News

Eczema is a very common condition, affecting 1 in 4 children and can have significant physical and mental health implications. Although diets have been more commonly used to prevent eczema, such as the RPAH elimination diet, it is now thought that food allergy is a consequence of eczema, rather than a cause of eczema. Thus, treating the skin through moisturising and topical steroid creams can be very effective in treating the eczema in the first place. Treating eczema through good skin care is critical given that eczema in the early stages of life is strongly associated with the subsequent development of food allergies. If the eczema does not respond to medical management, only then should exclusion diets be considered.

In this relevant presentation, Eczema Nurse Practitioner Jemma Weidinger and Accredited Practising Dietitian Ingid Roche share their knowledge and expertise on the causes and management of eczema, and then the dietary management of eczema. When diet is considered, cows milk, egg and peanut are the most common allergens aligned with eczema. They highlight that there is currently insufficient evidence to suggest the usage of food chemical elimination diets in the paediatric population, as these can often be overly restrictive, increase loss of oral tolerance, and may also increase  the risk of food allergy to the excluded food component. Long-term, exclusion diets can also have significant nutritonal implications including poor growth, nutritional deficiencies, low bone density and malnutrition.

As dietitians it is crucial that we do not unnecessarily suggest overly restictive diets to the paediatric population. When in doubt, we should always liaise with the mutlidiscpinary team, including general practitioners, eczema nurses, dermatologists, and allergists to ensure that the underlying cause of eczema is addressed.

Summary:

• It is now thought that food allergy is a consequence of eczema, rather than a cause of eczema.
• Early treatment of eczema through skin moisturisation is crucial in managing eczema, especially in the early stages of life.
• Eczema in the early stages of life is strongly associated with the subsequent development of of food allergies, so it is crucial the eczema in mananaged really well upon onset.
• There is currently insufficient evidence to suggest the usage of food chemical elimination diets in the paediatric population, as these can often be overly restrictive and may be ineffective.

Ingrid Roche has been an Accredited Practising Dietitian since 1995 and has developed her expertise in food allergy working at the Perth Children’s Hospital (formerly Princess Margaret Hospital) in the field of allergy and immunology. She also has a private practice in Perth. Ingrid was chair of the Dietitian’s Committee of the Australasian Society for Clinical Immunology and Allergy (ASCIA) from 2012 – 2018, during which time the ASCIA e-training dietitians was developed; as well as the ASCIA-CAL advanced learning course in food allergy in partnership with Dietitians Australia. She remains an active member of ASCIA and Allergy & Anaphylaxis Australia and is currently project co-lead on the food service project of the National Allergy Strategy. Ingrid is committed to providing and improving training in food allergy for health and other professionals, as well as improving the quality life for consumers and families living with food allergy. 

Jemma Weidinger is a registered nurse and nurse practitioner. She has postgraduate studies in child health and allergy nursing and a Master of Nursing (Nurse Practitioner). Jemma currently works as a nurse practitioner in the Department of Dermatology, Immunology and Allergy at Perth Children’s Hospital. Her role includes seeing and treating children with eczema, establishing a new rapid eczema allergy support service for infants and young children at Perth Children’s Hospital and developing eczema resources to educate and support health professionals. Jemma is the founder of Children’s Eczema Care.

To register for the presentation and associated documents including the assessment quiz click here