Study: Bath Oils for Childhood Eczema Provide No Medical Benefit

“Bath oils used to help treat eczema in children offer no meaningful benefit as part of their care, a trial has found,” reports BBC News.

Childhood eczema, also known as atopic eczema, is a common condition that causes redness and soreness of the skin. Treatments include using moisturisers (emollients), which have been shown to work, and using emollients as soap substitutes in the bath or shower.

However, until now, there has been little evidence for a third type of treatment: adding emollient additives to baths.

In the first big study of its kind, researchers found commonly prescribed emollient bath additives – designed to be added to bathwater and leave a thin layer over the skin – made little difference to children’s eczema symptoms.

The study, carried out in England and Wales, involved 483 children aged 1 to 11 years. Half were randomly assigned to use bath additives regularly for a year – in addition to their usual treatments, including standard leave-on emollients – while the other half did not use them.

The results showed that bath additives made too small a difference to symptoms to be considered clinically important.

Find out more about treating childhood eczema.

Where did the story come from?

The study was commissioned by the UK National Institute for Health Research as part of a programme to investigate which treatments are effective and provide value for money, and carried out by researchers from Cardiff University, the University of Bristol, the University of Southampton and the University of Nottingham.

It was published in the peer-reviewed British Medical Journal and is free to read online.

The UK media reports were generally accurate and balanced.

What kind of research was this?

This was a randomised controlled trial, which is often the best way to investigate whether a treatment works.

To make results more accurate, many trials like this use a dummy treatment (placebo) so that patients don’t know if they are receiving the real treatment. However, in this case, the researchers decided they could not make a convincing placebo for emollient bath additives so did not include one in the study.

What did the research involve?

Researchers used records from 96 general practices in Wales, south England and west England to identify children diagnosed with eczema. The children’s parents or carers were then contacted and invited to take part.

After screening, half the children were prescribed bath emollient additives for a year and the other half were asked not to use them. Most of the experimental group were prescribed Oilatum, Balneum or Aveeno bath products.

All children continued their usual eczema treatments, which included using emollients as creams and soap substitutes, and using steroid creams where needed.

Parents or carers recorded children’s eczema symptoms – weekly for the first 16 weeks and then monthly for a year – using the standard patient oriented eczema measure (POEM). In children, this is usually assessed on how severe parents or guardians think a child’s eczema is.

POEM gives a score of 0 to 28, with 0 to 7 being no or mild eczema, 8 to 16 moderate eczema and 17 to 28 severe eczema. A drop of 3 points on the scale is considered enough to represent a clinically meaningful improvement in symptoms.

The parents or carers also recorded how often the children bathed and how often they used the bath emollient additives.

The researchers compared symptom scores for the 2 groups, adjusting for eczema severity at the start of the study, use of steroid creams and soap substitutes, and ethnic group.

What were the basic results?

The average symptom score at the start of the study was 9.5 in the bath-additives group and 10.1 in the no-bath-additives group, meaning most children had moderate eczema.

Over 16 weeks, the average symptom score was:

• 7.5 in the bath-additives group
• 8.4 in the no-bath-additives group

After controlling for confounding factors, such as use of other eczema medication, the average symptom score was 0.41 points lower in the bath-additives group (95% confidence interval [CI]-2.7 to +1.10). This was not a statistically significant difference and was well below the 3-point difference considered to be clinically important.

The researchers also looked at subgroups to see if any particular group of children were more likely to benefit from the bath additives. While they did find some effect for children under 5 years old, it still did not reach the 3-point threshold.

They did find a possibly clinically meaningful benefit for children who bathed 5 times or more a week (2.27-point improvement, 95% CI 0.63 to 3.91), but this analysis was based on fewer children, making it less reliable.

How did the researchers interpret the results?

The researchers said the trial “provides strong evidence that emollient bath additives provide minimal or no additional benefit beyond standard eczema care in the management of eczema in children”.

Conclusion

The study shows that bath emollient additives may not be a useful part of eczema care for children.

But it’s important to be clear this does not apply to the use of leave-on emollient creams and lotions, or to the use of emollients instead of soap. There’s evidence that leave-on emollient creams work, and doctors agree using emollients instead of soap is helpful.

