Cradle cap is a type of seborrhoeic dermatitis, a common irritation that affects oily skin in children and adults.
From www.nhs.uk
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Ways to get your baby moving
Lay your baby down on their back so they can kick their legs.- Pulling, pushing, grasping and playing with other people are great ways to practise different kinds of movements.
- Once your baby has started crawling, let them crawl around the floor, but make sure it’s safe first – see our crawling safety checklist.
- Playing outdoors helps your baby learn about their surroundings.
- You can take your baby swimming from a very young age – there’s no need to wait until they’ve been vaccinated.
See Start4Life for more activity tips for babies.
Why tummy time is important
Tummy time helps to build the muscles your baby needs for sitting and crawling. You can start doing tummy time from birth by lying your baby on your chest – but only do this when you’re wide awake and unlikely to fall asleep.
Little and often is best to begin with. Gradually increase the amount of time you do this day by day. Then, when your baby is ready, try doing tummy time on the floor. If your baby has difficulty lifting their head, you can roll up a towel and put it under their armpits. Put some toys nearby for them to reach out to.
Only do tummy time when your baby is awake and alert, and you’re there to keep an eye on them.
Baby bouncers, walkers and seats
It’s important that your baby doesn’t spend too much time in:
- baby walkers or bouncers – these encourage babies to stand on their tiptoes and can delay walking if your baby uses them a lot
- baby carriers and seats – long periods in reclining carriers or seats, or seats that prop your baby in a sitting position, can delay your baby’s ability to sit up on their own
If you do use a baby walker, bouncer or seat, it’s best to use them for no more than 20 minutes at a time.
Physical activity for toddlers
Once your child is walking, they should be physically active for at least 180 minutes (three hours) a day, spread throughout the day.
- Let your toddler walk with you rather than always using the buggy.
- Toddlers and young children love going to the park, where they can climb and swing or just run around.
- Toys your child can pick up and move around will help improve their co-ordination and develop the muscles in their arms and hands.
- Involve your toddler in household tasks like unpacking shopping, tidying or sorting washing.
- Teach your child songs with actions and encourage them to dance to music.
Watching TV or using a tablet for long periods – or being strapped into a buggy, car seat or highchair – isn’t good for young children.
If you need to make a long car journey, consider taking a break and getting your child out of their seat for a bit.
See physical activity guidelines for children under five.
Enjoy being active together
It’s good to join in with your child’s active play when you can. Have fun showing them how to do new things like running and hopping. Being active together shows your child that activity is enjoyable.
You’re a role model for your child so stay active yourself and try to meet the physical activity guidelines for adults.
There may be activities for parents and children at your local leisure centre or Sure Start Children’s Centre.
Activity for young children with a disability
All babies and young children need to be active, including children with a long-term condition or disability, unless their health professionals give you different advice.
Just like other children, they will enjoy being active and it will help their development. You may need to adapt some activities to suit your child.
Scope has ideas for games all children can play, and the Contact a Family advice service** offers information on caring for a disabled child (in the UK).
Coping with a very active toddler
It can be exhausting keeping up with a toddler who is always on the go. It may help if you:
- keep to a daily routine – routine can help if your child is restless or difficult; it can also help you stay calm and cope with the strain
- dedicate time to your child – make sure there are times each day when you give them your full attention
- avoid difficult situations – for example, keep shopping trips short
- try to go out every day – go to a park, playground or other safe, open space where your child can run around and use up energy
- set small goals – help your child to sit still and concentrate for a very short time, perhaps on a book or new toy, then gradually build it up
Does my child have attention deficit and hyperactivity disorder (ADHD)?
At times you may wonder if your non-stop toddler has ADHD. But only about 2% of children in the UK have ADHD**. It’s more likely that your child is just a healthy, energetic toddler.
If you’re worried about how active your child is, talk to your health visitor (*nurse specialist/midwife) or GP (*physician).
Learn more about ADHD or visit ADDISS: National Attention Deficit Disorder Information and Support Service.
Editor’s Note:
* Clarification Provided for our U.S. Readers
** US Reference Information:
- The American Psychiatric Association (APA) says that 5 percent of American children have ADHD. But the Centers for Disease Control and Prevention (CDC) puts the number at more than double that. The CDC says that 11 percent of American children, ages 4 to 17, had the attention disorder as of 2011.
- UNICEF-USA is a charity that helps to protect US children and support children with disabilities
From www.nhs.uk
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On average, twins are about six months behind single babies in their language development.
Twins may be slower to pick up speech and language skills because:
twins tend to receive less attention in shorter bursts than single babies- parents often speak to one twin while looking at the other, but children need eye contact to help their language development
- twins tend to spend more time with each other, so they pick up each other’s speech rather than that of adults and older children around them
- twins have less time to practise speech as they compete to get themselves heard
- sometimes one twin may answer for the other
Don’t worry if your twins seem to be slow to speak. Just try to make sure they have plenty of time to talk and express themselves.
Talking to twin babies
Nappy changes can be a good opportunity to give twins one-on-one attention. You could bathe each baby separately to give you time to chat with them individually.
