Diathesis in an infant

Almost every second mother at least once encounters such a phenomenon as diathesis in an infant - this is a phenomenon that has not yet become a disease, but already requires an immediate response from parents and a pediatrician. Diathesis can pass without a trace, or it can lead to the development of unpleasant complications and health problems in the future. Therefore, it is very important to know as much information as possible about this threshold condition.

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Products that cause diathesis in infants

There are a number of potentially allergenic products that can provoke an inadequate reaction in the child's body. Such products should be introduced into the nursing mother's menu gradually, carefully observing the baby's reaction. Some mothers refuse such products altogether, until the end of breastfeeding.

Perhaps the most common allergenic foods are citrus fruits. Often, it is enough to eat just one slice of orange or lemon for a baby to develop a skin rash.

Berries can be placed in the same row with citrus fruits: strawberries, blackberries, wild strawberries. Other plant products of red and orange color also have a similar effect - these can be apricots, peaches, cherries, watermelons and even tomatoes.

In addition to vegetables and fruits, reddening of the cheeks can also be caused by whole milk, including in milk formulas. In this case, diathesis is provoked by the action of milk sugars and milk protein. To avoid complications, it is necessary to refuse to drink milk (fermented milk products are sometimes allowed) and carefully study the composition of baby cereals and milk-based formulas.

Another strong allergen is nuts, especially peanuts. Therefore, peanuts, peanut butter or paste are considered undesirable during lactation. As for other types of nuts, they should be introduced into the diet gradually, monitoring the health of the child.

Sausages, fish, caviar, bee products, carbonated and reconstituted drinks, eggs, animal fats - all these products are considered potentially allergenic. Any of them should be introduced into the diet of a nursing mother carefully and separately, and especially if you are going to use them as complementary food for your child.

Pathogenesis and causes of diathesis

The development of diathesis is largely explained by the peculiarities and imperfections of the enzymatic and immune systems of the child's body. In addition, the mucous membranes of the digestive tract in children have increased permeability.

An important factor in the mechanism of the pathology's appearance is hereditary predisposition. For example, the presence of an allergic reaction to something in one of the parents can serve as a factor in the development of a tendency to allergies in the child.

The skin and mucous membranes of a baby after birth are still extremely weak, neuroendocrine and metabolic processes are imperfect - the child is not yet ready to digest food that is unknown to him.

In addition to the listed factors, the state of the child's nervous system is also important, since diathesis can be a peculiar reaction of its central and vegetative parts. Often, the development of pathology is provoked by under-oxidized metabolic products, deficiency or excess of hormones of the adrenal glands and other glands.

In general, the causes of diathesis in infants can be listed as follows:

• excessive consumption of allergenic foods by the expectant mother during pregnancy;
• a tendency to allergies in one of the parents;
• poor digestion in a child;
• intestinal dysbacteriosis;
• unfavorable environmental conditions;
• overfeeding the baby;
• introducing complementary foods too early;
• incorrectly selected complementary food ingredients.

Symptoms of diathesis in infants

The first signs of the pathology are frequent and persistent diaper rash, red spots on the skin, and wet yellow crusts on the surface of the head.

Diaper rash is considered a characteristic sign of diathesis. It occurs in the groin area, armpits, behind the ears. It is quite difficult to get rid of it.

Redness and irritation are also observed on the face, head, back (especially in the lower part), and limbs. Yellowish or brownish crusts can be found in the hair growth area on the head.

The child himself may be pale, even pasty. In children prone to diathetic manifestations, body weight increases unevenly, easily lost during colds and intestinal disorders. By the way, loose and frequent stools (greenish) and abdominal pain can also be symptoms of an allergic disposition of the body.

The rash may cause itching, which is accompanied by scratching and, sometimes, secondary infection.

If the mucous membranes are prone to allergies, stomatitis (an inflammatory process in the oral cavity), conjunctivitis or blepharitis, allergic rhinitis, bronchitis (often asthmatic) may develop. The listed diseases have a severe course, with changes in urine analysis and intestinal dysfunction.

Now let's look at some typical symptoms of diathesis in more detail.

