newborn - sore bottom, constant pooing and frantic nappy changes

[runningrach]

my dd1 is 5 weeks old and has developed the most awful nappy rash. Doctor has given us an antiseptic paint to put on 3x daily and an anti-fungal cream for every nappy change but it seems to be drying out her skin and causing 'leathery' patches on her bum as well as a lot of discomfort.

I've seen threads on here with lots of good advice for treating nappy rash, but what I'm really struggling with is the nappy changes. She poos about every 90 minutes so needs frequent changes, but screams when we get near the change mat, and screams no-stop during change. She also screams when she actually does the poo, which at least has the benefit of letting me know she needs changing straightaway.

I'll clean her bum but then she'll do a little fart on the mat and soil herself again, or even a big runny poo or wee, and be so worked up that she kicks and tenses her legs and bottom whenever I get near it and make it very difficult to clean her. The continued soiling it seems to be caused by her frantic screaming.

Basically a change can take 10-15mins and involve at least half a dozen cleans because she keeps soiling herself, soiling of a couple of nappies or vests or towels, plus drive me to distraction because of the volume of screaming and continuous pooing. I'm sure this is making the rash worse and I can't stand hearing her screams of pain. Any ideas or commiserations?

Btw she is breastfed and on disposable nappies.

I seem to remember DS going through a similar runny phase at 3-6 weeks (few years ago so can't remember exactly when), so I don't think that's an issue. Although putting a reusable wrap over the top of a disposable might save you some vest laundry - and it doesn't last too long.

But the screaming and rash - have you changed your own diet recently? It's worth seeing if there's something you eat or drink which gives DD problems - just cut something out for a couple of days and if it makes a difference leave it out for a while/till DD weans. Culprits are often citrus, dairy, wheat, chocolate (sorry), sugar in general. With DS I had to eliminate grapefruit juice and coleslaw.

HTH.

I don't have an better advice than PerArdua but I just wanted to say poor you and poor LO. She will get better and you'll both forget this in time.

How about getting some of those disposable changing mat things and leaving her nappyless for a bit after each change? This will help get air on sore bits thus helping it heal and stop changes being so traumatic for both of you! We did this in the past and it helped. (If she poos on mat just fold that bit over, quick wipe and move onto new bit, bin the whole thing at end of nappy free session.) Also, use cotton wool and warm boiled water rather than wipes until soreness heals - made a big difference with mine.

my ds3 is 7 weeks old and when he was just over 6 weeks he stopped pooing constantly and now only poos every day or even less so there is hope!

Definitely cotton wool and warm water because babywipes really really sting broken skin. and make sure you dry - i use kitchen roll.

Haven't really got any advice sorry. I would agree with cottonwool and water. DS had problematic skin and could only tolerate water near his skin for a long time, no wipes and no bath products.

You could ask your GP to refer you so that she can be tested for intolerance. I've had 2 Bfing friends who's LOs have been diagnosed with diary intolorance. It might not be but might be worth ruling out.

Really feel for you, it must be so distressing. Hope you are getting some help and some nice time with your DD.

Sorry too for the spelling mistakes!

So sorry to hear about this!

My DS who is now 2.9 had this problem from birth to about 18 months. After much trying of this and that I found using cotton wool with cooled boiled water and then using the nappy creme METANIUM which can be bought at any chemist were the best at handling it.

We took him to the docs endlessly as the skin on his bottom was so sore it bled sometimes it was a horrible time for us all so you have my sympathy.

The anti fungals I got from the docs only made things worse but once I discovered metanium it was like a magic creme. Great stuff.

Do also try and leave nappy off as much as possible.

Good Luck!

Def agree with cotton wool and water and leaving her nappy-less for a while, also bepanthen is the wonder nappy rash cream, works amazingly.

Agree with handsoff METANIUM if fab. Have you tried it yet?

morning all, thanks for your responses good to know I have company! I haven't tried metanium (not sure if can get it here as i'm in switzerland) - the doc gave me i. I have bepanthen but stopped when the doc gave us stuff, maybe should restart. The paint he gave us is 2% eocine which dh said is wht is in egg white.

