Baby food allergy diaper rash

Characteristics of persistent diaper dermatitis in children with food allergy

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. 2019 Sep;36(5):602-606.

doi: 10.1111/pde.13733. Epub 2018 Nov 28.

Mehmet Halil Celiksoy¹, Erdem Topal², Zeynep Hazıroglu Okmen³, Cem Alataş⁴, Mehmet Semih Demirtaş⁴

Affiliations

¹ Department of Pediatric Allergy and Immunology, Gaziosmanpasa Taksim Education and Research Hospital, Health Sciences University, Istanbul, Turkey.
² Department of Pediatric Allergy and Immunology, Medical Faculty, Inonu University, Malatya, Turkey.
³ Department of Pediatrics, Gaziosmanpasa Taksim Education and Research Hospital, Health Sciences University, Istanbul, Turkey.
⁴ Department of Pediatrics, Medical Faculty, Inonu University, Malatya, Turkey.

PMID: 30488541
DOI: 10.1111/pde.13733

Mehmet Halil Celiksoy et al. Pediatr Dermatol. 2019 Sep.

. 2019 Sep;36(5):602-606.

doi: 10.1111/pde.13733. Epub 2018 Nov 28.

Authors

Mehmet Halil Celiksoy¹, Erdem Topal², Zeynep Hazıroglu Okmen³, Cem Alataş⁴, Mehmet Semih Demirtaş⁴

Affiliations

¹ Department of Pediatric Allergy and Immunology, Gaziosmanpasa Taksim Education and Research Hospital, Health Sciences University, Istanbul, Turkey.
² Department of Pediatric Allergy and Immunology, Medical Faculty, Inonu University, Malatya, Turkey.
³ Department of Pediatrics, Gaziosmanpasa Taksim Education and Research Hospital, Health Sciences University, Istanbul, Turkey.
⁴ Department of Pediatrics, Medical Faculty, Inonu University, Malatya, Turkey.

PMID: 30488541
DOI: 10.1111/pde.13733

Abstract

Background/objectives: Diaper dermatitis is often caused by irritant contact occurring beneath the diaper of an infant, and it is aggravated by factors such as dampness, friction, urea, and feces. Food-allergic patients are known to exhibit various skin lesions ranging from urticaria to eczema. This study aims to determine the relationship between persistent diaper dermatitis and food allergy.

Methods: A retrospective chart review was conducted of pediatric patients with a diagnosis of persistent diaper dermatitis between August 2015 and November 2017.

Results: The study included 157 patients diagnosed with persistent diaper dermatitis (67 male, 72 female; median age: 13 months). Diaper dermatitis was more common and included the whole perineum in children who had multiple food allergies (P = 0.001). In children with multiple food allergies, the course of diaper dermatitis was more severe, and the condition did not respond to topical treatment (P = 0.025). A longer elimination diet was required for patients with Type I reactions and persistent diaper dermatitis (P = 0. 018). In patients with Type II and mixed reactions, diaper dermatitis was more diffuse and covered the whole perineum (P = 0.025). In patients with Type II and mixed reactions, diaper dermatitis was more severe and did not respond to topical treatment (P = 0.025).

Conclusions: Persistent diaper dermatitis lasting longer than a month may be associated with food allergy. The diaper rash may also be the only indicator of the food allergy. Elimination of the responsible food may allow these patients to recover from persistent diaper dermatitis.

Keywords: allergy; diaper dermatitis.

Cited by

Imaging reveals distinct textures at three infant skin sites and reflects skin barrier status.
O Visscher M, Narendran V. O Visscher M, et al. Skin Res Technol. 2021 Mar;27(2):145-152. doi: 10.1111/srt.12925. Epub 2020 Jul 17. Skin Res Technol. 2021. PMID: 33085142 Free PMC article.