• Diathesis on the face of an infant is the most common manifestation of pathology. Redness and peeling can be found on the cheeks, temples, chin, bridge of the nose - at first in the form of small pimples, and after some time - in the form of a yellow crust, often causing itching and discomfort in the child.
• Diathesis on the cheeks of an infant almost never goes away on its own. It exists until the product that caused the allergy is excluded from the diet, or until special drugs are prescribed to eliminate the allergic predisposition of the body. The cheeks remain reddened for a long time, and later become covered with rough scales, which over time can appear on other parts of the child's body.
• Dry diathesis in infants is a term that characterizes rashes on the child's body. It means the presence of dry, hard-to-remove crusts and scales on the surface of the skin, without increased moisture at their base.

By the way, dry diathesis in infants occurs much less often than wet diathesis, but it requires no less attention from parents and doctors. Such skin must be additionally moisturized with special creams and decoctions.

• Diathesis on the bottom of a baby is more reminiscent of the well-known diaper rash, which can easily be joined by an infection. Infectious contamination manifests itself as pustules and ulcers. •
• Diathesis in infants on the legs is less common than on the head or buttocks. It can occur in both wet and dry forms. Moreover, the course of the pathology can change its type in one direction or another.
• Exudative diathesis in infants is also called infant urticaria or weeping diathesis. The condition is accompanied by persistent diaper rash, regardless of whether the child's hygiene rules are followed. A so-called milk crust appears on the hair growth zone - this is seborrhea. The child's sebaceous glands work in an enhanced mode, especially near the large fontanelle and on the baby's forehead. Later, seborrhea moves to the cheeks, which begin to redden and peel. Over time, eczema (both weeping and dry) appears at the site of peeling, and the child is constantly itching. Long-term weeping diathesis in infants leads not only to redness, but also to thickening of the skin at the site of the lesion. They are completely covered with blisters with liquid contents, which subsequently open and develop into small wounds covered with crusts.
• Allergic diathesis in infants can manifest itself as both dry and wet eczema. In all cases, the rashes are difficult to treat with standard treatment and are prone to repeated exacerbations. Diaper rash can most often be found in the groin, behind the baby's ears, in the armpits, on the neck. Such diaper rash is very persistent and often does not respond to treatment.
• Diathesis on the forehead of an infant occurs with a pronounced decrease in immunity, a tendency to infection of the affected skin and mucous membranes, increased sensitivity of the skin, and prolonged inflammatory processes. This condition is a common symptom that tends to appear almost immediately after the birth of the child.
• Diathesis behind the ears in a baby may not be noticed right away, since the signs are localized in the folds behind the ears, which at first glance are not striking. It is noteworthy that the baby often cries and scratches his ears. Upon closer examination, a yellow crust is found, which in no case should be torn off, but should be carefully combed out after bathing, having been pre-treated with baby cream or softening hypoallergenic oil.
• Diathesis on the hands of an infant can appear in skin folds, under the arms, on the palms. Sometimes the only manifestation of this type of hypersensitivity is excessive dryness of the palmar surfaces of the baby's hands. This symptom may be accompanied by dry feet, with subsequent development of peeling. In addition to finding the allergen that provoked this condition, such areas must be moisturized with special procedures and moisturizers for children's use.

Consequences and complications of diathesis

In early childhood and in older children, secondary infections of the affected skin often develop, which are caused by bacteria or viruses. The pathogens most often found in infected surfaces are staphylococci and β-hemolytic streptococci.

Simple herpes and eczema can cause great discomfort to children with diathesis.

A child with such a diagnosis may have an inadequate reaction to smallpox vaccination, which must be taken into account when carrying out routine vaccination.

Some infants with catarrhal diathesis may develop keratoconus, caused by prolonged irritation of the eyelids.

How long does it take for diathesis to pass in infants? Of course, the best scenario is to find the true allergen, eliminate it, and quickly recover the child.

In all other cases, diathesis is characterized by a weakening of symptoms in the period from 3 to 5 years. In some children, small manifestations of eczematous rashes may still be present for some time on the elbows, under the knees, on the palms, behind the ears, as well as in the face and neck area. However, with age, there is a tendency for the affected skin to dry out and thicken.

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Why is diathesis dangerous in infants?