Interesting you found the anti-fungal cream made it worse handsoff, i'm convinced the i is making it worse but dh says i haven't given it a chance!

We only use water and cotton wool on her, i thought wipes were only advised for bit older babies??

Started having nappy free time a few days ago - after an ufortunate incident involving projectile poo and our bedsheets i got a waterproof mat and put an old sheet on it.

But - when she poos without a nappy do you clean her again? I can whip her away from the soiled patch but if I dab at her dirty bum she freaks out again and kicks off the cycle off shrieking out constant little poos again. If I left her the poo would keep eating away at her skin?

Guess I need to start looking at my diet, i do eat a lot of the thing perardua mentioned. Thought i have cut out citrus til dh pointed out that ought to include my lemon sorbet! doh!

btw typing 1 handed while feeding so sorry for typos

I would agree with the comments re being very careful with what you eat. Citrus fruits make the biggest difference. You are absolutely right to be using only cotton wool and water at this stage. When you move onto wipes my recommendation would be Clearly Herbal Natural Baby Wipes. They're expensive but really make a difference. Finally, I didn't have a problem at this early stage but when DD was teething, her poos were toxic, so I switched the barrier cream from Sudocrem to Kamillosan. Again more expensive but has really made a difference. Good luck, its horrible when they're screeching with pain because of sore bottoms.

Yes, your dietary stuff crucial here. Sounds just awful for you - and her! I found lavender flower water (sometimes called a hydrolat) in a spray bottle just fantastic for getting rid of inflammation quickly (just spray after cleaning, no need for further touching). Also exposure to air for the undercarriage!

And never, ever use cream at all unless treating something specific - it's amazing how the skin finds its own balancing act. Have never used anything at changing time other than cotton wool and water/hydrolat. Some people automatically put cream on every time, I don't think it's required at all. Just gives the skin something else to overcome. However, in the case of hideous rash, would use some of the nice creams around that are more like a balm - olive oil based, with a bit of chamomile in. Or go to an aromatherapist and get them to make you something. Good luck!

Metanium is magic. I warn you that it is a devil to get out of things though - yellow cream.

My LO went through a phase of contstant pooing including pooing in the middle of changes etc. and got a very sore bum. Cotton wool and water for cleaning as lots of others have said, and plenty of nappy free time. We're using cloth nappies so I could leave mine laid on one for some nappy free time. Even if you're using disposables I would recomend buying a pack of old fationed terry saquares for nappy free time, or there are those disposable mats, but we would have got through hundreds! I laid mine on a terry nappy ontop of his change mat, or if he was bored of lying down put a carrybag in his bouncy chair and a terry nappy ontop of that for him to sit on.

For cleaning after nappyless poos mine did cry again when his bum was very sore so I used VERY wet cotton wool so you could practically just rince without wipping, driballing water over him, and with a trusty terry square underhim that soaked up the water and stopped it running everywhere - you do get wet vest though so I ended up just turing up the heating and leaving him naked.

After cleaning make sure you dry thoughraly, we used a cut up old tshirt for drying as it was softer then a towel or flannel.

Good luck!

Agree with all of above. Try cloth nappies as she may be reacting to the nappies. Don't worry about every small soiling when having free time, just let her have a break from all the touching if poss.

All the best!

Our midwife advised using just olive oil - no water at all - on very young skin.

We did this with both of ours and they never had nappy rash. Moved into water when they were a bit older with washable wipes.

Hope that it gets better very soon.

airing, metanium, chamomile etc will not help if the rash is fungal/thrush.

You can tell if it is fungal by looking for satellite rashes. Look for patches of irritation that are not linked to the main rash, often they are out to the sides along the inner thigh and along the nappy line.

If you find them then you really need to keep up the anti fungal cream. We used clotrimizole 1% cream on DD. I didn't realise her rash was fungal and it got so bad she was nearly bleeding, it was awful. I used every rash cream on the market and nothing helped. The clotrimizole had it significantly better in a couple of days.