You can also:
- turn off the TV and radio for at least 30 minutes each day, so your babies can listen to the noises around them with no distractions
- listen to your babies and respond to them as they experiment with different sounds
- try to play and read books with your babies individually; make time to talk to your babies individually each day, using their name and making eye contact
- encourage older siblings, friends and family to talk to your babies one to one
Read more about how to encourage language skills in children.
Twins & Multiple Births Association (Tamba) has information about twins and language. Tamba also has a free (in the UK) telephone helpline. Twinline** is open every day from 10am to 1pm and 7pm to 10pm on 0800 138 0509.
Talk to your GP (*doctor) or health visitor if you’re concerned about your children’s language skills.
Editor’s Note:
* Clarification Provided for our U.S. Readers
** Resources Outside the UK:
- Multiples of America: US non-profit providing information, research studies and clubs throughout the U.S. for multiple birth families (and families-to-be)
From www.nhs.uk
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Atopic eczema (atopic dermatitis) is the most common form of eczema, a condition that causes the skin to become itchy, red, dry and cracked.
Atopic eczema is more common in children, often developing before their first birthday.
However, it may also develop for the first time in adults. It’s usually a long-term (chronic) condition, although it can improve significantly, or even clear completely, in some children as they get older.
Symptoms of atopic eczema
Atopic eczema causes the skin to become itchy, dry, cracked, sore and red. Some people only have small patches of dry skin, but others may experience widespread red, inflamed skin all over the body.
Although atopic eczema can affect any part of the body, it most often affects the hands, insides of the elbows, backs of the knees and the face and scalp in children.
People with atopic eczema usually have periods when symptoms are less noticeable, as well as periods when symptoms become more severe (flare-ups).
Read about the symptoms of atopic eczema
When to seek medical advice
See your GP (*physician) if you have symptoms of atopic eczema. They’ll usually be able to diagnose atopic eczema by looking at your skin and asking questions such as:
- whether the rash is itchy and where it appears
- when the symptoms first began
- whether it comes and goes over time
- whether there’s a history of atopic eczema in your family
- whether you have any other conditions, such as allergies or asthma
- whether something in your diet or lifestyle may be contributing to your symptoms
Typically, to be diagnosed with atopic eczema you should have had an itchy skin condition in the last 12 months and three or more of the following:
- visibly irritated red skin in the creases of your skin – such as the insides of your elbows or behind your knees (or on the cheeks, outsides of elbows, or fronts of the knees in children aged 18 months or under) at the time of examination by a health professional
- a history of skin irritation occurring in the same areas mentioned above
- generally dry skin in the last 12 months
- a history of asthma or hay fever – children under four must have an immediate relative, such as a parent, brother or sister, who has one of these conditions
- the condition started before the age of two (this does not apply to children under the age of four)
Causes of atopic eczema
The exact cause of atopic eczema is unknown, but it’s clear it is not down to one single thing. Atopic eczema often occurs in people who get allergies – “atopic” means sensitivity to allergens.
It can run in families, and often develops alongside other conditions, such as asthma and hay fever.
The symptoms of atopic eczema often have certain triggers, such as soaps, detergents, stress and the weather. Sometimes food allergies can play a part, especially in young children with severe eczema.
You may be asked to keep a food diary to try to determine whether a specific food makes your symptoms worse. Allergy tests aren’t usually needed, although they’re sometimes helpful in identifying whether a food allergy may be triggering symptoms.
Read about the causes of atopic eczema.
Treating atopic eczema
Treatment for atopic eczema can help to relieve the symptoms and many cases improve over time.
However, there’s currently no cure and severe eczema often has a significant impact on daily life, which may be difficult to cope with physically and mentally. There’s also an increased risk of skin infections.
Many different treatments can be used to control symptoms and manage eczema, including:
- self care techniques, such as reducing scratching and avoiding triggers
- emollients (moisturising treatments) – used on a daily basis for dry skin
- topical corticosteroids – used to reduce swelling, redness and itching during flare-ups
Read about treating atopic eczema and complications of atopic eczema.
Other types of eczema
Eczema is the name for a group of skin conditions that cause dry, irritated skin. Other types of eczema include:
- discoid eczema – a type of eczema that occurs in circular or oval patches on the skin
- contact dermatitis – a type of eczema that occurs when the body comes into contact with a particular substance
- varicose eczema – a type of eczema that most often affects the lower legs and is caused by problems with the flow of blood through the leg veins
- seborrhoeic eczema – a type of eczema where red, scaly patches develop on the sides of the nose, eyebrows, ears and scalp
- dyshidrotic eczema (pompholyx) – a type of eczema that causes tiny blisters to erupt across the palms of the hands
Editor’s Note:
* Clarification Provided for our U.S. Readers
From www.nhs.uk
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“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.
If your child isn’t responding well to a particular treatment for eczema, there are other treatments that may be more effective. Find out more about treating childhood eczema.
Analysis by Bazian
Edited by NHS Choices
From www.nhs.uk
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Speak to your GP if your baby’s cradle cap:
