Bathing your kid twice a day .... is it me? Am I an evil step mother.

[lickencivers]

I’ve gained two lovely step children. One of which suffers from pretty horrific eczema. Especially on hands (all cracked open at the knuckles etc). Whilst I have dry skin myself I have zero experience of this sort of stuff with my own DC.

DP and their mum seem to be using a lot of steroid based cream and epiderm but it doesn’t do a thing to ease him.

I’ve suggested alternative things (like putting porridge oats in a sock in the bath) as helped the itching when Mine had chicken pox etc

However, they bath their kids normally twice a day. If not twice then definitely religiously every night. Without fail. Gina Ford babies —I didn’t do routine either— any way. Any help or advice? Because I’m getting ulcers biting my tongue.

Some recent guidance on excema from my toddlers consultant is daily bathing for excema. I think it makes the emollient more effective. Very hard to fit in time to do this with work ,his skin has improved anyway so I usually do every 3 days unless he's dirty.

The reason it irks me so is that tubes and tubes of fucibet are used with clearly no relief and regardless of that it’s treating the symptoms not the cause and The continual water exposure can’t possibly help. Which was sort of the reason for the post.

I’m not planning on interfering with the treatment, I was asking for a general consensus as it seems bonkers for so many baths. I am however not happy to standby as it deteriorate and neither parents seem to want to take responsibility and adopt a plan cohesively or seek further help. In the mean time when they are with me and they’re in discomfort I shall try and ease that like I would any child with the oats and the child’s farm etc. Not just going to leave them suffering because they’re not my kids.

Hands don’t appear to be infected. Fucibet been used for nearly a year on daily basis.

I suspect it's the swimming more than the baths. Swimming pool water is awful these days, so heavily chlorinated.

However, my tack in this situation is to say ' two baths a day isn't working, could we just try a different system for a couple of weeks and see if things improve, this includes no swimming. If still nothing improves then we'll try something else'.

I think you need to go to the next doctor appointment.

That is interfering with their treatment plan if their treatment plan is epiderm, fucibet and daily bathing.

If the treatment isn’t working they should go back to the dermatologist.

The fact that they got into a dermatology clinic in the first place shows that at least one parent isn’t ignoring the issue.

Does your DP go to the doctor appointments at all?

Or does he just leave that to the former missus?

Yes I’m sure she can tell the dermatologist that he’s unnecessarily prescribing a cream for treating secondary bacterial infection when to her expert eyes the skin “doesn’t look infected”.

Poor kids. Whatever advice they've had, current regime is not working and they should be going back to doctors and trying something differently. There are so many options to try these days.

We used to have blobs of aqueous cream in our baths and use it instead of soap. For my eczema that turned baths from painful to soothing. And hair wash once a week so bath had no soap in at all. Just as something cheap and easily available you could try if there isn't something on prescription to put in the bath. Swimming was never good, particularly in chlorinated pools, but if they must then slather on moisturiser straight after.

Really feel for them. I hope your DH can find a way to get more involved.

So the mother has not been advised to bath the kids twice a day?

Maybe she has taken the advice from the national eczema website (posted a few pages back?).

I think this thread goes someway to debunking that bathing everyday is the wrong thing though, given so many of us [currently under specialist care] have been told we should bathe daily, and have been given medical rationale as to why.

You do seem rather judgemental about the mum in general? I've seen comments about the kids being Gina Ford children etc.... it's not my bag but sneering at other people's choices isn't productive? If your DP doesn't like how she parents then he needs to get involved or he should have got involved many years ago

Dealing with eczema is hard, and its relentless and the mum is doing it all the time do cut her a little slack.

If the eczema is really really bad then bathing twice a day is recommended from dermatologists to prevent infection before reapplying emollients and especially if wet wrapping.

Keep out of it and let mum and dad deal with it. They know what the dr have said.

The last dermatologist appointment was a year ago and that’s when the fucibet was prescribed.

Seems v little point me replying any more as now I’m being attacked. Couldn’t give AF how she chose to parent her kids but when her systems in place don’t work it impacts on the kids and the whole family. It’s at her insistence that they’re bathed so often. The kids will say they are dirty if they’re not bathed. I don’t think a 4 year old should think he’s dirty when he had a bath less than 12 hours previously.

