Whether it’s a few specks or a thick yellow coating, most babies have some cradle cap at some point.  It is a common condition that causes no problems, and eventually (usually) goes away on it’s own, but it can be quite irritating to parents.

Facts:

It’s the pediatric version of Seborrheic Dermatitis, and it typically appears in the first month of life.  We don’t really understand why it happens.  It is typically not itchy (as the adult version is) and it bothers no one but the parents.  It usually resolves on its own, within weeks to months.  It most commonly presents as greasy scales and possibly redness on the scalp, but it can affect the face, neck, armpits, the area behind the ears, and the diaper area, either with scaly red bumps or with flat red patches.

Here is a picture of what cradle cap typically looks like.  Notice the yellow, greasy scales.

Cradle Cap Detail

Treatments:

Since cradle cap tends to resolve on its own, treatment approaches tend to be conservative.  They include:

  • Physical removal of scales with comb or brush
    • This is best done after soaking the affected area in olive oil, even overnight. Some
    • After the soak, remove scales and follow with a shampoo.  A soft toothbrush works very well for removal.
  • Omega 3s
    • The good oils we get from fish are good for mom and baby; they appear to support brain development, skin health, and immune health, among other things.  Deficiencies in omega-3 fatty acids can sometimes contribute to cradle cap.
    • Breastfeeding moms should eat lots of oily, good quality fish (at least 3 servings weekly).  For fish quality and safety information see Monterey Bay and NRDC.
    • Breastfeeding moms who can’t eat that much fish should supplement with a good quality fish oil; 1,000 mg total omega 3 is the general recommendation, but for supplement quality and dosing information, please see your naturopathic doctor.
    • Mothers who are using formula should consider using omega 3 fortified formula.
    • See your naturopathic physician if you want to supplement your baby with fish oil directly – it is imperative to select a good-quality, mercury-free brand.
  • Vitamin D
    • Another nutrient all moms and babies need, Vitamin D is essential for proper functioning of most of the body’s systems, including the skin.
    • Breastfed babies need 400 iu daily: this can be given directly on the tongue or mixed in a bottle of breastmilk.  As an alternative, breastfeeding moms can take 4,000-6,000 iu daily and babies will get what they need from the breastmilk.
    • Formula is already adequately supplemented with Vitamin D.
  • Probiotics
    • A third substance moms and babies both benefit from; they are important for good digestion, immune health, and other body functions.
    • C Section babies need probiotics even more because they were not initially colonized by good bacteria from the vaginal canal.
    • Babies need a special blend of bacteria, different from what adults need, so look for a good quality product that’s made for babies, and dose according to your child’s naturopathic doctor.
  • Food reactions
    • May play a role in cradle cap.
    • Breastfeeding moms who have failed to achieve results with the treatments listed above might consider looking at dietary elimination, but only under the guidance of your naturopathic doctor.
  • Vitamin Deficiencies
    • Certain specific vitamins deficiencies can contribute to cradle cap, including biotin, zinc, B6, selenium or manganese.
    • Consult your naturopathic doctor for details, it is not always safe to give these nutrients directly to an infant.
  • More stubborn cases may require
    • Special anti-fungal shampoos AND / OR
    • Cortisone cream or Zinc Pyrithione to decrease inflammation

Seek Medical Care If:

  • Symptoms do not improve with simple at home measures
  • Symptoms persist beyond a few months of age, or beyond a few months from initial onset
  • You are unsure of diagnosis
  • Symptoms are getting worse
  • Your child is immune compromised, under weight, having trouble gaining weight, or losing weight
  • The affected area(s) are showing signs of infection, including discharge, warmth, or redness

Image attribution: Starfoxy creative commons license, 

Photo credit: jcoterhals. Photopin creative commons license 

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Teresa Neff
Teresa Neff
Dr. Teresa specializes in pediatric and adolescent medicine and women’s health. After earning her doctorate from Bastyr University, she spent over two years at The Kids Clinic, in north Seattle, first as a medical resident, and then as a staff physician. At The Kids Clinic, she became comfortable managing urgent acute matters as well as chronic health concerns. Dr. Teresa loves combining her life long love of teaching children with her passion for natural medicine.As a primary care provider, she offers well child exams, well woman exams, sports physicals, lab studies, vaccines and vaccine education. In addition, she uses the various tools of naturopathic medicine, including Craniosacral Therapy, Visceral Manipulation, and Classical Homeopathy, among others, to build healthy foundations and to promote health and empower her patients.Dr. Teresa also studied breastfeeding and lactation with the Simkin Center and holds a certificate as a Certified Lactation Educator (CLE). Having experienced the struggles and the joys of breastfeeding herself, she is happy to help moms establish or continue breastfeeding. Dr. Teresa sees patients at Seattle Nature Cure Clinic in Seattle, Washington. Schedule an appointment with Dr. Neff in Seattle, Washington

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