References

REFERENCES

1. NIAID-Sponsored Expert Panel, Boyce JA, Assa'ad A, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010; 126(suppl):S1-S58.
1. Burks AW, Tang M, Sicherer S, et al. ICON: food allergy. J Allergy Clin Immunol. 2012;129:906-920.
1. Lack G. Clinical practice. Food allergy. N Engl J Med. 2008;359:1252-1260.
1. Klunk C, Domingues E, Wiss K. An update on diaper dermatitis. Clin Dermatol. 2014;32:477-487.
1. Jordan WE, Lawson KD, Berg RW, Franxman JJ, Marrer AM. Diaper dermatitis: frequency and severity among a general infant population. Pediatr Dermatol. 1986;3:198-207.

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Are Food Allergies Causing Your Baby’s Diaper Rash? – Cleveland Clinic

The skin is our largest organ. When it’s irritated, it’s almost impossible to ignore.

When it’s our baby’s skin that’s irritated, it’s somehow even worse.

Diaper rash comes in many varieties and has many causes, so it often takes time and experimentation to figure out what’s bedeviling your baby’s bum. If you’ve ruled out the diaper, wipe or — in the case of cloth diapers — laundry detergent as the cause of the irritation, it may be time to look at what your kiddo’s consuming.

Diaper rash vs. allergic reaction

First things first, let’s get our vocabulary straight. In the vast majority of cases, a child’s diaper rash isn’t the result of a food allergy. It’s the result of an intolerance.

While a lot of people use the terms “allergy” and “intolerance” interchangeably, they have specific medical definitions.

If a diaper rash is the only symptom you’re seeing, it’s unlikely your child is dealing with a food allergy.

An allergic reaction occurs when your immune system perceives the food you’re eating as a threat. The resulting response can look like a lot of different things, from hives and shortness of breath to full-blown anaphylaxis.

Allergic reactions can be severe and potentially life-threatening. If you think your child has a food allergy, you should get them immediate medical attention.

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A food intolerance isn’t exactly a barrel of monkeys either, but it also isn’t nearly as serious. “Intolerance” means your digestive system — or in this case, your wee one’s digestive system — can’t properly break a food item down.

Because food intolerances are purely a digestive issue, so, too, are the symptoms. Think diarrhea. It’s not pleasant, but — provided your baby isn’t dehydrated — it’s not an emergency either.

And the transition from breast (or chest) milk (or formula) to solid food is a big one. A few bumps in the road are to be expected, especially if your baby’s an adventurous eater.

According to pediatric allergist Sandra Hong, MD, “If a child has a food intolerance that causes frequent loose bowel movements, it will cause their buttocks to become red and sore, primarily because of the constant cleaning and irritation from frequent diaper changes. ”

In addition to monitoring their bowel movements, look out for redness and irritation around your little one’s mouth and anus. That could be a sign that they aren’t quite ready for the newest addition to their menu.

Foods that cause diaper rash

Acidic foods can be particularly rough on tiny tummies. Among the most common culprits are:

Berries, like strawberries and blueberries.
Tomatoes and tomato-based foods.
Citrus fruits, like oranges, lemons and limes.
Tart fruits, like pineapples, plums and peaches.

In other words: If it gives you heartburn, it could give your baby butt burn.

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That doesn’t mean fruit is off the menu. Apples, bananas, papayas and melons of all types are still fair game.

Tips to avoid diaper rash

If you’ve dealt with traditional diaper rash before, you’re probably already familiar with the basics of treatment and prevention. Dr. Hong reminds us that, whatever the cause of the diaper rash, “good barrier technique and a diaper cream high in zinc can be helpful.”

But how do you prevent diaper rash provoked by a food sensitivity?

You cut the offending food — or foods — from your baby’s diet.

Keep in mind, you’re not robbing your child of pineapple salsa for life. You’re just giving their little bodies time to adjust to solid foods before routinizing items they find particularly challenging.

Of course, if your child has a diagnosed food intolerance — like lactose intolerance or gluten sensitivity — you need to feed them accordingly to avoid diarrhea-induced diaper rash.

The bottom line

If your baby’s bum has seen better days, it’s possible that their diet is to blame. Food intolerances are common during the transition to solid food. Try cutting back — or cutting out — high-acid fruits. You’ll be able to reintroduce them as their digestive system adjusts.

Diaper dermatitis in children - how to treat, what ointment to use?

What kind of skin does a newborn baby have?

