Why Does Eczema Increase the Risk of Food Allergies
Why are babies with eczema 6 times more likely to develop food allergies? And what can parents do to prevent them?
In honor of National Eczema Month, we’re sharing about the connection between eczema and food allergies, and the link might surprise you.
To start, what is eczema?
Eczema is a condition that causes the skin to become itchy or inflamed and creates a rash-like appearance. It is not contagious and while the exact cause is unknown, researchers believe it’s caused by a combination of environmental triggers and genetics. According to the National Eczema Association (NEA), over 31 million Americans have some form of eczema.
Eczema also impacts 20% of children, and young children with eczema are 6 times more likely to develop a food allergy than their peers without eczema.
So what’s the connection? How does eczema increase the risk of food allergies?
According to the Dual-Allergen Exposure Hypothesis, when exposure to a food occurs through the skin, it can lead to sensitization and potentially the development of a food allergy, whereas exposure to a food through the gut (oral consumption), leads to tolerance.
Eczema causes small breaks in the skin, which increases the likelihood of exposure to potential food allergens (such as peanut protein) through the skin barrier, therefore increasing the likelihood of developing a food allergy.
One way we see that play out, according to pediatric allergist Dr. Gideon Lack, is that typically the most common food allergies in a given country also tend to be the most common foods in that culture. “In Scandinavia we see elevated rates of fish allergies, whereas in the U.S. there are more peanut allergies,” says Dr. Lack. “This happens because families are eating and cooking with these foods so they are in the household environment, but babies aren’t eating them, so their primary exposure comes through the skin.”
“Eczema tends to develop earlier in life than food allergies,” says Dermatologist Dr. Amy Kim, “So there is a crucial window for intervention starting as early as 4-6 months when it is critical to both aggressively control eczema and establish oral tolerance to prevent a food allergy from developing.”
Can I prevent eczema and food allergies?
If your child has eczema, you might be asking, “What can I do?” Here are some simple things you can do to decrease your child’s chances of developing food allergies.
Manage and treat your child’s eczema. The NEA encourages a daily bathing and moisturizing routine to keep the skin clean and to prevent dryness. Apply over-the-counter or prescription medication as directed. Avoid skin products that cause further itching or irritation. As always, consult your child’s doctor before beginning a new treatment plan.
Limit allergen exposure through the skin. The LEAP (Learning Early About Peanut Allergy) Study by Dr. Gideon Lack showed the importance of establishing oral tolerance to peanut protein BEFORE these proteins penetrate the skin barrier. After handling peanuts or other potential allergens, wash your hands thoroughly before touching your child. Avoid putting peanut butter or any creams or oils that contain peanut oil on your child’s skin.
- Introduce early, oral, peanut exposure. Based on Dr. Lack’s landmark clinical trial, the LEAP Study, The American Academy of Pediatrics and The National Institute of Allergy and Infectious Diseases now recommend that children, especially those with eczema, regularly consume peanut foods, starting as early as 4-6 months, to help prevent peanut allergy. The recommendations for how and when to introduce peanut foods depends on your child’s risk factor which correlates to the severity of their eczema.
High Risk (If your infant has severe eczema, egg allergy, or both): Talk to your doctor before giving any peanut foods to your baby. Your doctor may recommend allergy testing or introducing peanut foods under medical supervision. Once cleared, high risk infants should start peanut foods as early as 4-6 months and consume 6 grams (1 teaspoon) per week to help prevent peanut allergy.
Moderate Risk (If your infant has mild to moderate eczema): Introduce peanut foods around 6 months of age to reduce the risk of developing a peanut allergy. Depending on your preference, you can introduce peanut foods at home or in your doctor’s office under supervision.
Low Risk (No eczema or food allergy): Freely introduce peanut foods into your child’s diet at home in an age-appropriate manner together with other solid foods.
How exactly do I introduce peanuts to my baby?
If you’ve talked with your pediatrician and decided that your baby is ready to start peanut foods, you might be wondering how you’re supposed to feed peanuts to a gummy, toothless baby! It’s important to note that peanuts and peanut butter must never be given to an infant because of the choking risk.
The NIAID Guidelines outline how to introduce peanuts for the first time, the signs of an allergic reaction, and the following recipe suggestions for regularly including peanut in infant’s diets:
- Thinning peanut butter with warm water until desired consistency is achieved.
- Mixing peanut butter into fruit or vegetable puree.
- Adding peanut flour or peanut butter powder into fruit or vegetable puree.
- Peanut puffs that can be softened with water for infants less than 7 months of age.
Mission MightyMe’s Proactive Peanut Puffs were developed for exactly this purpose by Dr. Gideon Lack, who led the landmark research that formed the new feeding guidelines.
“We know that between the U.S. and the U.K. almost 100,000 children develop an allergy to peanut each year,” says LEAP Study author and Mission MightyMe Co-founder Dr. Gideon Lack. “We ought to be able to prevent the majority of those new cases. That is very much our mission and the reason we started Mission MightyMe.”
Remember that all babies, not just those with eczema, can benefit from early peanut exposure and the new 2020 USDA Guidelines Report recommends that all babies start peanut and egg as early as 4 months to prevent allergies to those foods.
Don’t miss the magic window. Make peanut foods a regular part of your infant’s diet with Mission MightyMe’s Proactive Peanut Puffs.
Photo by @Tubbytodd