Infant Care: Atopic March, From Eczema To Asthma & How To Prevent It

As many as 15% of all children develop baby eczema. Out of those, 50-70% develop asthma later in life due to what is called the atopic march, which is the progression from baby eczema to asthma. If you are the parent of a newborn or are expecting a bundle of joy soon, it's crucial that you protect your baby's skin at home and with the help of the day care staff. Here's why, along with a few tips that can help.

From Baby Eczema to Asthma

Researchers have discovered the reason for this phenomenon called the atopic march is a substance called thymic stromal lymphopoietin (TSLP), which is secreted throughout the body whenever the skin is damaged, such as by baby eczema. TSLP then travels in the blood until it reaches the lungs and causes the lungs to be hypersensitive to triggers that induce asthma.

Therefore, it's not the baby eczema that is causing the progression to asthma; it's the damage that the eczema causes to the skin that can lead to asthma.

You're probably wondering what causes eczema? There are fatty cells called ceramides that act as a protective barrier to skin. When the skin doesn't have enough of these fatty cells the skin becomes dry and can get easily irritated by triggers, such as soaps and allergens, which results in a flare-up of eczema. This lack of fatty cells is genetic, so heredity does factor into whether or not your baby is at risk.

Eczema makes the skin extremely itchy and painful. The itchiness of eczema is what causes babies to rub and scratch their cheeks until they turn bright red. As the babies continue to rub and scratch their skin, the skin can break open, ooze, and crust over. This is the damage that needs to be avoided as much as possible to prevent TSLP from getting secreted.

Protect Baby's Tender Skin

Now that you have a firm grasp on what causes eczema and how it can lead to asthma, you'll want to know how to protect your baby's skin. And since your baby spends a lot of time at day care, it's important to consider skin protection there as well. Here are a few tips.

  • Add healthy fats to your baby's diet to reduce dry skin. If you breastfeed, you can do this by increasing your intake of omega-3 fatty acids. If you formula feed, look for a formula that is enriched with fatty acids. Make sure to restock your formula supply at the day care facility as well.
  • Keep a log of any changes that are noticed. Since eczema is triggered by irritants and allergens, it's important to keep a log of any changes that can affect your baby's skin, such as using new laundry detergent or soaps, as well as anytime you notice a change in your baby's skin, such as scaly skin or splotches. Ask the day care to also keep a log, especially if either parent suffered from baby eczema and/or asthma since heredity is a factor.
  • Prevent your baby from rubbing or scratching their skin. It's important to keep your little one's fingernails trimmed as short and as smooth as possible. If you notice your baby rubbing his or her face, put a pair of baby mittens on their hands. Stock several pairs of clean baby mittens in your baby's day care diaper bag. Make sure to change them out regularly so fresh, clean mittens are always available to the day care staff.

Since baby eczema is fairly common in infants, many infant day care providers and nursery schools have experience in recognizing the symptoms of baby eczema.

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