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Children rebelling at wearing clothes is not an unusual problem in the United States. It's not particularly common in Siberia, but in warmer climates, the discomfort children feel with clothing outweighs the discomfort of frostbite.

There can be medical reasons a child doesn't want to wear clothes, and I'll address them a little later but it's better to start with interventions as if they were "going through a phase" in their sensory development. Here are some interventions to keep the matter simple:

  • Offer your child a body suit. Many children love a superhero suit even if they don't like wearing clothes.
  • Avoid anything that fits tight around the ankles, wrists, waist, or neck.
  • Don't make putting on clothes a battle of wills. 
  • Some children will need silk underwear to feel comfortable "down there."
  • Provide socks that are tight around the ankle.
  • Provide seamless socks, or turn them inside out.
  • Offer pants made of nylon or Lycra. If what you can afford is blue jeans or corduroy, make sure they are laundered with fabric softener.
  • Make sure pants, underwear, shirts, and blouses are tagless.
  • Buy clothes at the second-hand shop (although you may not want your child to know you do this). They will be well worn and softer.
  • Some children have allergies to dryer sheets and stain removers. Try omitting them from your laundry routine.
  • Use fabric softener when you launder all of your child's clothing, but avoid detergents with lemon or other scents. Often the odor of clothing, even a pleasant odor, causes irritation of the skin.

Often these interventions will be enough to help your child deal with whatever undiagnosed issue keeps them from wearing clothes comfortably. However, if you invest in the right clothes and you still have a little nudist, don't spend a small fortune on clothes. Consider medical issues:

  • Children who have eczema or who get hives often feel uncomfortable in clothing. Get treatment for the eczema or hives.
  • Extreme fussiness about clothes can be an early sign of obsessive compulsive disorder (OCD). Appropriate diagnosis and treatment will help your child deal with this and other life challenges.
  • Some children develop sensitivity to clothing after they contract a mild, chronic viral infection. 
  • And some children develop sensitivity to clothing after they contract a strep infection.

Strep infections sometimes result in a condition known as Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, or PANDAS. Strep infections are hard to get rid of. The bacteria can cloak themselves with proteins they get from the child's blood, and "hide" in joints, the heart, or the brain. Eventually the immune system detects them, and tries to kill them with inflammation. Unfortunately, the inflammation also irritates and destroys the child's healthy tissues.

In PANDAS, anti-strep antibodies turn out to be cross-reactive. They also function as anti-brain antibodies. The result can be the development of OCD, hyperactivity,  separation anxiety (a child who becomes "clingy" to a parent or parents), joint pain, bed wetting, and problems with joints and motion. If the problem is PANDAS, symptoms tend to be episodic. Severe behavioral problems may seem to come out of nowhere, and gradually improve. There may be a period of weeks or months without a behavioral issue, and something happens (usually another infection) to trigger another round of the disease. Many children who have PANDAS also have issues with keeping their clothes on.

The first step in treating PANDAS is making sure that it's the actual problem. Your doctor will have to run a culture of sputum or blood to identify antibodies to strep. Then the symptoms are treated like they are in OCD or ADHD. Your doctor should "start low and go slow," because you don't want your child overmedicated when symptoms naturally improve, or the underlying disease goes away in response to antibiotic treatment. PANDAS is a difficult condition, but the good news is that it doesn't have to be forever, and treatments don't have to be continued forever, either.

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