This study’s results only apply to emollient products added to the bathwater. If you’re not sure of the difference, speak to a pharmacist or your GP.

If your child has been prescribed bath emollient additives and is happy with them, there’s no reason to stop using them. The study found no increased risk of side effects – such as slipping in the bath, soreness or redness – among children who used them.

However, they may not make much difference to your child’s eczema, and it’s possible the NHS may decide to recommend that doctors stop prescribing these products in future.

The study was well conducted but had a few limitations, the main one being that, unusually for research of this type, there was no placebo. Placebos are normally included to control for the placebo effect – where people tend to feel better if they are taking a treatment because they expect it to work.

However, in this case, people that did receive the bath additives did not report symptoms significantly different from those not using the additives, which suggests the placebo effect did not have much influence in this study.

The study looked at lots of subgroups among the 483 children to see if any showed different results. However, this increases the likelihood that some of the results are due to chance.

We therefore cannot put too much stock in the finding that children bathing 5 times or more a week may get some benefit from emollient bath additives, as this analysis included just 143 children.

>

Child Health & Safety News 5/28: Can You & Baby Safely Co-Sleep?

In this week’s Child Health News: What’s Going On In Your Child’s Brain When You Read Them A Story? The “Goldilocks effect” studied n.pr/2GULEKS

Welcome to Pediatric Safety’s weekly “Child Health & Safety News Roundup”- a recap of the past week’s child health and safety news headlines from around the world. Each day we use social media to communicate relevant and timely health and safety information to the parents, medical professionals and caregivers who follow us. Occasionally we overlook something, but overall we think we’re doing a pretty good job of keeping you informed. Still, quite a bit happens every day – so to make sure you don’t miss anything, we offer you a recap of this week’s top 25 events & stories.

• For a child to learn his feelings truly matter, adults in his life need to fully listen, respond and reflect in the moment. http://bit.ly/2b3Biy8 2018-5-27
• Use Healthy Discipline so Children Can Feel Good About Themselves bit.ly/2GQHTGa 2018-5-27
• Should You Give Your Kids Gummy Vitamins? bit.ly/2sbGfcZ 2018-5-27
• For Troubled Kids, Some Schools Take Time Out For Group Therapy n.pr/2s4ldxQ 2018-5-26
• Child campaigners to Zuckerberg: scrap Messenger Kids bit.ly/2GN7O1D 2018-5-26
• Why Campus Shootings Are So Shocking: School Is the ‘Safest Place’ for a Child nyti.ms/2x6y4nQ 2018-5-26
• Australian gymnasts and staff to be trained to identify child abuse bit.ly/2kmo3tN 2018-5-25
• Closing coal and oil power plants leads to healthier babies, study suggests ind.pn/2s4dujh 2018-5-25
• Advocating for Life Support Training of Children, Parents, Caregivers, School Personnel, and the Public bit.ly/2KRzKnt 2018-5-25

PedSafe Child Health & Safety News TOP Headline of the Week
Is Sleeping With Your Baby As Dangerous As Doctors Say? n.pr/2IPtHPo
…are there ways to make it less of a risk?

• Tomorrow morning, Show Dogs is an AMC #SensoryFriendly Film bit.ly/2IzutAe 2018-5-25
• Kids Who Care newsletter #9 – Radical Community and Radical Compassion getrevue.co/profile/pediat… 2018-5-25
• Brazil’s austerity measures could increase avoidable child deaths | bit.ly/2IFkQDX 2018-5-24
• Baby Health: Importance of Tummy Time bit.ly/2IExQdb 2018-5-24
• May 25th is National Missing Children’s Day bit.ly/2GMRpKr 2018-5-24
• 5 Beach Safety Tips for Family Fun – Thurs Time Capsule 06/11- bit.ly/2km556w 2018-5-24
• The Benefits of Summer Camp are Lost When Smartphones Intrude bit.ly/2IDleis 2018-5-23
• Prenatal Testing: Do You Know the Benefits and Limits? by the Cleveland Clinic cle.clinic/2x5begu 2018-5-23

PedSafe Child Health & Safety News #2 Headline of the Week
SAT or ACT: How to Know Which Is Best for Your Special Needs Child u.org/2IXyGRt

