problems with my dd nursery regarding eczema

[misdee]

my dd has modrate-severe eczema, some days he needs her creams applied constantly throughout the day. it can be quite upsetting for her and quite uncomfortable. she started nursery last week, and they have told me that altho they are fine about giving her inhalors if she needs them they cant apply her cream. they work on the theory that if she has them applied b4 she starts the session then she shouldnt need them again in a 2.5 hour period. i know this not to be true. she also needs to moisterise her hands and arms after painting/sand and water play/washing her hands, but they havent really listened to me about this. the only thing they said i could do was keep her off if she is bad, or come in and apply her creams. i live a 30min walk away from the nursery, by which point a little itch could have turned into a huge scratching session with bleeding and a very upset child. is the nursery right in refusing this, what should i do?
not too sure what toopic to post this under so it may pop up in a few threads. sorry!!

I am not sure what the policy is but I know with our dd - she had a terrible cough and we had cough medicine to administer and the nusery said they could only administer perscription medication - for legal reasons. I don't see that it should be a problem with creams though - esp if she is doing water play/painting etc.

For dd's nursery in terms of other things with her - like physio things and that they are more than happy to do them. I did up a little book - great idea - outlining all the things about dd - what she can and can't do - what we do at home etc and they were more than happy to take that on board.

I would ask to speak to the nursery manager and see if you can get a letter from your gp or specialist to back up what you are saying.

Oh dear- I agree she needs this. I think the national eczema society produce a very good booklet for schools/nurseries. Making her stay off becuase they won't apply creams is surely contravening the disability discrimination act! Try and get the national eczema society booklet, and maybe a letter from the GP. The other alternative would be to wet wra her (just with emollients not moisturisers) but she might not like standing out in that way.

sorry durr brain not in gear- I meant just with emollients not steroids.....

i'm still pushing for wet wrapping, everyone fobs me off saying its too much hard work, but so is being up 5 times a night reapplying creams. she has had a hard night last night so am in 2 minds whether or not to send her today. she sees her consultant in a month, am gonna try and print out the eczema soceity thing for schools. so far she has been fine at nursery, but i worry all the time i'm gonna get called in. i have to see my gp today for me, but am gonna ask him for his opinion too on the matter.

Oh how ridiculous. Wet wrapping takes about 10 minutes and is far far easier than being up all night with a scratching child. Then other thing they say about wet wrapping is that you have to do it with steroids, but that's not true. We did it with just emollients (50:50 mainly) for a long time after we'd stopped the steroids and it was very soothing. the lovely lovely thing about wet wrapping is in the morning their skin is sooooo soft and creamy.

I have a ds and we have always wet wrapped him using just emolients, hv suggested it and showed us how.

Have to echo jimjams on the wet wrapping thing. Like you, we found we were up 4-5 times a night re-applying cream (sometimes, we thought unnecessarily, but you can't ignore a child who claims to be itchy!!).

We were referred to our local eczema clinic, and had a great session with the eczema nurse, who showed us how to apply the wet wraps. We were actually given a new type of wrap - by Tubiform - which are a series of garments, rather than the old style bandages that you have to cut to measure. This has, apparently, cut down on the time taken to apply them.

Our dd was given a book called 'Kimberley wears wet wraps' (which did sound a bit like an awful porn title to dh and me!!). It explained to her why we were doing it, and what she had to do to help.

We've been doing the wet wrapping all summer (mainly because of the heat), and have noticed a real difference. Dd's skin is better than it has been for ages, so much so that we were able to treat her to some ordinary pyjamas for a few days last week (until the hot weather returned - boo!).

The Tubiform stuff is expensive if you can't get it on prescription (about £35 a set of full body wear, and you need one wet set and one dry, plus one or two spare sets to cope with accidents). However, we've been told that they are now available on prescription as of 1st Sept.