During the first year of life, many skin functions are immature in children. After birth, the child enters new conditions for himself, his skin must provide mechanical protection, maintain optimal body temperature, prevent the penetration of microorganisms, and prevent moisture loss.

Protective mechanisms of the baby's skin may be insufficient due to friction, mechanical or thermal damage, excessive exposure to the sun, prolonged contact with moisture, and some skin diseases. Additional risk factors for its damage include the genetic characteristics of skin proteins (primarily filaggrin), early age, disruption of the structure of ceramides (for example, with low consumption of polyunsaturated fatty acids), contact with an aggressive / unfavorable external environment, stress, and various disorders. trophism, often associated with a problem of the nervous system, with poor nutrition, with improper skin care or with inadequate treatment. nine0005

It would seem that the skin should be washed as often as possible, but the frequent use of detergents leads to a thinning of the barrier lipid layer and makes the skin more vulnerable to the action of pathogenic microorganisms, increases moisture loss.

Original grease, what is it and what to do with it?

When your baby was born, his skin was covered with a primordial lubricant called ( Vernix caseosa ) is a kind of protective film that is unique to humans.

This lubricant promotes the maturation of the upper layer of the skin, contains antimicrobial substances that are active against bacterial and fungal pathogens, improves hydration, reduces moisture loss, thereby maintaining its firmness and elasticity, helps to change the pH of the skin to an acidic side, which facilitates colonization beneficial microflora after birth. And the presence of the amino acid glutamine in its composition promotes rapid cell proliferation, provides trophic function and restoration of the skin in case of damage. nine0005

What happens when you don't take good care of your skin?

Incorrect skin care in children often causes diaper dermatitis or sometimes it is called diaper rash ,

An important factor in the development of this inflammation is prolonged contact of the skin with the wet surface of the diaper, which leads to maceration and damage. The irritating effect of urine, feces, digestive enzymes, changes in the acidity of the skin under the diaper, bacterial and fungal infections play an important role in the development and maintenance of the inflammatory process. Such a child develops redness, slight peeling, and later superficial erosions may appear on the convex surfaces of the genitals and buttocks, exactly where there is good contact with the diaper. The child becomes restless, cries during a diaper change, while toileting the skin of the buttocks and genital area. If you did not take action in time, then after a couple of days a secondary infection is added, a fungus - candida often joins and we have a bunch of additional problems. The inflammatory response intensifies, spreads and causes even more anxiety for the child and the parents. In some cases, a severe but fortunately rare variant of diaper dermatitis can develop - called Jacquet's erosive dermatitis. nine0005

In which there are characteristic ulcers with clear edges and erosions with raised edges.

What can provoke the development of diaper dermatitis

Skin irritation from feces

Excess close-fitting diapers or clothing that rubs the skin. nine0076
Irritation from new clothes and hygiene products - the skin may react to baby wipes, a new brand of disposable diapers, or detergent, bleach or fabric softener used for washing, ingredients found in some baby lotions, powders and oils.

Bacterial or fungal infection . However, what started as a local skin infection can spread to other areas. The area covered by a diaper - the buttocks, thighs and genitals - is particularly vulnerable because it is a warm and humid area, making it an ideal breeding ground for bacteria and yeast. Such rashes can also be found in the folds of the skin, characteristic red dots may appear around. nine0076
New food children. When babies start eating solid foods, the amount of stool changes and frequency may increase, which in turn increases the chance of diaper rash. If your baby is breastfeeding, he may develop diaper rash in response to what mom ate.

Soft leather . Children with skin conditions such as atopic or seborrheic dermatitis may be more likely to develop diaper rash. nine0076
Antibiotic use . Antibiotics kill bacteria - both good and bad. This is their job. This reduces the number of bacteria that control the growth of fungi / yeast, which leads to an easy occurrence of fungal infection in the area of diaper rash. The use of antibiotics also increases the risk of diarrhea. Infants whose mothers take antibiotics are also at an increased risk of diaper rash.

Basic principles for preventing diaper rash :

The best way to prevent diaper rash is to keep the diaper area clean and dry .

