let down by GP over baby's eczema

[soontobeamum1982]

Argh i'm so fed up and upset. We have a family history of asthma/eczema/allergies on both sides so have been looking for it. Until now DD (6 months) has had eczema very mildly, and controlled by moisturising etc. Now we've started weaning it's kicked off badly - all over her face, swollen eyes, worst under the chin where skin in now peeling. And this has come from nowhere in under 2 weeks. Been to the GP twice and they just say keep going with Cetraben. Meanwhile it's getting worse, she's not sleeping or feeding properly as so irritated, she's refusing all solids (not that she was that interested from the off).
Took her to out of hours last night as her face was terrible and she also had a rash spread all over her. They gave some piriton but otherwise unfussed and said no point in allergy referral. Why not?
I'm going back to my GP tomorrow ready for another fight, but at this point I'm thinking of paying for a private allergy consultation as I really want to get to the bottom of it before it becomes so widespread it takes years to get rid of.
I'm not over reacting - DH has lived with terrible eczema all his life, has been hospitalised with it in the past, has to take the same immune suppressants that organ transplant patients take daily in order to keep it under control (and has to have his blood tests every month to check they're not wrecking his kidneys). Meanwhile I have food allergies and am terrified about weaning - daren't introduce egg or anything.
Why the hell won't they help? I've paid tax all my life (and lots of it) and now we need support I'm looked at like a panickly first time mum.
Gah.
Does anyone who has had a similar experience have advice? Any miracle cures? I'm 99 per cent sure it's CMPA at this point!

There is a facebook group for parents of children with CMPA and eliminating dairy and ither allergens is the most effective way of controlling reactions, whether allergy or intolerance. Parents don't need randomised clinical trials.

Well that settles it then, no need to bother with medical science or evidence, Facebook groups will sort everything out

Steroids weren't effective at all for my daughter. Only on mildly inflamed skin.

And some people don't respond to steroids. That's why there are other things to try. Including elimination as a long shot. But not elimination as the silver bullet.

Keep going to GP if what has been suggested is not working. They have to try first line treatment before considering a referral. I think if you ask tone referred to dermatology that may be easier to achieve than for allergy testing. And dermatologist more routinely will refer for allergy testing than GPs.

*to be , not “tone”

Well that settles it then, no need to bother with medical science or evidence, Facebook groups will sort everything out

Not at all what I am saying. We tried every steroid cream. Here's a selection of prescribed things (not all steroids) among many others we tried. She reacted to most of them by screaming and tearing at her skin. If a child is allergic to dairy then putting creams on whilst continuing to feed them dairy is somewhat pointless.

Firstly, all of those are creams, as opposed to ointments which are much more effective. Second, some of those are mild, some are more potent. A couple aren't steroids at all, there's an antibiotic and some moisturisers. Third, the OP's child hasn't tried anything yet. So for you to recommend the OP's DD skip the most recommended first line treatment and try something else, based on your experience which falls outside of the norm lacks logic. It's highly likely, based on evidence, that the OP's DD will respond perfectly well to standard treatments. I'm sorry your DD suffered, but advising people based on your outlying experience isn't helpful. Elimination of dairy may play a role, but the OP's DD's skin could look and feel great in a few weeks if the correct treatment is initiated.

My own experience is that the eczema will go away when the cause is found and removed. I would give it 2 to 4 weeks though, if it hasn't healed after that time it's unlikely it was that thing causing it.
My DC allergy to polyester for example only comes on during winter (it needs overheating + wearing polyester) so if I removed dairy and waited 6 months it would be cleared but not for the right reason. Incidentally DS1 had a lot of reflux as a baby which improved dramatically when I removed dairy from my diet (and came back when I introduced again a few months later so I had to hold on until he was 2). For that reason I thought the cause of eczema was the cow's milk he was drinking at preschool but no it was the polyester in the pre-school jumper as the eczema flared up dramatically the day he started back after mid-term despite on being on a dairy free diet.
OP, it is obviously not polyester related as your DD has eczema on her face but I would encourage you to keep a diary and that might help you identify the cause. It could even just be the stress of weaning causing it, she is still very young so no rush. I don't see any harm in removing cow's milk for a few weeks to see if that helps.

Try keeping the heating down too, can make a difference to eczema as heating makes the air drier.

not why are ointments more effective than creams, please?

My point way upthread about avoiding peanuts until the child is old enough to be reliably tested for food allergies (2yo where we live), is that often eczema, allergies and asthma manifest together. The risks of a dangerous reaction to peanuts are not worth the benefit (are there any in an otherwise balanced diet?) of eating them before 2yo. Peanuts can trigger extreme reactions, and if a child has an extreme reaction to peanuts they are at higher risk of having a reaction to sesame too.

I didn’t suggest that peanuts cause eczema. There’s no causal link, as far as I’m aware. They are just more likely to coexist in the same person. The point is to avoid a dangerous reaction to peanuts if possible.

the risks of a dangerous reaction to peanuts are not worth the benefit (are there any in an otherwise balanced diet?) of eating them before 2yo.