The routine and schedules are very prescriptive and the repercussions of not following them are huge - for the dc not the adults. They have sanctions.

Clearly in summary difference specialists advocated a varied approach.

Clearly it’s non of my business though. I go on letting them cry and excessive use of steriods and cracked bleeding skin being bathed. I’ll just leave them all to it.

One of my DC has chronic eczema. He needs a bath or shower every day as he's started puberty and smells otherwise, but even as a young child I was advised to bathe regularly as ot keeps the skin clean and stops infection getting in. There's no point piling creams on dirty skin.

Don't mind the people who are needling you.

If the last derm appointment was a year ago then I suspect another needs to be scheduled.

The Fucibet prescription needs to be reviewed as a matter of urgency.

4.4 Special warnings and precautions for use

Long-term continuous topical therapy with Fucibet should be avoided.
...
Fucibet should be used with care in children as paediatric patients may demonstrate greater susceptibility to topical corticosteroids-induced HPA axis suppression and Cushing's syndrome than adult patients. Avoid large amounts, occlusion and prolonged treatment (see section 4.8).

Due to the content of betamethasone valerate, prolonged topical use of Fucibet may cause skin atrophy.

Bacterial resistance has been reported to occur with the topical use of fusidic acid. As with all antibiotics, extended or recurrent use of fusidic acid may increase the risk of developing antibiotic resistance. Limiting therapy with topical fusidic acid and betamethasone valerate to no more than 14 days at a time will minimise the risk of developing resistance.

www.medicines.org.uk/emc/product/983/smpc

Since you and DP seem to have 50/50 custody of the children, can he make an appointment with the dermatologist, tell the mother the date and time, and bring the children (and you should go too).

I think you should definitely say something, OP. Your heart is in the right place, and they spend half their life with you!

They need a new dermatologist if you ask me - just like the link above there are better creams for kids that don’t absorb so much through the skin as the older ones. Also it sounds like a course of oral antibiotics is in order. If infected the eczema just won’t go away no matter how much steroid is applied. It will keep spreading and popping up. The germs quickly become resistant to topical antibiotics.

So people arent allowed to disagree with you OP? Alrighty then. Seriously why post in AIBU if you are going to get upset if someone says "yes you are being a bit unreasonable"

How are they getting all this steroid cream? My GP gives very little and only upon seeing my DC and deeming they are flaring. I certainly couldn't be using steroid cream for a year without question?

DS had awful eczema as a baby and toddler, weeping and cracked skin. Limiting his dairy intake (cow) and switching to goats milk was the game changer. As he's older, his tolerance to cows milk is better so it's not an issue though he gets occasional flare ups. Bathing and showering regularly wouldn't have made it worse as it's a food issue that needed to be controlled. I can imagine not bathing enough and using lots of creams can sometimes give rise to fungal or yeast infections as DS had at one point which made the condition 10x worse and we had to use an antimicrobial steroid cream. My DH has dry skin, showers daily and applies cream within minutes of coming out of the shower.

We only ever had one appointment with a dermatologist. He was clear with advice and guidance. My DS is under the allergy team so we continue to be reviewed by them. I have managed my sons skin for over 11yrs now and know what makes it worse and what creams to use. It can feel like a battle but we have to manage his environment too and his food as his is allergy related. I think if your expected to support your DH in looking after his DC you should know exactly what the issues are and have a clear care plan of what to do. Have the DC got any associated allergies?

They'd be better bathing them once a week with eczema and even then without soap.

Tell DP bathing so much will be making the eczema worse, it dries out everyone’s skin so is horrendous for eczema sufferers.

No one needs two baths a day anyway, it’s so ridiculous.

With the swimming, I can see that the shower at the pool is to wash off the chlorine and wee asap and the bath at home is for using the eczema products so may not be that bonkers.

What do does need to do is get specific advice for his children as we have read of different advice having been given on this thread.

Good luck.

If the last dermatology appointment was a year ago, they aren't better, and they are just carrying on with endless Fucibet an urgent review is needed.

It sounds as if both your DP and his ex have been carrying on, on the basis of minimal advice getting stuck in more and more rigid habits as the ezcema becomes more and more burdensome - all on the memory of an increasingly out of date treatment plan.

I've had eczema since I was 6 months old and yes bathing twice a day is not good for the skin. I think you should ask your partner to speak to a dermatologist about this.