Foods that babies with eczema are allergic to

Based on the "Guidelines for the Diagnosis and Treatment of Food Allergy in Chinese Children (2022 Edition)" and the clinical statistics of domestic pediatric dermatology, the current high-risk foods that are likely to induce allergies in babies with eczema mainly include milk, eggs, wheat, nuts, seafood, and soybeans. However, there are strong individual differences in the allergens of each child, and there is no unified list that all babies with eczema must avoid.

Not long ago, my cousin's little Chengzi, who just turned 1 year old, suffered from eczema for almost two months. She applied hormone ointments as prescribed by the doctor and moisturized her body three times a day. The red rash on her face just wouldn't go away. Finally, she did a food provocation test and found out that she was allergic to millet, which she eats two or three times a week. Instead, everyone assumed that eating high-risk eggs and milk would be fine. This made my cousin, who had given up her favorite milk tea for more than half a month because of dietary restrictions, dumbfounded.

Speaking of which, I have to mention the two mainstream views in the parenting circle on food taboos for babies with eczema. There is no absolute right or wrong, but the applicable scenarios are different. Traditional dermatologists prefer "strict avoidance": if it is clear that eczema worsens significantly after eating a certain type of food, or is even accompanied by vomiting, diarrhea, and respiratory discomfort, then strictly avoid it for 3-6 months. When the skin barrier and intestinal immunity are more developed, try starting with a very small amount, which can help the eczema subside the fastest. It is especially suitable for babies with moderate to severe eczema who repeatedly ooze and itch until they can't sleep all night. In recent years, the immunology community has increasingly advocated the "gradual tolerance school": as long as the food does not cause severe life-threatening allergic reactions such as laryngeal edema and severe breathlessness, there is no need to completely avoid the food. Slowly increase the amount every time you eat it to help the baby's immune system slowly adapt to this food. On the contrary, it can reduce the probability of long-term allergies. It is more suitable for babies with mild eczema who only have localized dry rashes and no allergic reactions in other systems.

Oh, by the way, don’t ban high-risk foods as soon as you see your baby with eczema. I met a new mother last year. Because her baby had two small patches of eczema on her cheeks, she didn’t even dare to touch meat, eggs, or milk during breastfeeding. She only ate white rice and boiled vegetables every day. In the end, the baby’s eczema didn’t heal. She fainted and was sent to the emergency room because of malnutrition and hypoglycemia. It was really unnecessary.

In fact, to confirm whether eczema is caused by a certain type of food, the method is very simple, which is to do a food avoidance provocation test - if you suspect any food, stop it completely for 2 weeks. If the eczema is visibly improved, add the food to the baby alone and observe it for 1 to 72 hours after eating (after all, there are two types of allergic reactions: immediate and delayed). If the eczema worsens significantly, or reactions such as rash, vomiting, red and swollen lips appear, it means you are really allergic to the food, otherwise you may just be overthinking it. By the way, the false positive rate of food IgG testing done by many institutions is very high. Guidelines have long since stopped recommending it as a basis for diagnosing food allergy. Don’t cut off your baby’s food rations with just a report.

There are also many parents who ask me if they are allergic to food and cannot eat it for the rest of their lives. In fact, it’s really not the case. About 80% of babies can gradually develop tolerance to common allergens such as milk, eggs, and wheat by the age of 3. Only a few allergens, such as nuts and seafood, may persist into adulthood. You really don’t need to be too anxious.

My cousin who is a nurse in the dermatology department often says that when we look at children with eczema, seven out of ten parents have excessive dietary restrictions. In many cases, the child's eczema is not caused by food at all, but by wearing too thick clothes, or applying moisturizing cream too thinly and too rarely. Don't focus all your attention on what to eat. Do the basic care first, and it will work better than anything else.