Use quality diapers which have good absorption characteristics;

Change the diaper as soon as possible after a bowel movement, if necessary, do this while the baby is sleeping. nine0076
For contaminated skin use tap water and mild cleansers , such as special baby soap, pH neutral and fragrance free. Do not use wipes containing alcohol or fragrances.

Do not rub the skin, when you wash it, try to get the area wet when you wipe your bottom, rubbing can increase skin irritation. After you've washed your butt, try laying your baby on a large towel and playing with it until the skin is dry. nine0076
Do not use solutions containing alcohol in the diaper area , it will dry out the skin

Do not overtighten diapers . Tight diapers prevent air circulation, creating a moist environment that is conducive to the appearance of a rash. Overly tight diapers can also cause irritation around the waist or hips.

Give your child the opportunity to be without a diaper for a while . At least three or four times a day for 10 minutes.

Bathe the child daily until the rash is gone. Use warm water with mild soap, unscented

When using reusable diapers, , use neutral baby ointment , which will significantly reduce the risk of skin irritation and create a kind of layer between the skin and the diaper. It does not contain medicinal components or metals. This is an ointment for prevention, not for treatment. nine0076
Use ointment regularly . If your baby has frequent breakouts, apply a protective ointment at every diaper change to prevent skin irritation.

After changing diapers wash your hands well , this will reduce the risk of spreading bacteria or yeast to other parts of the baby's body.

Use of powders such as corn starch or talc is not currently recommended by doctors.

European principles for the prevention of dermatitis - ABCDE prevention standard

A ir - aeration

B arrier - protection and preservation of the barrier properties of the epidermis: avoid the use of aggressive hygiene products, alcohol-based lotions, fragrances or powders. Use emollients, ointments that restore the barrier function of the skin, have a regenerating and anti-inflammatory effect. nine0076
C leaning

D iapper - careful selection of diapers and diaper change as soon as possible after a bowel movement.

E ducation - parenting education. Creation and implementation of training programs.

What else the doctor may prescribe, e If the rash persists despite home treatment:

Corticosteroid cream, such as hydrocortisone

Antifungal Cream

Topical or oral antibiotics if there is evidence of bacterial infection

May recommend seeing a skin specialist (dermatologist).

When should I see a doctor as soon as possible - for diaper rash?

When the rash looks unusual, there are pustules or watery blisters

If the child gets worse despite home treatment

If there is bleeding, itching or mucus

If you notice that the baby is crying when urinating or defecation

If skin changes are accompanied by fever

How to choose an ointment for the prevention and treatment of diaper dermatitis? What qualities should such an ointment have?

Proven to be clinically effective and safe in children

Improve natural skin protection

Maintain optimal humidity levels

Contains ingredients with documented safety and benefits

Free from unnecessary, potentially toxic substances, sensitizers and irritants, fragrances, antiseptics and preservatives.

At the same time, it has a pleasant texture and is easy to apply to the skin.

Today, it is recommended to use substances that enhance the natural protection of the skin, improve its regeneration and create a protective barrier between the skin and external irritants, while allowing the skin to breathe. One of the best, to date, means for the prevention and treatment of diaper dermatitis is ointment which contains dexpanthenol and lanolin.

Dexapentol or provitamin A is quickly absorbed by the skin, after which it turns into pantothenic acid, which plays a central role in the metabolism of each cell and has regenerative, wound healing and protective properties, participates in metabolic processes.

Pantothenic acid is an integral part of coenzyme A, which is found in the membranes of all healthy cells, participates in the regeneration of the skin and mucous membranes, normalizes cellular metabolism, accelerates cell division, increases the strength of collagen fibers, has a slight anti-inflammatory effect, improves the healing of damaged skin. One of the advantages of dexpanthenol is that it has a small molecular weight, easily penetrates into the deepest layers of the skin, attracts water to itself, this allows you to nourish and moisturize the skin at the deepest level. In addition, it has a good evidence base in European studies. Another very useful component is lanolin which provides additional moisture to the skin, forms a protective barrier against external irritants.

