Baby food allergy symptoms 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.

Intertrigo: advice to parents

September 8, 2021

Diaper rash, or diaper rash, is a common problem accompanied by baby crying.

Irritation of the skin in newborns can occur for various reasons, for example, due to friction or constant contact with moisture under the diaper. In order for the baby to always be comfortable, parents should monitor the hygiene of the baby and the condition of his skin. What to do if you notice redness in a child? nine0003

Features of children's skin

Diaper rash can also appear on the skin of an adult, but the skin of newborns is most prone to inflammation. The reason is simple - the skin of babies is different from the skin of adults, it is much softer, more sensitive and does not yet have the necessary protective functions, so it easily absorbs moisture and is damaged. In addition, there are folds on the body of a newborn child, in which sweat and pollution accumulate, which can trigger the inflammation process. nine0003

Most often, irritation appears in the diaper area - in the groin, on the legs, between the buttocks, but it is also not uncommon for the skin to turn red on the neck, in the armpit area. If the skin is severely inflamed or foci of irritation are present on the entire body and face of the child, urgently seek help from a pediatrician.

Causes of diaper rash

Almost all infants have diaper rash. If you pay attention to the problem in time, you can easily avoid the development of complications. The main causes of diaper rash:

1. Long contact with moisture. Inflammation can appear if the skin has not had time to dry after bathing, and also if the baby is sweating. After bathing, allow the skin to dry on its own or blot moisture with a soft cloth before putting on a diaper or clothing. Dress your child according to the weather and make sure the temperature at home is comfortable.

2. Infrequent diaper changes. Prolonged contact with enzymes in urine and feces irritates the baby's delicate skin. Check the diaper regularly and clean the skin thoroughly. If your baby has diarrhea, change the diaper as often as possible. nine0003

3. The baby has chafing in the diaper or clothes. The problem may arise due to the wrong size. Choose loose-fitting pieces in soft, natural fabrics. The diaper should be fastened securely, but not tight, so that air can circulate.

Treatment and prevention of diaper rash

Even the most attentive parents are not always able to prevent the appearance of diaper rash, because at the initial stage the child may not notice the appearance of irritation, and parents will see the problem only when changing the diaper. Treatment for diaper rash usually depends on the severity:

1. With a mild degree, only redness on the skin is visible, if you start treatment at this stage, you can avoid aggravating the situation.

2. The average degree is characterized not only by redness, but also by the presence of skin damage: erosion, microcracks.

3. At the third stage, pustules and ulcers appear on the reddened areas, the inflamed areas begin to get wet. Often a fungal or bacterial infection joins, which greatly complicates the treatment process. The child may have a fever, loss of appetite, worsen sleep. In such a situation, parents need to urgently consult a doctor. nine0003

To prevent and treat mild diaper dermatitis:

Change diapers more often. It is important that the baby's skin stays dry for as long as possible.
Thoroughly wash the baby's skin after removing the diaper and allow it to dry completely.
Leave the baby without a diaper and clothes for a while to allow the skin to "breathe".
Carefully change the brand of diapers, laundry detergents, baby cosmetics, and food products. Inflammation can intensify against the background of a change in the usual elements of a baby's life. nine0043
Use baby diaper creams and ointments to prevent diaper rash. Such products form a protective barrier, soothe the skin and eliminate discomfort. Stolichki pharmacies offer a wide range of products for the treatment and prevention of diaper rash: Bepanthen, Mustela, Lacri, Uriage, Johnsons baby, Libriderm, etc.

If inflammation does not passes and the situation is aggravated, immediately consult a pediatrician. The doctor will determine the cause of diaper rash and prescribe treatment, which may include medicines to fight infection, drying and anti-inflammatory drugs to quickly heal lesions, and antihistamines. nine0003

Diaper rash in a child - treatment in Moscow

Diaper rash in children is one of the most common problems faced by parents of a newborn. They cause discomfort to the child, lead to violations of the diet, sleep, tearfulness, irritability. If you do not respond in time and do not cope with diaper rash, it is possible to attach secondary microflora and develop bacterial skin lesions - streptoderma, staphyloderma, fungal infections.