It is really common for babies to get a fungal rash following diarrhoea as the candida spores are flushed out of the bowel with each movement.

Thanks for all the tips! I haven't heard the olive oil one before so will try that. I'm really not sure if fungal, not sure how the paediatrician concluded that either as he only glanced at it.

Unfortunately cloth nappies not really feasible, I had invested in some starter packs but we don;t have our own washing machine - communal laundry room - and there are no nappy laundry services in zurich, but i've tried 4 brands of disposables and none make a difference.

floweryboots I will try your very wet option too. Hopefully over the nest few days we will find something that does makes a difference! Thanks everyone!

Hope it does get better soon runningrach for your sake and for the sake of your poor DD.

If all else fails let us know and I'll post you some Metanium. It was the only thing that worked for my poor DN when she had the same problem.

i used to get all stressed out with my 4 mo - i can tell when hes pooing (he makes loads of grunting noises and i used to think he was in pain) and used to rush and change him straight away and had the same trouble you did - i now leave him 5 minuets after i think hes finished before changing him (and if he goes mor 5 mins after that)Or else he used to go whilst changing him... maybe skin is sore because ur cleaning her so much and she just hasent finished? (obviously thats only a suggestion noone wants to leave there baby uncomfortable in a pooey nappy but it doesnt seem to bother mine and it is only 5 mins) another thing ive found good is to stick a couple of pieces of kitchen roll under thier bum when ur changing a poo just incase they go more - much easier and quicker to clean! hope it gets better soon xx

Lots of sympathy for you both!

Have you tried drinking lots of cammomile tea? As you are BF this can be very soothing to baby (it helped with DD's reflux after I started drinking it by the pot full) - some health food shops do mothers blend tea too for BF'ers which may help settle your poor DC's belly?? Not really helpful advice necessarily, but perhaps worth a try.

I know it's a bit out there, but have you thought about trying to take some ideas from ECing? It worked really well for us. Our dc wore nappies but when we were at home we tried to catch poos in the potty. We did it from birth with ds and from about 3 months with dd. It's a lot of (unnecessary?) work to try to do it full time, but if you can predict your dd's poos then it can be really helpful. We didn't start trying it until dd was about 3 month old, and it eliminated her nappy rash within a couple of days. It sounds like your dd has much worse nappy rash than mine had but it might help and it would also help give the creams a chance to work.

Not read all the posts but we went through a whole year of what looked like a blow torch burn on DS's poor bum. We wasted time using every cream on the market then all the prescription ones and finally got a diagnosis of psoriasis after pushing to see a dermatologist. Timodine cream from the doctor works well but I'd go with TeddyBare and try EC because as soon as we took him out of nappies, the red bum disappeared. As soon as baby can sit up, get them on the potty, it'll save so much stress. Good luck.

Thanks all, funnily enough I've got a book on EC (diaper free baby) but we haven't tried it yet, seemed like too much to take in to start with with first baby!

Tea sounds good too! I've been drinking Weleda Stilltee (for nursing mothers) but maybe should try something different - chamomile next stop...

Thanks for your offer JJJ - things seem to be improving with switching to pharmaceutical cotton wool (seems smoother than standard stuff), using the anti-fungal cream (imazol) just on the inside of dd's bottom where it looks most sore, and lots of Bepanthen on the red leathery patches on the outside. She has got a bit happier and it's slower healing so fingers crossed...

Now I just need to fix my nipple pain and her constant demand for milk! :-)

i mean slowly healing, which is good!

Poor thing, it sounds awful. In terms of wipes, if you get fed up of the cotton wool/water combo, try reusable wipes - I use cheeky wipes. The starter kit is undoubtedly pricier than cutting up old towels would be, but although I have visions of being the sewing type I know that I'm really not! I find them a lot less hassle than cotton wool and just wash them with DS' clothes so there's no extra washing involved. They come with essential oils but you could just use them with plain water.