• Video: Breach Births – Choices for Moms to Be bit.ly/2s0YUc1 2018-5-23
• Road traffic a global health crisis, killing 350,000 children a year bit.ly/2IZ6Lk8 2018-5-23
• Additional Recommendations on Safe Sleep Environments for Infants bit.ly/2kgiBIS 2018-5-22
• 13 Reasons Why: What Parents Need to Know About This Netflix Series bit.ly/2rUrBHN 2018-5-22
• New App Helping MO Firefighters Treat Children Introducing Handtevy bit.ly/2kfp6LG 2018-5-22
• When Will My Kids See Their Grown-up Smile? bit.ly/2KEr2c2 2018-5-21
• Tomorrow Night at AMC, Deadpool 2 is Sensory Friendly bit.ly/2kawbgC 2018-5-21
• Ozone exposure at birth increases risk of asthma development bit.ly/2k9FmOk 2018-5-21

---

 

Would You Buy Your Special Needs Child a Dog Chew Toy?

That was where my sleep-deprived, over-stressed mind went in an aisle of the pet store while I was there to buy cat food. I was tired of finding holes in my child’s shirts and also terrified she would chew off a button and then choke on it. I had tried teething toys for toddlers, but they were made for adorable little jaws and tiny teeth that were just peeking through the gum line. I had tried teething toys for older children with special needs, but she ripped right thought those in a few hours. Even the upgraded medical grade versions were torn in a few days…and I would obsess about whether the bits she was chewing off were large enough for her to choke on it. I didn’t buy the dog chew toy because I figured it had probably been made of or coated in a ton of chemicals and had also probably not been safety tested for humans. But another thing crossed my mind – what would people think?

We are responsible for teaching our children so many things – social skills, academic skills, life skills, vocational skills – but in this case I think kids can teach us. When a toddler is frustrated about not getting a cookie they don’t care whose eardrums they pierce with their shrieks. When a child on the spectrum is flapping their hands in excitement they don’t care who is watching or what anyone else thinks about their actions.

Of course we grownups in civilized society HAVE to follow certain rules or we might be arrested, committed or evicted – not necessarily in that order. But isn’t there more room for deeply feeling an emotion like frustration or joy, or to truly experience something like the grass or the music?

Children with special needs growing up today have the advantages of the Americans with Disabilities Act, the inclusion movement and the many special needs events that are happening nationwide (and worldwide). Also, check out the This Is My Child campaign for more tips on dealing with ignorant strangers and family members.

At the end of the day though…when you realize all the other critics are silent, how then do you answer the question and be at peace with yourself?

This Saturday Show Dogs is an AMC Sensory Friendly Film

Since 2007, AMC Entertainment (AMC) and the Autism Society have teamed up to bring families affected by autism and other special needs “Sensory Friendly Films” every month – a wonderful opportunity to enjoy fun new films in a safe and accepting environment. Tomorrow, Show Dogs is Sensory Friendly at AMC.

The movie auditoriums will have their lights turned up and the sound turned down. Families will be able to bring in snacks to match their child’s dietary needs (i.e. gluten-free, casein-free, etc.), there are no advertisements or previews before the movie and it’s totally acceptable to get up and dance, walk, shout, talk to each other…and even sing – in other words, AMC’s “Silence is Golden®” policy will not be enforced during movie screenings unless the safety of the audience is questioned.

Does it make a difference? Absolutely! Imagine …no need to shhhhh your child. No angry stares from other movie goers. Many parents think twice before bringing a child to a movie theater. Add to that your child’s special needs and it can easily become cause for parental panic. But on this one day a month, for this one screening, everyone is there to relax and have a good time, everyone expects to be surrounded by kids – with and without special needs – and the movie theater policy becomes “Tolerance is Golden“.

Families affected by autism or other special needs can view a sensory friendly screening of Show Dogs on Saturday, May 26th at 10am (local time). Tickets are typically $4 to $6 depending on the location. To find a theatre near you, here is a list of AMC theatres nationwide participating in this fabulous program (note: to access full list, please scroll to the bottom of the page).