I think you are well within your rights to ask nursery to reapply cream. Our dd needs more every 2-3 hours, especially after sand or water play. We wrote down the procedure for them, and supplied a pump dispenser to make it easier for them. We also supplied some soap free 'soap'.

Some times I think it's just nervousness on the part of the staff - they think it's 'catching' or very time consuming. Perhaps if you offer to demonstrate what's needed, then they'll come round. Good luck though.

By the way, can anyone recommend a sun cream suitable for eczema? We've been trying Proderm, but it doesn't seem to irritate any less than anything else.

thanks. my condultant mentioned the new wet wraps when we last saw him, i'll ask again about them next time i see him.
the only suncream i found that doesnt irratate is by banana boat. i think i've tried almost every suncream going on the markte, one doc suggested just keeping dd in the shade all summer so i didnt have to worry about suncream. she was 2 at the time, so unless i tied an sun umbrella on her it was impossible.

Misdee, I replied on the other thread re he nursery. Regarding wet-wraps, who has fobbed you off? IME docs love the treatment. We used wet-wraps for about 8 months and they did work well at first, definately eased the itching. We still resort to them occassionally when ds' skin is very dry as it is a really good way to moisturise.

Utka, I always recommend a sun cream by Roc, spec for sun sensitive skin. We have tried loads of different ones but this one didnt irritate ds at all.

Bunny, i have been fobbed off by Helth visitors (tho not the ones i have now), her consultant who has been treating her on and off for 2 years, the GP's in stevenage and harlow. Am currently battling the docs here. I will succeed this time!!
We did try and get an appointment with a nurse who specialised in wet wrapping but hit a brick wall as she was uncontactable. then moved from the area.
But my Hv here is great, she is helping me make my home eczema and asthma friendly as it can be. shame she cant pay for a new leather sofa for me.....

keep battling misdee. Our dd had awful eczema fron 5 months old. We were lucky enough to be shown wet wrapping at Great Ormond Street ( although we had to pay - a lot!) and after that we got all the bandages and creams on prescription. DD is now almost 2 and we just do the occasional wrap on her wrist or arm if it flares up, and we get all the stuff we need, including aveeno moisturiser, on presription.So keep nagging ! wet wrapping is a bit of a hassle at forst but it's worth it.

she missed nursery last tuesday, and also today as this morning she ripped her legs to pieces. have also just taken her down the A+E as her breathing is a bit off (no wheezing but not breathing normally, hard to explain). not sure if she will be going in tomorrow, she wants to go, but dont want to be picking up a bleeding distressed dd tomorrow afternoon.

Misdee, I hope she is ok, some children have so much to deal with dont they. Ds is on yet another course of antibiotics for infected eczema. I am curious abou your gps/hvs resons for resisting the wt-wraps treatment. It can be so effective. What resons are they giving?

i honestly dont know the reasons behind it. her consultant just recommends different treatment, the wierdest one we've tried is using clingfilm instead of bandages. it actually worked quite well, but have atm run out of efcolan (or something like that, and GP hasnt put it on repeat for me yet), which is a steroid treatment, which i hate using, her skin is damamged enough thro steroids.
she has only had once course of antibiotics this year so we've done well at keeping infections at bay, tho she is a bit of a mess tonight so will cart off down the GP's tomorrow, probably will be antibiotics this time. 2 summers ago she was almost constantly on anti-biotics, steroid tablets, fuciden H/fucibet, steroid creams, i dont ever want her to get to that stage again. the dermol seems to work quite well at keeping things under control.

