by Mary Bove, ND, RH (AHG)
Background
A 28-year-old woman brought her 12-week-old girl to the office with the complaint of skin rash and severe itching over 70% of her daughter’s body. The baby had a normal vaginal delivery at 41 weeks, weighing 8 pounds 3 ounces. She is currently breastfeeding with no problems related to nursing or lactation. A mild rash started to appear on the baby’s arms and neck, along with signs of cradle cap, at eight weeks of age.
Over the last two weeks the condition has significantly worsened. The baby is constantly scratching and is often up at night with discomfort. The mother reports that heat, hot water, and some fabrics appear to make the skin flare. She also reports the rash flaring for no apparent reason. The baby has several normal breast milk stools daily, mild colic on occasion, and is otherwise happy.
Upon examination of the infant’s skin, lesions are present on the flexor aspects of the arms and legs bilaterally, abdomen, back, neck and face. There is a thick patch of cradle cap covering 80% of her head. The skin lesions appear to be erythematous, dry, and scaling and vary in size from several mm to 2 cm on the arms, legs, and trunk. On the neck and face it presents in a more confluent pattern. One area on the chin has a yellow serous discharge which dries and crusts over the top of the skin. Vital signs: heart rate 118/ min; temperature 99; respirations 20/min.
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