There’s more to learn about baby eczema. Read our Baby Eczema Guide for more information about the causes, treatments, and implications of baby eczema.
There’s one thing that’s become clear in the last few years: babies with eczema are at higher risk for developing food allergies.
In fact, how old a baby is when eczema starts appearing and how bad that eczema is determines the risk of food allergy. Severe eczema is the biggest risk factor for babies for developing food allergies.
The study above found that the earlier your baby’s eczema first appears, and the more severe it is, the higher the risk of food allergy.
Babies who develop eczema very young (age 0-3 months) that need prescription strength medicines (severe eczema), have a 50% rate of food allergy. Babies who develop eczema closer to a year old, and those with mild eczema, only have a 5% rate of food allergy.
Why Does Eczema Cause Food Allergies?
Doctors have long thought that eczema creates the conditions for food allergies to develop. Eczema lesions — the dry, itchy patches of skin — create breaks in a baby’s skin. Food particles can get through these cracks and sensitize your baby to those foods, before they even have a chance to eat them.
Food particles getting through a baby's eczema-prone skin.
While sensitization doesn’t necessarily confirm an allergy, your baby’s body has already decided something is a threat, and is ready to attack that thing every time they come into contact with it.
But not all eczema causes food allergies. New research has proven that the unaffected skin from children with both atopic dermatitis and food allergy was more prone to water loss, had more Staphylococcus aureus bacteria, and had different gene expression. It was the combination of both eczema and a weakened skin barrier that set off food allergies.
Additional research, so far only done in mice, at Boston Children’s Hospital showed that scratching the skin promotes allergic reactions to foods, including anaphylaxis. The study showed that injury to the skin from scratching activated immune mast cells (the same cells that “attack” allergens) all the way in the small intestine.
Both of these studies point to the critical role that controlling and treating baby eczema may have in preventing food allergy. If your baby’s skin barrier is protected with regular use of emollients, and if your baby does not scratch at their skin, having eczema may not lead to food allergies.
Can Eczema be a Symptom of a Food Allergy?
There is no conclusive evidence that the persistent, itchy rash unique to eczema is caused by an underlying food allergy.
Scientists have uncovered how eczema may cause food allergies, but they have not found ways that food allergies can cause eczema. Further, because eczema flares can last for many days, and may take days to appear, isolating food as a cause of eczema is difficult.
Dr. Peter Lio, Assistant Professor of Dermatology and pediatrics at Northwestern University and founding director of Chicago Integrative Eczema Center, spoke to the National Eczema Foundation about this topic. He said that “while there is a group of people who have food reactions that look like an eczema flare-up rather than specific hives, and can take days to manifest, these seem to be pretty rare.”
Despite this, many parents try removing particular foods from their baby’s diet to prevent eczema flares. Peanuts, milk, soy, wheat, fish, and eggs are the most commonly identified culprits. If you believe a food allergy may be the cause of your baby’s eczema, discuss with your pediatrician how to safely try an elimination diet.
Preventing Food Allergies
In both babies with eczema and without eczema, early and regular exposure to a food is the only proven way to reduce the risk of an allergy to that food. Eating 2 grams of peanut, eggs, tree nuts, dairy, and wheat protein 2-3 times a week each, from when babies start solids, has been shown to reduce the chances of those food allergies by 75%.
The current guidelines from the American Academy of Pediatrics decide how & when a baby should start eating foods based on the severity of their eczema.
4- 6 month old babies that have:
- No eczema or food allergies should start eating commonly allergenic foods 3 times a week at home as soon as they can eat solid foods.
- Mild eczema that responds to emollients or over-the-counter medicines should start eating commonly allergenic foods 3 times a week at home starting by 6 months old.
- Severe eczema that requires prescription drugs, egg allergy, or both should see a doctor to get tested for existing sensitization to foods.
- Babies who are not sensitized should begin eating commonly allergenic foods 3 times a week starting between 4-6 months old.
- Babies who are sensitized, but pass a food challenge, should begin eating those foods 3 times a week starting between 4-6 months old.
Only babies with a developed allergy (less than 0.5% of babies) should avoid foods.
How To Introduce Your Baby to Peanuts, Tree Nuts, Eggs, Wheat and Dairy
There are a few rules to follow when feeding your baby allergens:
- Make sure your baby is ready for solids by feeding them pureed vegetables, or baby cereal.
- Feed them each allergen alone, or mixed into a food your baby already likes.
- Always feed your baby their first taste of an allergen on a day when you’ll be awake with them for a few hours.
- After each food has been tolerated, make it a regular part of your baby’s diet.
Lil Mixins is the easiest way to introduce peanuts, eggs, and tree nuts to your baby because the foods are prepared safely, and stir into or sprinkle onto almost anything your baby would eat. In addition to Lil Mixins’ three flavors, adding yogurt and wheat cereal into your baby’s rotation are easy ways to get all the major culprits covered.
Remember that if your baby has eczema, they are more likely to get food allergies. Start feeding your baby all the common allergens by following the 4, 3 , 2, 1 method:
- As early at 4 months old
- 3 times a week
- Serve 2g of the protein each time
- And continue until your baby is 1
Keep learning about baby eczema with more information about the difference between an allergic reaction and eczema.