Diathesis in infancy can proceed in different ways: signs can reveal themselves as skin problems, changes in the lymph nodes or glands, nervous disorders. Depending on the manifestations, diathesis is divided into the following types:

• The lympho-hypoplastic type is characterized by a marked increase in the lymph nodes and thymus gland, as well as a decrease in the function of the adrenal glands. The child often suffers from colds and infectious diseases, allergic reactions. This type of diathesis often occurs in children whose mothers suffered from complex infectious diseases during pregnancy.
• The neuro-arthritic type is accompanied by the development of arthritis, gout, and metabolic disorders. This condition is considered a hereditary variant of diathesis.
• The catarrhal-exudative type occurs against the background of decreased immune protection, a tendency to infectious diseases, hypersensitivity of the skin, and protracted inflammatory processes. It occurs more often than other types.

The complicated types of diathesis that we have listed require immediate treatment. If this condition is neglected, very undesirable consequences may develop in the form of dermatitis, neurodermatitis or psoriatic rashes.

Diagnosis of diathesis in infants

If characteristic signs of diathesis are present, then diagnosing the disease, as a rule, does not cause difficulties.

A careful assessment of the anamnesis - hereditary cases of bronchial asthma, allergic dermatitis, hay fever, improper nutrition of a pregnant or nursing woman - immediately suggests the possibility of developing diathesis.

In addition, the doctor may prescribe tests:

• elevated plasma IgE levels;
• reaginic antibodies to certain foods or chemicals;
• OAC – eosinophilia;
• stool analysis for dysbacteriosis and helminth eggs.

Instrumental diagnostics of hypersensitivity in children is used extremely rarely.

Differential diagnostics are carried out with seborrheic dermatitis, scabies, primary form of dermatitis, allergic form of contact dermatitis, eczema, ichthyosis, phenylketonuria, acrodermatitis.

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Treatment of diathesis in infants

After diathesis is detected in a child, treatment should be started immediately, and it is necessary to begin with a thorough assessment of the child's and nursing mother's nutrition, with compliance with hygiene rules for both the child and all family members, as well as with a general cleaning of the premises.

The child is given proper nutrition. If necessary, folk remedies and medications are used (as prescribed by the doctor).

You should not self-medicate: each child should receive an individual consultation and treatment plan. Therefore, you should not neglect the help of a medical specialist - a professional look at the child's condition in this case is mandatory.

A sick baby must be protected from possible stress, strain, and excessive contact with strangers. It is necessary to strictly adhere to the daily routine and feeding, and provide the child with constant access to fresh air. The mother needs to keep a food diary, where everything that enters the child's body will be recorded, including with mother's milk.

The diet for diathesis in infants should be revised in accordance with the age of the baby. If the child is already being introduced to complementary foods, then you should pay attention to its ingredients. Children who have too rapid and excessive weight gain can limit sweet additives, both in the form of simple sugar and in the form of sweet fruits. Semolina porridge and flour dishes are excluded. Vegetables and other plant foods are left, as this is extremely necessary for the general alkalization of the body (diathesis is characterized by acidosis - acidification - of the blood). Significantly reduce the daily intake of salt and water. Often, doctors additionally prescribe potassium-containing agents, as well as adding a small amount of vegetable oil to food.

Children under 1 year of age should be fed mainly with breast milk. Complementary feeding should be introduced carefully, under the supervision of a pediatrician, according to the generally accepted technique and scheme for adding complementary feeding. If the child is fed mixed, then it will be necessary to limit the consumption of fresh milk: porridge should be cooked in water or vegetable broth.

It is recommended to add fermented milk products (kefir, acidophilus, yogurt) to the child's diet. Potential allergens should be completely eliminated, including dry (and canned) mixtures.

The mother's diet for diathesis in infants involves the exclusion of generally recognized trophoallergens: oranges, lemons, tangerines, chocolate, strawberries, as well as canned, smoked products, animal fats, spices, whole milk. If the child develops complications in the form of eczema or neurodermatitis, the mother's diet becomes much stricter.

Medicines are prescribed only by a pediatrician and only in extreme cases.