I know what you mean about the steroids. Without them ds suffers so much, they do help alot but we use them every single day somewhere on his body and I worry so much about the long term damage. My husband has used a clingfilm treatment, I shall have to ask him about it.

well today i had to cart her off to the gp, where they perscribed yet again, steroid cream (emovate) i asked again about wet wrapping, she told me emoillants/moisterisers and steroid cream was the best treatment available. i had an arguement with her stating i didnt want to use steroid creams on my dd skin all the time. she has been on them pretty much at least one week a month since she was 6 weeks old, she has thick black hairs on her ankles (one of her worse places for ezcema). why wont they listen to me??!!! i was up 4 times last night reapplying creams, she has had 2 baths today, and a dose of piriton to see if she sleeps better tonight. she is wearing her sleepsuit from cotton comfort (mittens, button tapes, flat seams etc), but even that doesnt stop her rubbing her skin raw if she cant actually scratch.
if her consultant refuses to discuss wet wrapping next month i'm seriously looking into going private.

rant over.

Have you tried another gp? You might find going to another practice where they have a different policy will help. Everyone I have met medically has been so pro wrapping. Ds has had antibiotics for 3 days now and they have worked so we are getting some good nights sleep here. It is so hard to function after a disturbed night isnt it? It is like having a newborn, up every hour or two. I have loads of wraps, I could post you some if you want to see if they help. Use them with lots of emollient and see if they help your ds sleep. We found ds got some really peaceful nights when wrapped. I'll happily send them to you, go to the contact another member button if you want them, and email me. Chin up.

My DS had bad ezcema from six weeks and the GP didn't really know what it was. When he was five months old I told him to see a Dermatologist privately who is from Great Ormond Street. He recommended that we used Balneum Plus bath oil (two baths a day) washing him with Aqeueos cream even his hair using no other soaps or bath oils. After his baths we use Diprobase as his emolient (4 times a day) and for flare ups a steroid cream called Stiedex on his body and Elidel (non steroid) on his face. At the beginning we had to use the Stiedex and Elidel for about two weeks but now we rarely have to use them. We also were advised to change his diet to avoid foods which can make it worse ie. diary, citrus etc. We are now able to control it which means he is no longer scratching all the time.

I also meant to say that I was told that grass, sand and swimming pool water can make ezcema worse.

louli, i have tried balneum plus, have tried epaderm, emulysifying ointment, dermol 500, oilatum cream, oilatum bath emoillant/plus/junior, have tried washing her in aqueous cream, have used e45, infaderm, emouvate, fuciden, fuibet, fuciden H, elfocan (not sure on spelling), hydrocotisone ointments at .5, 1 and 2%, have had steroid tablet treatment, god knows how many antibiotics.
have tried every soap powder going, was ok with aerial non bio but now they have added quick wash action her skin has flared up. all washing goes on at 60 degrees, bedding get changed frequently, nails are cut almost every night. she wears special sleepsuits (costing 45quid a time), my home is cleaned everyday, have a dyson vacumn cleaner, have blinds no curtains, try to wet dust once a week.
i've tried doing the opposite of what advice says and let her get filthy, cut down on baths/creams etc, didnt work.
so i really think wet wrapping is the only thing left to try.
(hae also followed special diets when she was younger.)

I agree with bunny- wet wraps are the way to go. Is it on this thread that someone mentioned wet wrap suits? They sound a better bet than seeing a consultant. We found wet wraps with 50:50 a godsend (soothing for him and a nights sleep for us)

Misdee, it sounds awful. I don't know what to say. If you do decide to see a another consultant here is a link to the one we saw (Dr Harper) here

louli, can u give me an estimate of the cost? i just dont know what to do anymore, if this next appointment doesnt go the way i want, then its going to be my only option. just tearing my hair out at lack of co-operation with gp's and nursery, all whilst my dd is tearing her skin off.
she has an appojtment in nov with the paediatrics dept at the local hospital in nov as well to try and get referred for allergy testing as well.

we have also used stiedex and euricin lotion. have probably exhausted most treatments to date.

Misdee, we saw the consultant twice and each appointment was £130 expensive I know. If you
have medical insurance for your dd then just tell your GP to refer you to him they would then probably pay the bills. Or maybe you can ask your GP if they can refer you to Great Ormond Street - I don't know how that works. Good luck I hope she gets better soon.