Knowing the causes, symptoms, methods of prevention and treatment of diaper rash in children will help parents avoid the protracted course and complications of this disease. nine0003

Features of children's skin

The smaller the child, the more his skin differs from the skin of an adult:

It is thin, delicate, especially the upper stratum corneum.
The lipid barrier on the surface of the skin is still immature, it weakly protects the epidermis from microbes and other damaging factors.
The skin is well supplied with blood.
Easily injured - rub it roughly with a hard towel to form a superficial skin defect. nine0043
Her condition directly depends on nutrition. The slightest deviations in the diet, dysfunction of the gastrointestinal tract lead to skin reactions.

Where does diaper rash usually form? Under a diaper?

Most often, diaper rash occurs in a child on the pope, in the inguinal region and natural skin folds - elbows, knees, near the hand, foot, behind the ears, on the neck. Favorable conditions are created here - high humidity, which, with little friction or malnutrition, leads to damage to the epidermis. nine0003

Given that the child cannot control the natural physiological functions, the area of the perineum is most exposed to wetting. If we add to this the possibility of rubbing the skin with a diaper, it is clear where redness first appears and the skin peels off.

Diaper rash and similar skin manifestations may appear not only in childhood. Among adults, they primarily disturb obese people on the inner surface of the thighs, in the groin, under the breasts, and under the armpits. In infancy, up to 75-80% of children at least once encounter this pathological phenomenon. nine0003

Are diaper rash and diaper rash in newborns the same thing?

High humidity always contributes to skin damage. With prickly heat, there is a general overheating of the child, increased sweating and a skin reaction in the form of redness, itching, and peeling. The skin is covered with vesicles and pustules. Typical localization - in the folds of the skin on the neck, armpits, under the knees, on the back.

Diaper rash is more associated with improper care of delicate baby skin. They appear with a rare change of diapers, a rare or improper bathing of a child, if the baby spends all the time in a diaper and his skin does not breathe. nine0003

Causes

The main causes of diaper rash are the characteristics of children's skin and high humidity. Diaper rash in children is caused by:

overheating of the child and increased sweating;
poor hygiene, infrequent diaper changes;
mechanical irritation of the skin with a diaper (inappropriate size, poor quality material), synthetic fabrics, rough seams on clothes;
allergic reactions to certain products (food allergy) or soaps, detergents, creams (contact allergy). nine0043

Increase the likelihood of diaper rash:

insufficiently thorough wiping of the skin after water procedures;
unsuitable hygiene products;
temperature fluctuations;
concomitant pathology in a child - overweight, metabolic disorders, lactose intolerance, tendency to diarrhea, diathesis;
also more vulnerable are formula-fed babies, premature babies, after birth trauma. nine0043

At the initial stages of the disease, it is enough to eliminate the causative factors; in case of severe diaper rash, the appointment of therapeutic ointments, baths, preparations inside is required.

Classification of diaper rash in a child

Diaper rash in a child may differ in course, etiology, localization, presence of a microbial component:

Diaper dermatitis is a classic diaper rash, prolonged contact of the delicate integument of the body with fecal enzymes and urine salts leads to skin irritation. Localization - intergluteal folds, inguinal-femoral, lower abdomen. nine0043
Allergic dermatitis is associated with exposure to a specific allergen. Most often, an allergic skin reaction occurs with the introduction of a new complementary food product or with errors in the diet of a nursing mother. An allergic disease may occur during antibiotic treatment.
Microbial dermatitis - candidiasis when affected by fungi, the rash affects mainly the genital area.
Impetigo with penetration of streptococci and staphylococci. Characterized by rashes of the type of bubbles, a temperature reaction is possible, the formation of pustules. The gluteal region is most commonly affected. nine0043
Seborrheic eczema is caused by dysfunction of the sebaceous glands. On the priest and in the groin area, hyperemia with clear boundaries is formed, the tissues are swollen, have a greasy sheen.
Intertrigo - accumulation of moisture in the folds with the appearance of redness. For treatment, it is enough to eliminate the factors leading to increased skin moisture.

