For older infants, who are taking some solid food, try cutting out different foods in turn, but replace them with others that are equally nutritious. Begin with the most common offenders: milk, milk products and chocolate, cutting out beef at the same time as this can sometimes cross-react with milk. If the child is eating any food or drinks containing additives, then these should be avoided as well. Next try eggs and chicken, then nuts and peanuts, then citrus fruits, then fish. Omit each food or set of foods for about two weeks before going on to the next set.

If the child gets better when certain foods are excluded, then they should be reintroduced to check that they were the source of the trouble. Begin with a very small amount and watch carefully for reactions – these can sometimes be severe. Some doctors recommend that no foods should be reintroduced until the child is over a year old, to minimize the risk of future sensitivity. This is probably a good idea, but it means that you may never know if the food you avoided was indeed the guilty party, because the child is likely to have outgrown the sensitivity by the time the food is eaten again.

If these measures are unsuccessful, then it may be worth carrying out an elimination diet, as described in Chapter Fourteen. In no circumstances should you do this without help and advice from your doctor – restricting the diet of small children can be very dangerous.

In the case of eczema, it may be better to start with a simplified form of the elimination diet. Rather than cutting out a whole range of foods, concentrate on the foods that are known to be problematic in eczema: milk, eggs, beef, chicken, food additives, oranges, lemons and other citrus fruits. These should be avoided during the exclusion phase of the diet (see pp269-74) and then, if the eczema clears up, tested in the normal way during the reintroduction phase. If there is no response to the exclusion phase, then cut out nuts, fish, wheat, tomatoes, lamb, peanuts and soya as well. Should this produce no results, then you could consider trying Stage 3 of the elimination diet, if the eczema is bad enough to justify this, and if your doctor agrees.

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