Our baby & toddler eczema care routine

See our updated post on eczema care for babies & toddlers. For more posts with baby-related tips, see our: favorite places to buy practical baby clothes, and starting solid foods.

Eczema…the pesky skin condition that plagues so many of us and our little ones. We’ve been battling it on Nori since she was a few months old, and everyone says most babies will outgrow it, but Nick is a prime example of an adult who’s been trying to manage eczema his whole life.

I’m sharing our fairly standard eczema-mitigating routine as recommended by Nori’s dermatologists and allergists. This is just what we do, so as always, please consult your doctors for any medical advice!

1. Moisturization & bathtime routine

We’ve tried countless eczema-specific products like Tubby Todd, Eczema Honey, Mustela (Nick is the product tester for Nori). For us there have been no “miracle” products, rather what’s important is a continuous daily routine of keeping the skin protected and moisturized.

• Bathe / shower regularly in lukewarm water for around 10 minutes. We used to be told those with dry skin should bathe less frequently, but now our docs all suggest daily baths, with the keys being:
  • lukewarm temperatures – around body temperature or below, which we check using a thermometer
  • not too long in duration, which can strip the skin of natural oils; and
  • sealing in moisture immediately afterwards (see 3rd bullet below)
  • test for water hardness as hard water may contribute to eczema
• Use diluted bleach baths or cLn wash regularly to limit bacteria on skin. Sounds a little intimidating, but it’s supposedly more gentle than chlorine in a swimming pool and every doc kept instructing us to do it to help prevent infection on flare ups.
• Seal in the moisture after bathing while skin is still damp. After your little one gets out of the bath or shower, gently pat off water drops then immediately pat (not rub) a layer of thicker moisturizer on damp skin to “seal in” the moisture. This should be done within 2 to 3 minutes of getting out of the bath.
• Moisturize during every diaper change, if possible. This isn’t practical for us but we aim to moisturize 2-3x a day, and we ask her caretakers to do the same. See below for a list of gentle moisturizers we use!
• Topical steroid use. We do use prescribed steroids during flare ups but of course would prefer not to. But by following this daily routine and everything else in this post, we don’t use it much anymore. I have gotten a lot of reader recommendations to look into Dr. Richard Aron’s eczema regimen (involves topical steroids), so wanted to pass that along.
• Wet wraps if needed. We have not done this since it’s cold in our house in the winter, but our docs strongly suggested this and several mamas say it works well.

2. Favorite products in our routine

We’ve been told that minimally dyed 100% cotton, bamboo, and silk are recommended fabrics for eczema prone skin. In my experience, bamboo and silk have been more gentle on Nori’s skin than standard cotton.

• Frarance-free gentle cleansers and moisturizers. We usually do not use soap at bath time as it can be harsh, instead a gentle cleanser wash like Honest, Babo, California Baby, Eucerin or a product like Aveeno with colloidal oatmeal to help the itching. For moisturizing, we’ll use an unscented, dermatologist-recommended lotion like Tubby Todd, Vanicream Cream, Cerave Cream, Hydrolatum or Eucerin and then pat some Cerave Healing Ointment on top of the rougher patches. (Note: ointments to use on smaller patches are thicker and usually clear, while lotions to use all over the body are a little thinner with a creamier consistency)
• Anti scratching shrug sleeves. This concept was a recommendation from you guys and has been a GODSEND, especially for bedtime as she used to scratch herself bloody all the time. Here are two good options that we own:
  • Scratch Me Not are my favorite brand of sleeves,  they’re a good fit if you go by their wingspan measurements, durable quality with silk mittens.
  • Polka Pinka Etsy shop sews handmade scratch sleeves in several styles. Ours seem very soft and comfy for Nori, and the hands can flip open or shut. These are pricier but you’re also supporting a small minority-owned business. Note orders take do take some time to be made and shipped.
• Silk crib sheets: A total luxury and splurge product (that mama doesn’t even get to indulge in), but we have 1 silk crib sheet from Silky Tots that’s extra nice and gentle on her face and scalp, especially when Nori would rub her head back and forth against cotton sheets til it was raw and bloody during bad eczema flare ups.
• Zipper onesies with flip over mitts and footies, so you can cover a hand or foot, if needed. The foldover covers are more common in infant onesies but are getting hard to find in bigger toddler sizes! Here’s my 2 favorite brands that each also feature double zippers for easy diaper changes:
  • Little Sleepies bamboo zippies – super soft, stretchy, and lightweight so are especially nice in the summer. At first I thought these would be too thin for winter, but I LOVE them and we just layer if necessary. Only sizes up to 12-18 months have the foldover covers, which I’m bummed about as Nori is just about to outgrow that size. Due to the fabric, these are the only flipover mitts that she cannot break free from!
  • Kids Tales cotton blend zipper rompers – medium to thicker weight fabric. Nori lives in these at home and I love them for travel. Tag is on the outside so you need to trim it off. I’ve been very happy with these (favorites are the pineapple and watermelon print), but FYI I have found a fabric feel inconsistency and had to return one due to a broken zipper. Nori can break free from these foldover mitts overnight (so for bed time, I keep them open but layer a Scratch Me Not over it), however they work temporarily if I need her to stop scratching during a diaper change.
• Bamboo hooded towel + washcloths. These are so soft, and the towel is a generous size.
• Electric gentle nail file to help keep sharp nails from doing too much damage.

