Baby S's Eczema

So Baby S has eczema.  We're lucky in that it doesn't seem to bother him too much and for the most part it is confined to his cheeks.  At the same time, it is bad enough that strangers will ask me "What's wrong with his face?"  and I've been putting off getting his pictures done until it clears up.   The thing about eczema is that pretty much anything could cause it.  Is it the detergent I'm using?  The food I'm eating (Baby S is exclusively breastfed)?  Our dog? Our non-organic cotton sheets?  The weather?  Although most doctors believe only a small number eczema outbreaks are caused by food allergies, most moms I talked to seemed to think certain foods aggravated their kid's eczema.  I tried going off dairy for 2 weeks (my brother did, in fact, have a milk allergy growing up, so it seemed a good place to start).  Baby S's skin didn't really improve, but I questioned myself constantly.   Did his skin look a little less red?   A little more red?  I switched to soy milk and his skin seemed worse, did he have a soy allergy?  He was particularly fussy after I ate grapefruit, maybe citrus is the cause?  I could easily drive myself crazy and end up eating nothing but brown rice and avocados.

After changing our detergent, lotions and soaps, going off dairy and slathering Baby S with calendula ointment for weeks with no improvement we finally saw a dermatologist.  He diagnosed Baby S with eczema and a mild bacterial infection and gave us Mupirocin ointment for the bacterial infection, Fluticasone cream for the the eczema and told us to use Cetaphil or Aquaphor on the rest of his body to help ensure the eczema didn't spread.  Baby S's skin cleared up within a week of using the creams, but as soon as we stopped the eczema came right back.  The dermatologist put us back on the Fluticasone cream and told us to slowly wean Baby S off it, switching from twice a day to once a day to Aquaphor only over 3 weeks.  So that's what we're trying now.

I know about the risks of using steriod creams and I am not thrilled about using them--  skin damage,  reduced ability to fight skin infections, permanent discoloration, etc.  My pediatrician is also not thrilled.  In fact, at Baby S's 6 month check up she urged me to stop the cream immediately and "see what happens".   I hate it when you get conflicting advice from doctors.  Her position is that eczema is a symptom of something happening internally and the steriod just covers up the problem, it doesn't solve it.  A valid point, but I also want my baby to be comfortable and, vain as it sounds, I want to see his cute smiling face unmarred by crusty red patches.  Or at least I'd like his skin clear long enough to get a nice photograph.  So, I booked his portrait session for a few days from now and afterwards we'll start weaning him off the steriod cream.  If the rash comes back I don't think will do another round of Fluticasone, we'll stick to baths and lotions and do our best to manage.