• Ensuring hyposensitization of the child's body is one of the primary tasks in treating the allergic predisposition of the immune system. The course of treatment is carried out for at least one month. Antihistamines are prescribed in combination with calcium-containing agents, vitamin P and C. If the child's condition is acute, the course can be repeated - monthly for 10 days with a further twenty-day interval.
• The acute period of diathesis can be smoothed out by using Ketotifen, an antihistamine and membrane-stabilizing drug. Its dosage is calculated as 0.025 mg per kg/day, twice a day half an hour before meals. A similar (analogous) drug Zaditen inhibits the production of mediators of an allergic reaction.
• Diathesis may be an indication for the prescription of anticoagulant (blood thinning) drugs, such as Curantil or Trental.
• The prescription of vitamins and their complexes is used to stabilize metabolism, reduce acidity of the body and activate the immune system. As we have already said above, vitamins C and P are prescribed for a fairly long period (at least a month). In the dry form of diathesis, the effect is observed after 20-day therapy with Retinol (vitamin A), which is recommended to be combined with Pangamic acid (vitamin B15) and sulfur preparations. Vitamin complexes of group B are taken orally in the form of independent courses of 15-30 days.

It should not be forgotten that a child may develop an allergy to vitamin preparations, so the intake of such medications must be monitored.

• Sedative treatment in the acute period may include the use of valerian infusion (a glass of boiling water per 2 g of raw material, 1 teaspoon), Trioxazine (¼ tablet up to 4 times a day), small amounts of barbiturates (Phenobarbital, Elenium). Taking such drugs reduces the sensation of itching and improves sleep. All drugs are prescribed only by a doctor.
• Medicines for normalizing bowel function are one of the important components of treatment. Often, sorbent medicines are prescribed for this purpose, which eliminate or reduce the effect of toxins and allergens on the body, reducing their absorption and removing them from the digestive tract. Enterosgel for diathesis in infants is prescribed between feedings. The daily dosage is divided into three doses - usually it is one teaspoon of paste (for children under 1 year). Thus, the child is given 1/3 teaspoon three times a day. For ease of administration, you can add a little water to the medicine, up to about 1 teaspoon. If the baby is not yet able to take the medicine from a spoon, then the diluted medicine is drawn into a syringe (without a needle) and offered to the child. The therapeutic intake of Enterosgel usually continues from 1 to 2 weeks.

An ointment for diathesis in infants is usually prescribed by a pediatrician or pediatric allergist. At the acute stage, accompanied by dry peeling, baths with tannin, oak bark infusion, potassium permanganate (weak solution - about 0.3 g per 10 l), chamomile decoction, string, and also with starch are used. When stopping the acute phase, talc, white clay, diphenhydramine-zinc ointment, intal with lanolin, etc. can be used.

• Fenistil gel for diathesis in infants can be used from the age of one month, and for premature babies - a little later, at the discretion of the doctor. The drug is applied to limited areas of the skin, at least 2 and no more than 4 times a day. After applying the gel, the child is not recommended to be in the sun.
• Bepanten ointment for diathesis in infants can be used in the maternity hospital. The drug is absolutely safe for both the baby and the nursing mother - it is made on the basis of dexpanthenol (provitamin B5). It perfectly restores tissues, relieves inflammation, moisturizes. Often the ointment is prescribed both as a treatment and for prevention. Please note that for infants it is better to use the ointment: Bepanten cream is suitable for older children. The drug is used daily at least 2 times a day.
• The medicinal product Sudocrem for diathesis in infants has anti-inflammatory, astringent, adsorbent and antifungal effects. It can be used for preventive and therapeutic purposes. This cream is hypoallergenic, it soothes the skin well, relieves itching and inflammation. Sudocrem is evenly distributed over the affected skin surface, from 4 to six times a day. The product is approved for use from the moment of birth. The active ingredients are lanolin, benzyl alcohol, benzyl benzoate and cinnamate.

There is another method of treating diathesis, which still causes controversy among specialists regarding its appropriateness and effectiveness - this is homeopathy. Homeopathic medicines are no longer surprising to anyone - they are widely used to treat both adults and children, including infants. All this is due to the fact that such products are considered practically harmless: natural ingredients, safe dosage, no side effects. However, despite the harmlessness, self-medication is highly discouraged. A specialist consultation should be mandatory.

Products for children are available in various dosage forms - these can be creams, tinctures, granules, etc. Special homeopathic preparations are also produced that eliminate skin diseases in children, including diathesis, eczema, and urticaria. Most often, the homeopathic preparation "Rus toxicodendron" is used to eliminate itching and inflammatory phenomena on the skin. The dosage of this product is strictly individual and must be prescribed by a doctor for the entire course of treatment. Before use, you should carefully read the instructions for the drug.

