Rash Wars

Ugh. My baby has been RASHY for months. They come, they go, they flare up, they calm down. Sometimes they're scaly and dry, sometimes they're a little inflamed and red. They show up mostly on the backs of his arms and shoulders, the backs and sides of his upper thighs, and all across his back. Of course we've consulted the pediatrician (at his 6-month check-up, shortly after all this rash business started), and we were given hydrocortisone cream and advised to use it for only a few days at a time since it is a steroid cream and prolonged exposure has negative side effects. I spent weeks cycling him on and off of it - it would clear up in two or three days, we'd stop the cortisone, and it would come right back within two or three days. That just isn't a regimen that we can continue - it's not a great idea for him to be on a steroid cream constantly, with only a few days' break at a time, and we're not doing that forever - it's just not a solution.

I got some Aveeno Baby Eczema Therapy cream, which has done a great job of keeping his skin nice and moisturized but hasn't eliminated the rashes. We apply it daily after bath time, and sometimes we'll apply a little more directly to the rashes during the day if they're looking dry and scaly. Using the Aveeno at least makes me feel like I'm doing something to help keep the rashes from bothering him, but I WANT THEM GONE, dangit! The good news is that he rarely ever seems bothered by them. I never see him trying to scratch or rub at them, with the exception of a spot at the base of his head that occasionally flares up - I have seen him scratch at that once or twice.

I have considered a variety of sources. First of all, is he just a kid who is going to have problems with eczema? Well, I hope not, but it's certainly a possibility. It may be that there's no environmental trigger - he just has dry skin problems. I don't like that answer, so I'm not stopping there. Contact dermatitis from a detergent or fabric softener? Haven't changed detergents (we use Target's brand of Dreft on his clothes and A&H Free on ours), and I stopped using fabric softener on his clothes a few weeks ago. Now, which of his clothes have been washed with and without fabric softener? Am I going to re-wash ALL of his clothes without, so that I know for sure? If I was even remotely convinced that that was the cause, I would, but I truly don't think it is. I feel like these rashes would be all over him if it was something in his clothes. Not to mention the fact that they're the worst in areas that his clothes don't cover right now, like the backs of his arms down to his elbows (he has been wearing mostly sleeveless and short sleeve shirts for weeks now). I'm more concerned with a food allergy. When this started, he'd had rice cereal, oatmeal cereal, bananas, apples, pears, sweet potatoes and squash. That's my list of concerning foods. He has been off of rice cereal since about 6 months when we switched to oatmeal, so I'm not worried about the rice. I have eliminated pears for over a week, squash for over a week and bananas for about a month, all with no change. So I still have sweet potatoes and apples to try eliminating, but I decided that oatmeal was more likely to be the problem. We've been on rice cereal since Saturday, and I believe we're beginning to see some improvement (!) Here's hoping!

Now, if it was the oatmeal, what does that mean? The box says "may contain traces of wheat", so is it really a wheat allergy problem? Is it gluten? Dear GOD I hope not. Of course I'll do whatever needs to be done as far as feeding my son - if we have to go gluten free, then so be it - I just don't want that for him. I don't want him to have to deal with that! Isn't the whole "one kidney" thing enough? Honestly. But then again, I'm probably getting ahead of myself. It's just a rash at this point. It may not be gluten, and even if it is, perhaps he'll grow out of it. And then again, maybe it isn't a food allergy at all. He doesn't seem to have any internal symptoms. He hasn't had any tummy troubles or gas issues to my knowledge, and has normal stools (of varying color and consistency of course, but never any diarrhea or constipation or particularly dark stools). A gluten intolerance seems unlikely in the absence of internal symptoms. If it is a food allergy it's certainly a mild one, given that the rash seems to be the lone symptom.

If it turns out that eliminating the oatmeal clears it up, I suppose I'll just have to dig deeper into oat and gluten allergies, consult the pediatrician, and try to figure out just how far we should go in terms of avoiding certain ingredients, or when it would be safe to try re-introducing them if it's at all likely that he'll outgrow it. The next question becomes, do I need to change my diet? The knee-jerk answer would be "Of course!", but I've studied enough biochemistry to know that gluten is a big ol' honkin' protein that very well may not pass into breast milk. I would imagine that only the smaller peptide building blocks of gluten would find their way into breast milk, and even then probably only in small quantities. I'll have to look further into this. I have no qualms about adjusting my diet if the need arises - continuing to breastfeed is my priority - but I'd like to be sure that it's necessary before taking that dive!

At any rate, that's what's on my mind these days... always "working on" something! Perhaps next time I'll delve into what's going on in the less baby-centric corners of my life (before those little corners disappear altogether! HA!)... like my new car, or preparing to return to medical school, or household projects... Gee, maybe I do still have a life ;-)