Ages 1-2

My 18-month-old has eczema all over his body. Most of the time it bothers me more than him, but if it was baby eczema shouldn’t he have outgrown it by now? Is it a diet issue and can you give a toddler an elimination diet? Does this mean he’ll develop allergies and asthma too?

Unfortunately, some babies do not outgrow their eczema, although it does often get much better with much longer periods of remission. The diet is not usually a major factor, and I would certainly not recommend an elimination diet at his age, as it is likely to cause more harm than good. There are a number of treatments, including keeping the skin well hydrated; using a moisturizer or oil in the bath as well as applying it after the bath. Avoid irritating products and stay away from woolen garments. In addition, the use of a prescribed mild steroid anti-inflammatory cream is usually required for flare-ups of the rash. Having eczema does suggest atopy, which predisposes to asthma, hay fever and other allergies. That said, many children with eczema have none of the other atopic conditions.

My 15-month-old hasn’t put on any weight since his last check-up three months ago. Should I be adding higher-fat foods to his diet or is this normal in toddlers?

It is true that weight gain slows dramatically after the first birthday. In the first year of life, babies triple their birth weight, but in the second year of life they only gain about 2″“3 kg in the whole year, so many parents become concerned at this dramatic change in weight gain. As long as your toddler’s weight at check-ups continues to plot along the percentile line on the growth chart and he is active, energetic and healthy, I wouldn’t think any changes are required. If his weight drops by more than two percentile lines, your doctor should exclude any specific cause for this, and may suggest interventions, including high-fat supplements (e.g. butter and oil), be added to various foods.

Illustration by Rhonda Mulder