The phrase “baby skin” is familiar to many, and usually refers to soft, smooth, silky skin. However, in practice, it is not so easy to meet a baby with such skin. As soon as the baby leaves the womb, he is faced with tough environmental factors that do not have the most favorable effect on the delicate skin, therefore, up to a year, periodic pimples and redness are quite common.

Usually, the first rash on the cheeks appears at the age of one month (or so). Seeing the sprinkled cheeks of a toddler, mothers wonder: acne or allergies?

Doctors of the post-Soviet space often say that it is an allergy and put the mother on a hypoallergenic diet. And the calculation of “all allergens” begins. It so happens that it takes a couple of months to calculate, and then the rash goes away abruptly. You might think that this last excluded product was to blame. However, it also happens that this is just a coincidence. The baby had neonatal acne, which went away by itself by 3-4 months.

In fact, the prevalence of neonatal acne (neonatal acne) is only about 20%, and it is more common in boys. The reason for acne is that in the first time after birth, under the influence of placental hormones (hormones that are contained in the placenta and help to ensure the normal development and functioning of the fetus), the secretion of the sebaceous glands is enhanced, and these glands appear in the form of small yellowish-whitish smooth pimples, the main image on the nose and cheeks (Photo 1). These pimples may have a red base and may look like prickly heat. Also, acne can be expressed by single comedones (blackheads) on the cheeks (less often on the forehead).

Photo 1

Seborrheic areas (scalp, eyebrows) can be crusted by the yeast fungus Malassezia. In general, these fungi are normal flora of human skin, however, with increased secretion of the sebaceous glands, they can actively multiply, which leads to seborrheic dermatitis.

By three months, the rash usually disappears as sebum production and yeast colonization are reduced to normal levels. In this regard, treatment of acne and seborrheic crusts is not required – only normal hygiene procedures are required. It is better to wash the crumbs with water without chlorine (filtered or mineral). After washing your face, you can apply a moisturizer or lotion. Applying 2% ketoconazole cream twice a day or 1% hydrocortisone cream once a day may speed up the resolution of the rash. However, this is not necessary at all.

Photo 2. Left cheek

Another rash is quite common. First, pimples appear on the cheeks with or without a red base and white heads (pustules). Then pimples spread to the forehead, chin, neck, ears, less often to the chest, back, arms, stomach. Also, pimples can combine into large spots and burst, as a result of which weeping crusts are formed (Photo 2). Remarkably, such a rash, as a rule, appears and goes away without intervention at about the same time as the gas. Therefore, it is believed that it is associated precisely with the development of the gastrointestinal tract.

At the age of about one month, the intestines begin to work actively, the baby consumes more food. Since the gastrointestinal tract starts only after the birth of the baby, it is the most vulnerable and malfunctions for some time. In particular, there may not be enough enzymes, bile, lacto- and bifidobacteria to assimilate all incoming food. For the first few months, there is an active colonization of the intestine with microflora. Various bacteria are waging a real war for the right to take a “place in the sun”, which is accompanied by increased gas production.With good nutrition of the mother, as well as compliance with measures for the  prevention of atopic dermatitis, by 3-4 months, the processes of local immunity in the intestine mature (the level of immunoglobulins A increases, which help protect the mucous membranes from microorganisms and viruses); a decrease in the permeability of the intestinal mucosa (due to the growth of lacto- and bifidobacteria in the intestine, a protective film is formed, which prevents toxins and allergens from entering the blood); increasing the amount of enzyme production (in particular, pepsin, which is responsible for the processing of proteins, including milk); increased secretion of hydrochloric acid and a decrease in the pH of gastric juice (hydrochloric acid contributes to the death of bacteria and viruses that enter the stomach, and also helps the digestion of proteins); maturation of other enzymatic processes of food digestion.

Accordingly, by 3-4 months “allergy” in an average breastfed baby goes away without special treatment and mother’s diets, when the intestinal mucosa reaches a certain maturity. To reduce rashes, you can correct the mother’s diet by reducing the amount of “heavy” protein (cow’s milk protein, gluten) in the diet or follow a rotational diet for some time (one type of protein no more than once every four days). It should be remembered that unreasonable exclusion of foods from the mom’s diet can reduce the rash, but will almost certainly increase the ripening time of the intestines.

Skin care for a rash caused by immaturity of the intestines is similar to care for acne in newborns: hygiene procedures and avoidance of secondary infection.

An important difference between allergies is that its symptoms are stopped by antihistamines. They have no effect on acne. If the doctor suspects allergies and prescribes a hypoallergenic diet, it should be remembered that even with such a diet, food should be as complete as possible, including cereals, meat, fruits, vegetables, sweets (while breastfeeding, sweet is an important element of nutrition, the question is how sweet it is) … With allergies, after 2 weeks of the diet, significant improvements will already be seen. If they are not there, then the mother’s diet is clearly not to blame. If they are, it is possible that the rash is really connected with the mother’s nutrition, or perhaps the time required for the rash to pass on its own has passed. After improving the condition of the skin, the products begin to gradually return to the diet and monitor the baby’s well-being.

You may be interested in the following entries:

The diet of a nursing mother and its effect on milk

Treatment of atopic dermatitis: our experience

Causes of atopic dermatitis in infants

Prevention of atopic dermatitis

How to introduce complementary foods for atopic dermatitis: mom’s experience