This is a completely natural component, produced by the sebaceous glands of sheep, the composition is very similar to the secretion of the human sebaceous glands. Lanolin has excellent moisturizing and softening properties, it is able to hold twice as much water as it weighs. It protects the skin by forming a thin film on its surface, preventing skin friction in the places of folds, which is one of the causes of dermatitis. This substance is approved in the USA for use in newborns, and for the treatment of the nipples of a nursing woman as a wound healing agent. nine0005

Diaper dermatitis prevention and treatment
Thus, Diaper dermatitis is a combination of delicate baby skin and insufficient care for it. By following the simple rules of care, washing and using ointment for prevention, you can ensure that your child will have healthy clean skin and delight you with his good mood!

Video - diaper dermatitis treatment and prevention

Let your children be healthy and successful!

how it manifests itself, what it looks like, what to do, how long it takes for a newborn to be allergic to formula

We deal with the signs of intolerance to baby food and answer the question of what to do if the baby has an allergy to infant formula.

Nutrition for babies in the first year of life if breastfeeding is not possible should be prescribed by a pediatrician. He will definitely ask about the presence of allergies in parents and close relatives, ask about how the pregnancy went, did the mother take antibiotics, does the mother have bad habits. These are all risk factors for food allergies in babies. nine0005

How infant formula allergy manifests itself

The reaction to an allergen manifests itself through different body systems. Here are the symptoms of a food allergy:

On the skin : redness that starts on the face and spreads throughout the body, small blisters, peeling

From the digestive system : regurgitation fountain, loose stools, especially green, constipation, bloating, colic

Respiratory : shortness of breath, cough, wheezing

How long does it take to become allergic to the mixture

How quickly the disease will make itself felt depends on the characteristics of the child's health. In some babies, the first signs of allergies occur immediately after feeding. In others, the allergen will manifest itself only after a few days, when it accumulates in the body. In any case, you should immediately contact a specialist who will diagnose and prescribe adequate treatment. nine0005

Allergy to hypoallergenic formula

Hydrolyzed mixtures are called hypoallergenic - those where the milk protein is split into amino acids and peptides, which are easily absorbed by the body and in most cases do not cause an undesirable reaction. They are prescribed in cases of severe allergies. They are bitter, and babies are reluctant to eat them.

However, an undesirable reaction can also occur on a hypoallergenic mixture. That is why only a pediatrician should recommend the mixture and select treatment in case of an allergy. nine0005

Why are babies allergic to formula?

The reasons are different. A doctor and tests will help to deal with them.

The most common of the reasons:

temporary or congenital lactase deficiency. The tests prescribed by the pediatrician will help to establish this reason. And treatment can be a temporary or permanent transition to a lactose-free mixture, such as soy. How to recognize lactase deficiency, read the article of our pediatrician. nine0076
allergy to animal protein - casein. After passing the analysis, the doctor will recommend replacing the mixture with soy or hydrolyzed. Read more about lactase deficiency and cow protein allergy in our article.

incorrect transition to artificial feeding or a new mixture. Learn how to change the mixture so as not to harm the baby's body.

rotavirus infection. This is a temporary, but rather acute condition, during which the child needs special nutrition. Learn more about nutrition during rotavirus. nine0076
excess food. This is the most common cause of allergic dermatitis in artificial babies who cannot regulate the amount of formula they eat. Why this happens, find out from our material.

formula is not suitable for your baby. Children prone to allergies may react to the composition of improved mixtures enriched with vitamins and trace elements. How to understand what exactly caused the allergy? It is necessary to pass tests and follow the advice of a pediatrician to switch to a suitable mixture. nine0076

What to do

Regardless of whether treatment is required, a reduction in the volume of the mixture eaten or a transition to a new diet, the appointment should be made by a doctor.

Therefore, the first thing to do is to contact a pediatrician who will establish the cause, possibly offer to take tests and prescribe treatment.

Soy formulas for allergies

Soy infant formula is prescribed for allergies to animal protein - casein. And in the absence of allergies to soy. Therefore, if the doctor has prescribed an analysis for an allergy to animal protein, ask if it is worth immediately taking an analysis for a reaction to soy protein. nine0005
Soy nutrition is an absolutely complete replacement for dairy nutrition until the transition to adult food.
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