Coming in June: Solo: A Star Wars Story (Sat 6/9 & Tues 6/12); The Incredibles 2 (Sat 5/23); Jurassic World: Fallen Kingdom (Tues 5/26)

****************************************************************************************************************************

Editor’s note: Although Show Dogs has been chosen by the AMC and the Autism Society as this month’s Sensory Friendly Film, we do want parents to know that it is rated PG by the Motion Picture Association of America for suggestive and rude humor, language and some action. As always, please check the IMDB Parents Guide for a more detailed description of this film to determine if it is right for you and your family.

Video: Breach Births – Choices for Moms to Be

This film explores the choices women need to make when faced with the dilemma of a breech pregnancy. A baby is in the breech position if it is lying bottom or feet first. Roughly 3 in every 100 babies are in the breech position at full-term.

Editor’s Note: Video Highlights

No-one expects their baby to be breech. Know that there is no particular reason why this happens and there are choices that are available to you.

First Option to Consider: External Cephalic Version (ECV)

• ECV – performed by doctor or midwife
  • Using hands externally to manipulate baby by gently pushing on mom’s tummy to try and move baby to a heads down position
  • First step is an injection that relaxes the muscles in the womb, improving the likelihood of success in turning the baby
  • Next step is typically to lift baby’s bottom out of the pelvis and attempt to turn one way. If unsuccessful, an attempt is made to turn the other way
  • Procedure can vary in degree of discomfort from mildly uncomfortable to somewhat painful depending on position of baby.

If ECV is Successful

• Vaginal birth or Cesarean section – for other reasons
• It is rare that the baby will reverse and turn back

If ECV is Unsuccessful

• Planned Cesarean section – will take time for body to recover from procedure – cannot drive for period of time
• Vaginal breach birth (baby is born vaginally in breach position)

There’s always the possibility that your baby will turn spontaneously before the birth

Discuss your options with your GP or Midwife to determine the best for you and your family

 

>

>

 

Child Health & Safety News 5/21: Third-Hand Smoke Risky For Kids

In this week’s Child Safety News: Dangerous social media challenges could leave behind lifelong injuries: Ice + Salt = burns bit.ly/2Gq5T2z

Welcome to Pediatric Safety’s weekly “Child Health & Safety News Roundup”- a recap of the past week’s child health and safety news headlines from around the world. Each day we use social media to communicate relevant and timely health and safety information to the parents, medical professionals and caregivers who follow us. Occasionally we overlook something, but overall we think we’re doing a pretty good job of keeping you informed. Still, quite a bit happens every day – so to make sure you don’t miss anything, we offer you a recap of this week’s top 15 events & stories.

• Hyper, cranky kids? These foods may help bit.ly/2wXV3BIUseful…and logic based 2018-5-20
• Ethical Challenges Raised by OpenNotes for Pediatric and Adolescent Patients by the AAP bit.ly/2rZ7XKT 2018-5-19
• How in-house child care helps retain employees dmreg.co/2GvSO8c 2018-5-18
• Does Daycare Influence How a Child Performs in Grade School? bit.ly/2IuaGBZ 2018-5-18
• Do Housing Assistance Programs Help Kids? It’s Complicated! bit.ly/2LalHKB 2018-5-18
• California Lawmakers Move to Ensure Lead-Free Water in Child Care Centers, catching up with Oregon, Washington and 4 other states bit.ly/2IycAkY 2018-5-17

PedSafe Child Health & Safety News Headline of the Week
We’re expecting our first child. I’m concerned about ‘third-hand smoke’ from my mom bit.ly/2GAdV9o

• Sunburns in Children: Focus on Prevention Thurs Time Capsule – 06/11 bit.ly/2KwVN2i 2018-5-17
• Can I Get Pregnant Right After My Period? Teens Need to Know bit.ly/2IJH86H 2018-5-16
• Safe and secure summer: What to know before your child goes to camp bit.ly/2Il9DZh 2018-5-16
• How to Get Past Parenting Guilt When Your Child Has Learning and Attention Issues u.org/2oIz2OH 2018-5-15
• 15-minute break for physical activity can boost a child’s health bit.ly/2KU7CRc 2018-5-014
• 7 Ways for Dads to Strengthen Their Relationship With Daughters bit.ly/2IcgzaP 2018-5-14
• What Are The Benefits Of A Well Child Exam? bit.ly/2wG2c9w 2018-5-14