I think that's out dated advice now. The earlier children are introduced to them apparently less likely to have severe reactions.

www.sciencealert.com/feeding-young-kids-peanuts-really-could-head-off-allergies-later-in-life

I sat in on an allergy clinic and dermatology clinic as an observer. Key points:

1. Avoid anything perfumed (which includes some Child's Farm products)
2. Use emollient four times daily - whichever one you prefer, and the dermatology nurse had samples to give out
3. Some foods irritate skin directly rather than due to allergies e.g. Tomatoes are quite acidic so make sure you wipe face/ hands well afterwards
4. Food diary, including a note of uncooked vs cooked food as some people can eat cooked eggs etc

Thanks everyone. Lots of great advice here (and a few unnecessary rows, but hey ho, it's Mumsnet). For those asking, I am now eliminating dairy from both her diet and mine (I breastfeed) but this is all very sudden. She was fine on my milk and the eczema has come up very badly in less than 10 days since starting solids, so I've been keeping a food diary and trying to work out what (if anything) is the trigger.
An update: we got a referral and some new ointment this morning. No steroids, but happy to try this and elimination while we wait to see the eczema clinic. I also saw the HV about weaning who also wanted me to keep a very close food diary as we have a history of allergic reaction on both sides. We will see where we end up. I feel mildly more positive this afternoon but will be thinking about private allergy testing because weaning is now terrifying. She came up in a rash after pear, of all things, today.

My daughter had bad eczema as a baby - sometimes to the point her face looked like it had been burned it was so raw and inflamed. We did get referred to a skin specialist who advised us to keep a food diary. We tried 6 months with goats milk instead of cows milks. And a further 6 months with no dairy at all (surprisingly hard with a small child!). I found that Fucidin was good for skin when it got badly inflamed/infected. Keeping her nails cut super short (shorter than you'd usually want to cut them) prevented the worst of the skin scratches/breaks. Eventually after a year we discovered that the main culprit was most perfumes and detergents. Fairy non-bio was fine. Virtually every other washing powder (bio and non-bio) was a disaster and caused raging skin. We bathed her only in a special emollient designed for baths and as she got older we found one type of shampoo that didn't react (and she still uses it now she's a teen).
The worst of it cleared up by the time she was 4 and while she still has patches on her wrists and behind her knees its pretty manageable most of the time and I cant remember the last time it was inflamed but we had to let all family know to have bedding washing in Fairy if we were visiting and spent the odd joyless night when someone forgot and she scratched all night.
Finding an emollient that suits is trial and error. We tried 4 or 5 before we tried diprobase which was the only one that didn't burn when we put it on.
Now though we are entering the joys of 'I want to wear makeup' and the reactions it can cause!

Oh and we have a long family history of Psoriasis but she was the first to have eczema.

It is possible that she has been reacting mildly through food passing through your milk and that now she is getting the food without processing, the reaction is worse. (we had this with peanuts... it was only in hindsight that I can remember specific instances while feeding)

Also, it is possible that she is hypersensitive as her body is stressed but when you exclude the big hitters, the other reactions will reduce.

Good luck.

She came up in a rash after pear

My dd also reacts to pear. Fresh pear gives her eczema on her tummy after a few days, but Ella's pouch pear puree gave her an immediate rash around her mouth, which may have been due to it containing lemon juice.

She came up in a rash after pear, of all things, today

I have oral allergy syndrome and pear is probably my biggest allergen.
research.bmh.manchester.ac.uk/informall/allergenic-food/index.aspx?FoodId=39

Also, it is possible that she is hypersensitive as her body is stressed but when you exclude the big hitters, the other reactions will reduce.

Yes - the body reacts more to minor allergens when it's coping with a bigger allergic load. I am allergic to birch pollen, so in spring my body is already coping with much more of an allergic load in general, and I'm more likely to react to foods that usually would be fine.

With my youngest we had to drop weaning to allow her skin to heal. Then start again strictly with one food at a time. She's allergic to pear (amongst a zillion other things)

Also have a sniff of your washing powder - a change if ingredient/make up set us up for a fall once and I only thought about the change to the smell a few days later.

Thanks everyone. @ExFury I thought we might have to pause weaning. She's only 6 months + 2 weeks so we could probably easily drop for a week or two. But I've had conflicting advice. HV says down to one main meal a day of single flavours and keeping a food diary (both of which I'm doing), one doc said carry on as normal but no nuts and egg (also avoiding those for her, we hadn't introduced anything but fruit and veggies and baby porridge yet anyway), but another Dr said it's really important to keep going or she could end up with some kind of developmental delay.
We have a referral at least. I do hope it's just dairy and not everything! Will try pear again in a few weeks when (if) things settle to see what happens. It was an Ella's pouch funnily enough.

soontobeamum1982

We couldn't wean at 6 months as dd was in and out of hospital on various cocktails of antibiotics and antivirals and barely taking my milk, never mind solids. At 7 months her dietician said we should forget waiting days to see if there's a reaction and instead just rattle through all the food groups. Well, we tried to "rattle through" but ended up with reaction after reaction, inflamed skin, eczema flare after flare, and no idea what was safe and what wasn't as it really can take a few days before a reaction is visible...by which point we were onto a new food and getting confused. So, we stopped and went back to basics, and she's in no way developmentally delayed. Advanced in every way (apart from height...though she's on track to be as tall (small) as I am!)

NotBadConsidering, I suspect you are not a parent of an atopic child.

soontobeamum1982
If you aren't a member already I recommend joining this facebook group:
www.facebook.com/groups/CMPASforWeaning/

Thanks @Raisins18 that makes me feel better. I'm going to just do very simple single tastes for the next couple of weeks and see how we get on. Looking at the food diary we've done already I do strongly suspect dairy, but of course there may be other things too. Feeling quite overwhelmed tbh, but the health visitor is at least supportive.
Do you every get full allergy testing?

DD had blood tests at 6 months whilst an inpatient, somewhat by chance, and bypassing referral from our GP. Those showed she was "off the scale" allergic to dairy, and quite strongly allergic to egg and peanut. She had skin prick tests at age 1 and 2 but refused her last set. We're having more done soon though. As results can be misleading in very young children they just use them to give an idea of what to avoid rather than label them with a definitive allergy, and many dairy/egg allergies are grown out of by age 2.