From the August 2019 issue

Common Baby Skin Conditions

A pediatric nurse practitioner from Children's Hospital of Michigan offers insight on eczema, cradle cap and other common skin issues.

For new parents, it can be surprising when your newborn’s skin is as silky and smooth as you expected. Oftentimes, the skin can have dry patches, white bumps and even scaliness.

An infant’s less-than-perfect complexion may cause new moms and dads some concern, but most of the time these skin conditions are benign.

“If a rash is something you need to be worried about, the rash will let you know,” says Cortney Mazur, R.N., MSN, CPNP-AC, a pediatric nurse practitioner at Children’s Hospital of Michigan in Detroit.

Mazur, also a mom of two daughters ages 4 and 18 months, says most baby rashes resolve on their own within one to two months of age.

As for eczema, which impacts 10-20 percent of all infants, this skin condition tends to resolve by age 4 or 5. However, “about 10 percent of kids will continue to have chronic eczema for the rest of their life,” Mazur says.

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So, what are the signs of eczema, how can tell if your child has cradle cap – and what are the best treatment options? Read on for insight.

Eczema

Also known as atopic dermatitis, this condition – which causes the skin to be red, itchy and scaly – is often hereditary.

“You’re more likely to have eczema if your parents or siblings or other family members have eczema,” Mazur says. “Eczema tends to go hand-in-hand with allergies and asthma, as well.”

In some cases, however, it can simply be the luck of the draw.

“Baby’s skin is very sensitive and it can be affected by a lot of different things,” Mazur says.

When it comes to treatment for eczema, keeping the skin moisturized is key. You don’t want the skin to get too dry, she says.

While you only need to bathe your baby two to four times per week, if he enjoys bath time, you can bathe him daily. When doing so, use lukewarm water and soap that is free of fragrances and dyes – and limit bath time to 10 to 15 minutes.

After the bath, pat the skin gently to leave the baby’s skin damp. Apply moisturizer such as Eucerin or Aquaphor – at least once a day or up to four times per day.

When washing baby’s clothes, use Dreft detergent or any detergent that is fragrance-free. Avoid fabric softener.

Dress your baby in looser-fitting clothing that’s 100-percent cotton. Be sure to avoid overdressing the child, she suggests, as he or she could end up getting heat bumps.

If you follow those instructors for one week, but your child still has areas that are red and rough and dry, talk to his pediatrician about using a steroid, Mazur suggests.

Cradle cap

Cradle cap, which affects 10 percent of infants up to the age of 1 month old, can be an itchy and irritating condition for infants.

“It looks like scaling in their baby’s hair or at the hairline that can sometimes have a yellow crusting on the scalp,” Mazur says.

To help alleviate, Mazur suggests rubbing baby oil or mineral oil into the scaly areas. “Rub it on there and take a really soft bristle toothbrush to massage the area,” she says. “The key to this is that parents have to wash the hair with baby soap to get that excess oil out.”

This can be done once daily. While it will go away on its own, if it doesn’t start to look better, see your child’s doctor to get an antifungal shampoo or topical steroid.

When to worry

While Mazur stresses that most infant skin conditions are harmless, there are a few red flags to look out for.

“Anytime there’s a clear fluid-filled blister, we worry about herpes infection, and we worry about that within the first couple months of life,” Mazur says. It’s especially worrisome if it’s accompanied by a fever.

Small red or purple dots on the body that don’t blanche or go away when you press on them are also a cause for concern. Known as petechiae, these dots occur as a result of bleeding under the skin.

If any area of the skin is oozing pus or is hot to the touch – or the rash is associated with the baby not waking up to feed or a fever – sometimes the rash can be a presenting factor of something more serious, Mazur says.

It’s important to contact your child’s pediatrician immediately.

While most skin conditions resolve with time, it’s important to trust your mother’s intuition, Mazur suggests.

“Ask the silly questions,” she says. “Don’t Google when it comes to rashes – and trust your pediatrician.”

For more information, visit the Children’s Hospital of Michigan website.

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