Other therapeutic methods, including surgical treatment, are not used for diathesis.

Traditional treatment of diathesis

Basic recommendations regarding the treatment of allergic predisposition of a child’s body using traditional methods:

• The use of chicken egg shells is very popular for diathesis. Before use, the boiled egg must be washed well, the shell must be peeled and dried for three days in a warm, well-ventilated room. After drying, the shell must be crushed to a powder state and given to the baby 2 times a day, 1 teaspoon at a time. The powder can be mixed with complementary foods or liquid. The duration of treatment is up to 3 months. This recipe eliminates the signs of diathesis, thanks to the calcium in the shell.
• Succession for diathesis in infants usually goes well with chamomile. These herbs are used for baths - a strained herbal infusion is added to the bathing water, which perfectly eliminates itching and inflammation in the skin. To prepare the infusion, use 1 tablespoon of dry succession and chamomile flowers per 1 liter of water.
• Fir oil ointment is another effective remedy for treating children. Usually, the oil is mixed with any baby cream in a 1:3 ratio. The skin should be lubricated twice a day - in the morning and at night.
• An infusion of dandelion rhizome is also used quite successfully. For 1 tbsp. of rhizome take 200 ml of boiling water. The medicine should be infused in a warm place under a lid for about 2 hours, then filtered and added to the child's food or drinks 1 tsp. three times a day. Burdock root can be used in the same way.
• Bay leaf is also often used for diathesis in infants - it is an excellent remedy for cleansing the skin, restoring local immunity and suppressing allergic reactions. For treatment, boil 100 g of leaf in 1000 ml of water over low heat. Then leave the decoction for 30 minutes and add it to a bath of water. Bathe the child (preferably at night). There is no need to rinse the body after bathing: just blot the skin with a soft towel. The course of treatment is until the baby is completely recovered.
• Celandine for diathesis in infants should be used with caution, carefully monitoring that the infusion does not get into the child's digestive system. When applied externally, the plant has a pronounced bactericidal and soothing effect, eliminates inflammation, pain and itching. The bath is prepared at the rate of 0.25-0.5 g of dry raw material per 100 ml of boiling water. This proportion can be used both for baths and for compresses or lotions. After 2-3 days, the itching decreases, and the child calms down.

Herbal treatment should always be done with the approval of a pediatrician. Do not experiment on a child or use little-known and unverified recipes. If in doubt, it is better to consult a specialist.

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Prevention of diathesis

All the food that the expectant mother eats plays a huge role in the development of diathesis in the child in the future. The diet of a pregnant woman should consist of low-allergenic products (for example, excluding oranges and tangerines). Of course, you do not need to completely exclude citrus fruits from the diet - you can add a slice of lemon to tea, or eat half an orange. However, you should not overeat and rely on such products. The fact is that some allergens have the ability to accumulate in the woman's body, which after the birth of the child may well manifest itself as diathesis.

It is desirable that the diet of the expectant mother contain a minimum amount of simple carbohydrates (sugar, baked goods, sweets and cakes), and a maximum amount of healthy foods (vegetables, cereals, kefir, cottage cheese, fish).

When breastfeeding, a woman's diet is also very important. The diet should consist of well-processed, non-allergenic products that do not contain preservatives, dyes, stabilizers, or other chemical additives. Food intake should be moderate, with sufficient amounts of liquid.

In general, there is no specific diet for preventing allergic tendencies in children. Parents should independently monitor which foods cause rashes in their child and exclude them from the diet.

The prognosis, subject to compliance with all medical recommendations and rational, competent nutrition, is quite favorable. However, it should be taken into account that if the above rules are ignored, diathesis can transform into a more severe and complex form - this can be a food allergy, bronchial asthma, eczema, etc.

Let us recall that diathesis in infants is not a disease, but a kind of borderline condition, a predisposition to the development of pathologies. This condition can be stopped in time and prevent the occurrence of many diseases associated with age-related imperfections and the baby's adaptation to external conditions. Diathesis is easily prevented and much more difficult to treat, so the child's health almost entirely depends on the nutrition and lifestyle of his parents, as well as on the conditions in which the baby is.

ICD 10 code

Allergic or atopic diathesis:

• L 20 – atopic dermatitis;
• L 20 – L 30 – dermatitis and eczema.