Atopic dermatitis, or eczema, affects between 10 percent and 20 percent of children. The first signs of the condition typically appear in early infancy. Sometimes, symptoms resolve by puberty.
Many parents of children with eczema wonder if they could have prevented the condition. While some pregnancy factors may lead to an increased risk of childhood eczema, genetics and environmental factors also play a role, making eczema impossible to prevent.
It’s important to keep in mind that eczema is a polygenic and multifactorial disease. This means that there is usually more than one gene and risk factor that leads to its development. In addition, there’s not always a clear cause for eczema. Some babies at high risk will never get eczema, while others with little or no risk will develop the condition.
Here’s what doctors know about how factors during pregnancy influence the risk of childhood eczema.
Certain traits and habits of birth mothers may impact a baby’s risk for eczema. Mothers may be able to change some factors, but not others.
Maternal age may have an impact on eczema in early life. There’s evidence that second-born children (born to mothers at the average age of 28) have a higher risk of eczema than first-born children (whose mothers were 25 years old on average). However, it’s unknown whether the mother’s age, the children’s birth order, or other outside factors are responsible for this association.
A mother who faces stressful events during pregnancy or within the first four months of a child’s life may be more likely to have children with eczema. Negative life events during this time period, such as financial problems, divorce, or the death of a loved one, are associated with a higher risk of atopic dermatitis in children.
Researchers think this association is due to how stress impacts the body. Stress releases cortisol and other hormones, which can change a person’s immune response. Prenatal care that assesses maternal stress levels and provides guidance, resources, and support for stress management may help lower the risk of atopic dermatitis in children.
Good nutrition is essential for a healthy pregnancy, but no specific diet has been identified to protect against eczema. However, a higher intake of omega-3 fatty acids is associated with a lower incidence of allergic diseases.
Studies show conflicting evidence on the effects of vitamins (including vitamins E, C, and D) on eczema outcomes. Some studies have associated vitamin C intake during pregnancy with higher levels of childhood eczema, while others have associated high levels of vitamin D in pregnancy with a higher risk of childhood eczema. Another study suggests that no single vitamin or nutrient in the mother’s diet affects the risk of atopic dermatitis in childhood.
That said, taking a standard prenatal vitamin and following your doctor’s guidance about supplements are sensible ways to get the nutrients you need for a healthy pregnancy.
To reduce the risk of atopic dermatitis in children, research supports public health recommendations that people avoid smoking and drinking alcohol when pregnant. There’s also some evidence that using hormonal contraceptives (birth control) within 18 months of conception is associated with higher rates of childhood eczema. If this is a concern for you, talk to your health care provider for guidance on effective alternatives to hormonal birth control.
Living conditions surrounding pregnancy can sometimes influence a child’s likelihood of developing eczema.
A mother’s exposure to secondhand smoke, mold, or dampness in the living space during pregnancy is associated with an increased risk of eczema in children.
Cesarean section deliveries (C-sections) may lead to higher rates of eczema than vaginal births. This association is likely related to how the delivery methods impact a baby’s immune system development. Some doctors advise that people take probiotics while pregnant and during breastfeeding to help prevent infant eczema. Evidence for their effectiveness is limited, however, and there aren’t any guidelines for their use to prevent eczema.
Several studies have evaluated the relationship between birth weight and atopic dermatitis. A systematic review found that after adjusting for gestational age (how many weeks into pregnancy the baby was born), babies with higher birth weights had an increased risk of atopic dermatitis during childhood.
Some babies have a greater predisposition to eczema because of their genetic makeup. Parents who have a family history of asthma or allergies are more likely to have children with eczema, likely due to genetic mutations. Mutations in the CARD11 and FLG genes are autosomal dominant, meaning that inheriting one copy of the mutation (inheriting from only one parent) raises the risk of eczema. Inheriting two copies (inheriting from both parents) increases the severity of eczema in those who have it.
Living conditions within a child’s first few years of life can also influence their likelihood of developing eczema.
Living in a home with the following risk factors can increase a child’s risk for developing eczema:
In some cases, eczema is a sign of a food allergy. When introducing new foods in the first year of life, be mindful of any skin changes that happen at the same time. Follow up with your pediatrician if you notice any changes.
While there’s no way to prevent eczema, you can talk to your child’s pediatrician about ways to help reduce flare-ups and improve your child’s health and quality of life with eczema. For instance, applying petroleum jelly may prevent rashes. Read more about managing your child’s eczema symptoms.
Fortunately, about 50 percent of children with eczema will experience major improvements or remission (disappearance of all symptoms) as they grow older. It’s important for parents to avoid feeling guilty about their child’s eczema. Instead, focus on what you can control to help your family get a better handle on managing the condition.
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