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.

Another vote for the EC idea here. You don't need to do it full-time or even often. You could start off by holding her in the pottying position whilst wearing a nappy. Then when you feel brave enough, try holding her in that position over a bowl / bath / sink / toilet / bit of soil outside.

It's amazing how much less poo goes on their bottom when pottying them. We only started at 8 months, but I'd definitely start from birth next time.

There's more info on the Born Ready site.

I know a friend of mine said she never wiped after a poo, she always washed her DC's bottom - either under running water in the sink, or in the shower. That might be a way to avoid irritating her skin by rubbing it.