Diaper rash is more severe in children with reduced immunity and concomitant diseases.

Grades and symptoms

There are three degrees of diaper rash in a child:

Slight redness on the folds of the skin, the general condition is not disturbed, there are no skin defects.
Redness intensifies, there are small rashes along the folds. The child painfully reacts to changing clothes, changing diapers, washing, wiping. If he reaches the place of diaper rash with his hands, he can comb it.
The area of the lesion of the skin area increases. Cracks, ulcers, inflammatory and purulent elements are visible on a red background. The child is capricious, eats poorly, sleeps restlessly, the temperature may rise. nine0043

When is it time to see a doctor?

If the redness increases, cracks, erosion appear, they cause anxiety in the child, affect his sleep, appetite, you need to see a doctor. It is not necessary to treat the second, third degree of diaper rash on your own. If parents are faced with the occurrence of such a disease for the first time, it is better to show the child to the pediatrician immediately. The specialist will quickly and accurately identify the cause, help to establish nutrition and care for the baby.

Diagnosis

The doctor asks the parents how often they change the diaper, wash the child's perineum, what they feed him. On examination, the specialist assesses the degree of development of the subcutaneous tissue, draws attention to the redness of the skin in the folds, its intensity, size. It looks exactly where the integrity of the skin is broken, how deep the wounds are.

He also assesses the development of the child - neuro-emotional, physical. Additional tests help rule out other skin diseases:

scraping from the affected area of the skin to detect microflora.
allergy tests to determine the cause of an allergic reaction.
analyzes of urine, blood, feces.

According to the indications, a consultation is held with a pediatric allergist, nutritionist, dermatologist, gastroenterologist.

Treatment

For treatment, the doctor:

will adjust the diet of mother and child;
will select ointments and medicines, tell you how to treat diaper rash in a child; nine0043
will teach you how to properly care for the crotch area.

The most commonly prescribed medicines are:

Products with zinc, talc, tannin have an anti-inflammatory effect, accelerate wound healing. They are prescribed for the second degree of diaper rash.
Panthenol, cetrimide, benzalkonium accelerate the regeneration of the epidermis and the closure of skin defects.
Bathing a baby in decoctions of herbs with a drying effect helps to remove weeping and heal erosion. Recommended sequence, oak bark, chamomile. nine0043
If the allergic nature of diaper rash is detected, the diet is limited, in more severe cases, desensitizing agents are prescribed, ointments with glucocorticoids are used topically. Such drugs should not be used on their own, they can lead to serious side effects.
If inflammation has joined in places with a skin defect, local use of antibacterial ointments, synthomycin emulsion, silver nitrate, zinc preparations is indicated.

The doctor sometimes prescribes UVR to the affected area. Ultraviolet has an antimicrobial effect and improves the functioning of the immune system.

Prevention

Diaper rash can be avoided by following these recommendations:

Examine the baby's skin every time you change clothes and diapers, immediately pay attention to redness.
With slight redness, powder, powder, oils, baby cream will help. You need to apply them on clean skin, after washing under running warm water with baby soap and gently blotting the skin. nine0043
Change diaper frequently. After a bowel movement, diapers should be changed immediately. There are products that are applied to the skin before putting on a diaper, they reduce skin contact with a humid environment.
Bathe the child every day in a bath with decoctions of medicinal herbs or a weak solution of potassium permanganate. It helps to wash away the products of skin secretion of sweat and sebaceous glands. Otherwise, they cause irritation and the formation of diaper rash. If it is not possible to bathe the baby or he is sick, wash the folds with warm boiled water once a day and blot dry. nine0043
Prevent overheating of the child. The room should be ventilated, maintain a comfortable air temperature (18–20 degrees), dress the child according to the weather, take change of clothes, take off warm clothes indoors.
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