Why is it so important to treat childhood eczema holistically?

If you are only using a skin cream then you are not using an holistic approach.

Holistic management includes recognition of the causes of immune system malfunction and how to address this in the gut. Best results are achieved the younger you can add healthy bacteria to the gut; this changes the immune reaction to normal skin germs. Dermatologists and allergists call this the gut-skin axis.

If the holistic approach is not used, we see atopic eczema as the initial of a group of diseases; especially in those with these risk factors:

• Caesarian section birth (no bacterial transfer from the vaginal tract to the infant)

• Formula feeding (no staph transfer from mother’s breast)

• Antibiotics in the first year (indiscriminate killing of infant’s gut microbiome)

• Fillagrin defects (genetic component)

• Family history of eczema or allergies (may be partly due to highly processed foods and insufficient vegetables, fruit, pulses)

Without treating the underlying cause, the eczema in infancy and early childhood is often followed by food allergy, episodes of wheezing, or asthma, hay fever or allergic rhinitis. Some patients will have lifelong eczema and episodes of asthma. Clearly the underlying immune process is still faulty, and affects the skin, the lungs, and then the nose and eyes. This is because our immune system must recognise a normal mix or quantity of bacteria and not over-react with immune cells in the skin or eyes or lungs.

What many doctors have not been telling you, is that this atopic march or cascade is entirely preventable, and that the secret lies in how we develop the microbiome within us, and around us. Yes, it has been known for many years already that by giving nursing mothers probiotic drinks, and then by giving infants being weaned probiotic yoghurts, simply introducing the healthy bacteria, lactobacillus and bifidococcus, one can develop a more diverse microbiome in the gut. What this does then is quite extra-ordinary. It reduces the chance of going on to develop eczema and the atopic march by more than half.

We have known for some time, too, that breastfeeding offers a different microbiome to an infant, by allowing germs from the mother’s breast into the gut of the infant, and because mother’s milk contains A2 beta casein protein, different healthy bacteria thrive in the infant gut. It is the different bacteria that one finds in the child’s gut that tells us if this child is going to be allergic or not, since it affects how the immune system recognizes bad bacteria and deals with them. The more diverse the bacteria in the gut, the more able a child is to defend himself or herself normally from foreign germs and foreign proteins, including those ordinarily found in various foods. Like cow’s milk, which contains mostly A1 beta casein, different from mother’s milk, like hen’s eggs, like peanuts or other nuts, or seeds like sesame, or wheat protein, gluten.

So what other holistic measures are known to treat eczema, and prevent this atopic or allergic march? Well, I have touched on using probiotics or live yoghurt in the nursing mother’s diet, and in the weaned infant diet, as this introduces healthy bacteria into both the mother’s gut and the infant gut, which offers significant protection.

Now what about prebiotics? What are these I hear you ask?

Prebiotics are foods that encourage the growth and development of normal and healthy bacteria in the gut. Perhaps it won’t surprise you to find out that eating plenty of fresh fruit and vegetables is the way the gut develops a wide range of healthy bacteria, leading to a more diverse microbiome in the gut. What surprised me in reading this research is that the child needs this especially in the years that the immune system is developing, in order to successfully prevent infections, and also to prevent allergies.

Eating more than five portions of fresh vegetables and fruit every day increases the amount of vegetable fibre in the gut, a kind of semi-digestible pulp that requires healthy bacteria to fully digest and assist us in getting the right nutrients out of it. So by eating more fresh vegetables and fruit, more of the healthy bacteria grow in the gut, and the child develops both an easy regular bowel habit, and a healthy immune system, less prone to developing eczema, asthma, and allergies. In fact the five portions we have been told about, is also a myth. More than five is much better, and the research that lead us to the magic number five, was done on people eating 800g of fresh vegetables and fruit daily, which in my experience is a lot more than five portions. So five was simply a number produced by a committee trying to get research findings into the public domain.

But how do you get children to eat so much fruit and vegetables, I hear you ask?

And yes I do realize that 800g is practically impossible for a child, but possible for an adult. The first step, I would argue, is for adults to try for 800g themselves, and set an example to their children. When I tried to go for 800g the results were astonishing. In six months of changing my diet to a more plant-based diet, I lost around ten kilograms, or a stone and a half in bodyweight. For the first time in around five years, I was back to a normal weight and shape for my age. I lost my middle aged spread, felt healthier, and got a lot fitter. The way I did this was to eat only vegetables and fruit for breakfast, having my five a day all at once in a smoothie. I filled a nutribullet with a portion of celery, kale, ginger, pear, apple juice and water to make a pint of smoothie mixture full of vegatble and fruit fibre. The type of vegetable or fruit should vary of course, depending on individual taste and what is available and fresh.

However, in feeding grandchildren breakfast in the morning, I realize that young children will want to try whatever you are having, and it is a simple matter to put any pureed fruit and vegetable on top of live yoghurt for them to eat for breakfast, or mix with a little cooked oat porridge. The key thing is to avoid and put off using factory made children’s cereals for as long as possible, since these are neither fresh, nor do they contain any fruit or vegetable fibre, which is prebiotic.

Some of you may now have read this article and wondered why I have not got into food avoidance regimes. In fact the science shows that avoiding peanut butter, for example, does not help prevent peanut allergy. It is the reverse. In Israel, where children are routinely given peanut butter as a weaning food, the incidence of peanut allergy is extremely low. This supports the science indicating a healthy and diverse microbiome is the key. The more different foods that can be introduced into a weaned infant diet before they become fussy and choose their own foods, the better for the gut, and for future taste in food.

One must also avoid introducing any element of food in the diet, which is toxic to healthy germs in the gut; there is plenty of evidence that fizzy drinks and squash containing artificial sweeteners are harmful to healthy bacteria, and are actually driving up diabetes by causing insulin resistance. Emulsifiers which cause fat molecules to stay in solution are also harmful to the gut microbiome, so margarine for example is quite a harmful product. Butter is in fact, more healthy.

In summary, the things which help prevent eczema, asthma, and allergies, appears to be prompt treatment of any eczema, intermittent treatment with diluted steroid cream between episodes, a diet rich in probiotics, prebiotic foods containing vegetable and fruit fibre, and keeping unhealthy germs off the skin and out of the gut. Vitamin supplements do not do it, and keeping your house squeaky clean does not do it either.