In the last month or so, our family has made some adjustments in our thinking and eating to help our son Jack with his eczema. I am learning so much right now and I'm getting so excited about how Jack is improving. I wanted to write this post to catch up our family and friends, but also to get some of these things written down so that others who struggle similarly may benefit.
Jack's eczema started when he was around 3 months old, shortly after his first round of antibiotics, which he'd taken for a double ear infection. I felt horrible about having to give him antibiotics at such a young age, but his screams in pain conjured a particularly painful Christmas Eve from my childhood, and I couldn't stand it. Also remembering that his Daddy has ruptured ear drums twice in his life, I acted in what I thought was his best interest, and he got the antibiotic. Although I don't regret that choice (especially given his family history), I do wish that that episode had never happened. It was the beginning of multiple illnesses (pneumonia, more ear infections)and more antibiotics. I actually lost count, but I think it's somewhere between 4-6 rounds, during which time we discovered he is allergic to amoxicillin (hives were no fun). In the same time line, Jack's eczema went from an annoyance to a real concern. He went from a couple spots on his wrists to behind and on top of the knees, inside and around the elbows, all around his ankles, and spreading across his knuckles as well. It varied in intensity on a day-to-day level, but over weeks and months, he was definitely getting worse. Some days I couldn't keep him from scratching and other days, he seemed unbothered by the red, irritated patches.
Until a month ago, we'd only really tried traditional treatments. When he was a little baby, he'd rub his wrists (the first place it showed up) over and over on my chest as he slept next to me through the night. I mentioned it to our pediatrician, and he diagnosed eczema and prescribed a mild steroid cream. I applied it thinly only when Jack was uncomfortable because I felt uncomfortable using it intuitively, but when desperate it provided some relief. As his eczema worsened, I began applying more often (up to twice daily), but this only provided momentary relief and never long-term progress. In fact, looking back now, I believe I may have exacerbated the problem by using these Rx's. Jack's skin would briefly improve (but never heal, it always felt, at best, leathery in these spots) and it would also lighten the color (hypopigmentation is listed as a possible side effect of the corticosteroid creams). I have also been worried about Jack's being at the 5 percentile for weight since he was about a year old. I am thin, and was as a baby/child, so this could account for all of that, but when I read this information about the cream I was using for Jack, it struck a chord with me as well.
Pediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced HPA axis suppression and Cushing's syndrome [non cancerous tumor on the pituitary gland] than mature patients because of a larger skin surface area to body weight ratio.
[The HPA axis is involved in the neurobiology of mood disorders and functional illnesses, including anxiey disorder, biopolar disorder, insomnia, PTSD, borderline personality disorder, ADHD, major depressive disorder, burnout, chronic fatigue syndrome, fibromyalgia, irritable bowel syndrone, and alcoholism. Antidepressants, which are routinely prescribed for many of these illnesses, serve to regulate HPA axis function. (Source here.)]
Hypothalamic-pituitary-adrenal (HPA) axis suppression... (has) been reported in pediatric patients receiving topical corticosteroids. Manifestations of adrenal suppression in pediatric patients include linear growth retardation, delayed weight gain... Administration of topical corticosteroids to pediatric patients should be limited to the least amount compatible with an effective therapeutic regimen. Chronic corticosteroid therapy may interfere with the growth and development of pediatric patients. (Source here.)
Though we were using a mild corticosteroid, and certainly not "chronically", these side effects troubled me. But more troubling was the simple fact that Jack was not improving. We talked with his pediatrician who was very nonchalant about it all, suggesting he'll just outgrow this and that it tends to run in families. He also prescribed a stronger steroid cream for Jack. Still, the waxing and waning suggested something more than just a proclivity for dryness. I felt his body was responding to something, I just couldn't narrow down the trigger any more than soy products (due to his itchy after eating edamame and ranch dressing) and I knew that couldn't account for all of it.
So, a couple months ago, I became determined to try something new and focus my efforts to find a fix. Jack was only getting worse, my heart was aching for him to find relief, and the medicines I was getting from his pediatrician didn't seem right, both intuitively and empirically. Some trite quote says that "the definition of insanity is doing the same thing over and over and expecting a different result". Though simplistic in its parameters of insanity, a point I'll let rest for the purposes of this post, the concept applied here-- we couldn't expect Jack to improve with this course of treatment. Traditional medicine was not bringing Jack wellness.
So I sought out my acupuncturist's help. Prior to this turning point, I had had a mental block about enlisting her treatment because Jack is too young for needles (actual acupuncture treatment). But all of a sudden it occurred to me that she can do much more than just needles (herbs, acupressure, etc.). I googled "eczema acupuncture" and read this good article, which really helped me understand the nature of eczema from the Chinese medicine standpoint. I called Paula, and that simple move prompted a shift toward wellness. Here's what we are now doing for little Jack.
During the first couple of NAET treatments for Jack, Paula advised me about the importance of the gut/intestines/digestion to your overall health. She explained to me that because of Jack's multiple rounds of antibiotics, his digestive tract was likely out of balance. When the good flora is killed along with the infecting bacteria, this leaves lots of space and no competition with the natural yeast that lives there as well. Without the inhibiting bacteria that is present in a healthy person, the yeast can overgrow and dominate the gut and this has many unpleasant consequences.
First among them is that the person is not able to break his/her food down into the smaller enzymes necessary to make energy or nourish the body (since the healthy flora is part of that break down process). The body can show a host of negative symptoms as a result of the lack of proper digestion and nutrition (even from a well-balanced, otherwise healthy diet). Eczema is one of them. Paula diagnosed Jack to have this over-growth of yeast (candida) in his system, which was likely caused by the antibiotics he has taken. Operating on that supposition, she suggested we adjust his diet to exclude sugar (since sugar feeds yeast), yeasted products like bread (no need to put more yeast in there), and also diary products (often high in sugar and the protein is inaccessible to a compromised system because it is particularly large and can't be broken down without enough good bacteria to do the job). If we followed this diet, the yeast would have less food and begin to die off/not multiply as quickly. She also suggested that we add probiotics to encourage bacteria growth and provide some competition for the yeast. Here's more about diagnosing and treating candida/yeast overgrowth. And here's a good, short article from a holistic medicine magazine about the connection between eczema and candida, as well as many ideas for easy, holistic treatment.
This sounded simple enough, but when we decided to take on this dietary change, our family went through a week of grief. Actually, it was my husband and I who grieved. Being self-proclaimed "foodies", especially being a big baking household, the thought of no milk/cheese and no more home-baked bread was super sad. After a day or so of this teary processing, we realized that we'd just have to focus our foodie creativity in a different direction for a while-- that this new diet wasn't a life sentence for Jack; it was a trial and error thing that, at most, might last a few months to a year if it proved helpful. And if it proved helpful-- we'd have a happier, healthier boy-- totally worth it.
We cleaned out our pantry and made a few trips to our local health food store, Trader Joe's, and Whole Foods. I became a big time label reader and learned a lot this way-- amazing how many things have sugar in them-- beans? c'mon, why?! We made conscious decisions about what to prepare ahead for snacks, because I knew in a time crunch when kids are hungry-cranky, that'd be the time I'd be most tempted to give them something off-diet. We decided to keep fruits and vegetables totally on the table (we have a good organic CSA membership and we know it is all "clean"), but we try whenever possible to choose the lower glycemic fruits (like apples, pears, berries) rather than the higher glycemic fruits (like stone fruit). We switched the morning organic whole milk to rice milk, also organic and enriched to provide almost the same amount of nutrition. We eat lots more rice, as the preferred carbohydrate without bread around (mostly organic, brown rice). We've learned to use Agave nectar in place of maple syrup so we still get to have pancakes, a family favorite. We sweeten Jack's oatmeal with agave as well, and grind in some flax seeds for the omegas, which help his elimination (good-- get the dead yeasties out of there) as well as his skin.
Adding the probiotic was easy peasy too. Here's the one Paula ordered for Jackie. We mix a quarter teaspoon into about 8 bites of applesauce for him, and its is a yummy treat. We also purchased some chewable probiotics which are less potent, but you can't really overload on them and since we don't really pass out jelly bellies anymore, the chewable vitamins have become a kind of treat in the kids' minds. Speaking of vitamins, they are taking Vit. C a couple times during the day (I learned that Vit. C is a natural histamine blocker, helps with itch, as well as immune supporter in general), a mutiple vitamin, calcium, and omegas.
On day 6, Jack's eczema flared up to twice its regular size and was, needless to say, itchy. We were feeling discouraged about it, but decided we'd stick with the diet and probiotics until our appointment two days later with Paula. By our appointment, the eczema was looking much better. Paula explained that the flare up was to be expected. Apparently, when yeast dies off, symptoms can flare up.
The first, most noticeable improvement was Jack's appetite. It was always tough to get him to eat before this dietary shift. Jack used to ask for sweet treats all the time. But once our minds were commited to this, saying "No" became easy and he could tell we meant it, so he stopped asking. He learned to ask for what we say yes to, and he seems to be developing a taste for healthier foods. His appetite is much greater now, too. He eats probably double the volume he used to. This is a really pleasing change for me as his mom. Having everyone tell you your son is "tiny" gets old pretty quickly. Each time I heard that, I felt a pang of worry about whether something might be wrong with him. Now that he is a good eater, if Jack stays relatively small, I have the ease of knowing that it is just his body type, not some side effect or deficiency.
The other really quick change was his overall attitude and behavior. Jack's always been a good boy, but he just seems a bit brighter and happier since his body is feeling better. This is also especially pleasing for a mom.
Since that initial flare up, Jack's eczema has been lots better, too. The usual spots are not as red, and some spots have completely disappeared. I'd estimate that the surface area of affected skin is less than a quarter what it used to be. The texture of his skin is also much smoother, there is no leathery skin now, even when a spot "flares" redder than we'd like it to be. (He's had another semi-flare up, after eating a bit too much fruit in a 24 hour period, and then the last day or so since I upped his probiotic a bit and got strict again after letting him have a piece of sister's birthday cake.) The difference between a yeast die-off flare up and regular old eczema is that once the flare up passes, the skin is continuing to heal and overall health is improving. I feel like we're now on the opposite path as before: day to day he might look better or worse, but comparing now to 4-5 weeks ago, there's no question that he is MUCH improved. (I wish I'd taken more "before" pictures now, but at the time, when my kid was uncomfortable, I'd actually try to avoid photographing the red spots.)
And last, but not least, I am learning to trust my intuition more.
I, of course, preferred soaps and lotions for him that were all natural, but many of the products marketed this way were disappointing. They contained soy, which we've suspected as a trigger for him, and they also contained many other preservatives or extras that we just didn't need. I read this article from Acupuncture Today when I began thinking about changing the products we use. It explained why you want to keep moisture in but also allow skin to breathe (in other words, why petroleum products are no good), and also suggested certain herbs and oils as beneficial. Upon further research, I found these same herbs and oils repeated over and over again all over the Internet (calendula, lavender essential, jojoba oil, coconut oil, almond oil...). I began collecting necessary ingredients and I made a couple different oil mixtures and a palm oil based cream, but we've seen the best results with the following recipe (amounts are approximated).
I began by infusing dry calendula flowers (purchased from my acupuncturist, Paula, but also available online at the link above, which also explains their beneficial properties) in extra virgin olive oil. To do this, I grabbed a hand full, placed them in a jar, saturated with olive oil (about 2/3 full of flowers) and left in a dark cabinet for 3 weeks. Every time I opened that door in the pantry, I shook up the jar a bit to keep things moving. On mixing day, I poured the entire contents into a pot and heated very low for a few minutes, then strained through cheesecloth, squeezing the flowers and then wringing the cheesecloth to get all of the good drops of calendula-infused olive oil I could possibly get.
Next, I melted some beeswax in the calendula-infused olive oil, again on low heat, and poured in about three tablespoons of coconut oil, a couple drops of tea tree oil (anti-fungal, anti-septic), a splash or two of some sweet almond oil, a splash of Vitamin E oil, a splash or two of jojoba oil, and a bit of evening primrose oil. Once melted together, I poured it into my empty vessels and allowed to cool. It solidifies when cool because of the beeswax.
Though this recipe is approximate, the ratio is really all you need to make your own salve. If your stuff is too dry/thick when you're done, just scrape out of your vessels, and warm over a low flame until liquid and add more oil this time. You want your salve to end up solid so you can scrape some out with a finger nail when you're using it, but you want it to melt into your skin when rubbed a bit. It feels great!!! Jack loves it and I've noticed that if I rub an irritated spot with a baby wipe and he complains of it hurting, the salve takes the pain/burn away, so it is very mild and soothing. Even in a flare up, this stuff feels good.
I'm continuing to research and learn more. I found this neat forum of moms who have a similar story, and it is good to read what others think and do for their kids. We have an appointment Friday morning to talk to a local homeopathic doctor and I am excited to hear his thoughts and suggestions. I also purchased some zinc in liquid form from my health food store today, since that is also recommended for eczema sufferers. I'm planning to look into digestive enzymes... there's a lot of information out there and we're checking into it. The natural route might not be the quick fix of the corticosteriod cream, but it is definitely turning out to be worth it in the long term. I am so grateful to have the resources around me to find a way to help my little Jackie boy.