang in there everybody, there is light at the end of the eczema tunnel.

 

How much sleep does my baby need?

Tuesday, September 8th, 2009

 

babyandmumGood question!

Last blog on tired signs, Annabel asked how much sleep should she expect her 9 week old to have? While specific advice is not possible in this format, there are some guidelines which can help parents figure out the answer to this all important sleep-question for their baby.

As a general rule, the following can be expected for how much sleep a baby may need:

 

• A newborn baby, in the first 2-3 weeks, will generally require 16 – 20 hours per 24 hour period. Feeding and sleeping are more predictable at this early age, but after 2 – 3 weeks things usually get tougher.

 

• After 3 weeks parents often find their baby sleeps less (approximately 16 – 18 hours) and cries more.

 

• 6 weeks may see your baby sleep around 15 – 16 hours each day.

 

• By 4 months babies may sleep 5 – 10 hours plus 2 naps of 2 – 3 hours each.

 

• A baby of 6 – 7 months can sleep through without an overnight feed, giving you anywhere from 6 – 12 hours, plus morning (1 – 2 hours) and afternoon (1 – 2 hours) naps.

 

• By 9 months the average sleep can be 11 – 12 hours overnight plus 2 naps, and by 12 months babies may sleep 12 hours with 2 daytime naps that may be shortening.

 

As you spend more time with your baby, you will understand more about your baby’s individual sleep needs, tired signs and patterns. It is useful to establish a routine for regular settling and sleeping. A Sleep Chart can help to get this started. Free here.

 

Remember, a fussy baby is extremely common… and when you are awake in the middle of the night with your baby – at 3 weeks old, 9 months or 19 years old – you are not alone!