Historical points that influence the likelihood that food—for example, cow's milk is exacerbating eczema
| How severe is the eczema and when did it start? | Underlying food allergy is more likely in early-onset, more severe eczema, especially if it resistant to conventional treatment. |
| Is eczema being managed appropriately? | Management regimens are often suboptimal. Consider cumulative number of tubes of steroid preparation used monthly, and potency of steroid. |
| Is there a family or personal history of atopy? | An atopic family history (particularly maternal), is common in food allergies children. Siblings of children with food allergy have an increased chance of having food allergies themselves. |
| Are there associated symptoms? | Consider food allergy in children with eczema and gastro-intestinal symptoms such as gastro-oesophageal reflux, diarrhoea/constipation, failure to thrive, irritability and sleep disturbance. |
| Was infant breast fed? | The course of the eczema in relation to the amount of cow's milk exposure in the diet (or via breast milk) can provide an important clue to its possible role. For example, it may be relevant that eczema first presented when cow's milk formula was introduced following a period of exclusive breast feeding. Was an infant formula used in the nursery while breast feeding was established? |