Outside of our bathing and bedtime “maintenance” routine, below are other steps we take to help prevent and mitigate eczema flare ups in the family.

3. Gut health and FOOD allergies

• Probiotics. Many have suggested a linkage between eczema and gut health, and the importance of probiotics. I don’t have anything special to recommend – we just give Nori standard kids probiotics by Culturelle or Gerber Soothe drops as a baby. She was put on antibiotics twice as a newborn which likely wiped out a lot of her healthy gut bacteria. Knowing the potential association between antibiotics in infancy and allergies, I wish there was more I could’ve done to not need the anbitiotics.
• Eliminating cow’s milk from mom’s diet while breastfeeding. This is a common blanket suggestion that docs give breastfeeding moms for issues ranging from reflux to eczema to general fussiness. I did not notice any difference after eliminating dairy from my own diet, but have heard from fellow moms who noticed a big difference. Just make sure you’re getting your calcium in other ways so you don’t become calcium deficient.
• Testing for food allergies prior to starting baby on solids. Current American pediatric guidelines encourage introducing babies to common food allergens once they start solid foods (allergens include egg, dairy, peanut, tree nut, fish, shellfish). But if your baby already has eczema, your doc may suggest allergy testing first, in case these foods will worsen their skin condition. According to specialists, about 25% of kids with eczema have a food allergy.
• Our pediatrician had Nori do a blood allergy test when she was 6 months old (and again at 1 year old), and then a more reliable skin test at age 2. Each came back positive for nuts, dairy and egg allergies, along with some others that turned out to be false positives. Most doctors believe babies will outgrow dairy and egg allergies (less hopeful for nuts), so we are currently doing an egg ladder challenge and will hopefully tackle dairy next – see example egg & dairy challenge instructions.
• Also, I’ve heard a lot of great things about the SoCal Food Allergy Institute (currently has a patient waitlist) from readers far and wide, so just wanted to mention them for anyone dealing with severe food allergies.
  
• Nori does develop a skin rash on her hand and mouth after eating certain foods but it usually goes away after we wash the areas with water. Our allergist suggested applying a layer of vaseline around your little one’s mouth prior to eating potential allergy or itchy foods, to minimize contact-related skin irritations.

4. Environmental factors

• Reduce indoor allergens and dust by vacuuming and cleaning regularly around the house, including washing dust mite-trapping objects like stuffed animals and bed linens. We got rid of our big fluffy rugs that couldn’t easily be cleaned. Also this is a given to some, but keep your windows closed during high pollen seasons.
• Keep humidity levels around 40% and make sure to clean your humidifier (it’s a pain, I know). We run a cool mist humidifier only when our heater is on, because excess humidity can then contribute to mold. When we travel, it’s pretty noticeable how Nick’s (and now Nori’s) eczema changes in different climates, to the point that we’ve considered moving for this purpose.
• Keep temperatures cool but comfortable to avoid sweat. Very important for us – sweat immediately triggers Nick and Nori’s flare ups, including if her back gets a little too warm sitting in a stroller or carseat, or if she’s wearing too many layers. We keep our home temperature around 68 degrees and it’s been trial and error on how warmly to dress her overnight to be comfortable without sweat.

5. Contact factors

Being married to someone who has dealt with allergies, asthma and eczema most of his life, this is the norm in our household:

• Laundry:
  • Use a small amount of free & clear, fragrance free detergent. We use this one from Target. Note that unscented is not the same as fragrance free, as sometimes unscented products still have fragrances in them to neutralize odors. I found this article on laundry by a fellow eczema mama to be a helpful read.
  • Machine wash laundry with an extra rinse cycle.
• No / minimal perfumes or fragranced products on us or in the home including soap, lotion, etc. We ask this of house guests and caretakers in our home too since both Nick and Nori are sensitive.
• Clothing and bedding in cotton, silk, or bamboo as mentioned above under our favorite products.

We have gotten a lot of valuable tips and advice from you guys (like the scratch sleeves!), so please feel free to share other things and products that have worked for you and / or your little ones!