At my wits end about dd's nappy rash - in so much pain

[LadyMetroland]

My dd is 2 and since May has developed appalling nappy rash. She gets it in bouts that last about a week, then we have maybe a week or two clear, but then it's back again. During a bout, she is in absolute agony; can barely sit down, walks like a cowboy and is in tears nearly the whole day. Been to doctors four times and am using Canesten with steroid, but to no effect, because of the following:

The major problem is that she lets out little bits of poo throughout the day, rather than one big poo, and so I have to change her nappy very frequently - maybe 8-9 times in a day. She's doing this because it hurts her so much to do a poo that she clenches up as soon as a little bit comes out.

I am using Water Wipes (99.9% water) and am very gentle but it is obviously making it worse to be changing her so often. It also means the steroid cream I put on in the morning has no time to work. There is no time for the skin to heal. I can't let her go round without a nappy for very long because a) she screams that she wants a clean one put on as she knows she's going to let out more poo, and b) she is letting out little dribbles of loose poo all the time so I would just have poo everywhere. Washing her down in the bath or shower is also not on the cards because the poo gets stuck into her skin and needs some kind of gentle wipe, but also because she literally screams blue murder, as if she is really being hurt, if I take her near the bath or shower (I do give a bath before bed, with salt in it, but I have to force her into it and hold her down which is just awful)

Bepanthen etc has no effect because it just slides off the affected area - the area is so red and weepy that cream just won't absorb because it's just raw.

Tonight she has screamed in agony every time I've changed her nappy. She is in constant tears and it is absolute agony to watch. I even considered taking her to A&E to try and get some kind of local anasthaetic or major league painkiller for her (obviously didn't do this but I am desperate)

Does anyone have any advice or experience? I'm off to the docs again tomorrow morning.

Buy if you have to (I got in on prescription) sprilon spray - designed to keep bed sores protected from soiling.

Was truly amazing when everything else had failed.

Try egg white. Spread it on like a barrier cream. It works wonders!!

Bepanthen didn't work for our DCs either but metanium (yellow one) is called magic cream here!

You've probably already tried it but if not it may be worth a go.

Have you tried metanium yet? As far as I know bepanthan is more like a barrier cream, whereas metanium will actually heal the rash.

X-post jemima!

Rather than using wipes have you tried using oil?

We used olive oil, but you can use almond, coconut etc, as it cleans stuck on poo without striping the skin.

We only ever used tepid water and oil on DD's nappy rash and it would clear up after two or three days.

You need to go back to the GP and sort out the pooing. If she is with holding it needs nipping in the bud very quickly or you will end up with more problems.

She may need antibiotics if the rash is infected.

Please don't put her in a salt bath - you are literally rubbing salt into the wound which must be agony.

A really good barrier cream, lots of nappy free time and pooing on the potty is the way to go. At 2 she should be able to poo on the potty or toilet.

Another fan of metanium in this house:)

This Weleda nappy cream works wonders! Good luck, I hope you get it sorted and your DD feels better soon!

Have you tried metanium? This helps my little boy who used to get pretty horrid nappy rash. Much better than sudocrem and bepathan.

I'm not sure what water wipes are but maybe try just cotton wool pads with warm water, the wipes have to have chemicals on them no matter how much the manufacturers say they are sensitive, natural etc.

Hope she's ok - poor poppet!

I also recommend metanium, amazing stuff. If that doesn't work, go back to your GP. She shouldn't be suffering that much (neither should you).

Metanium works a treat!

Go to the doctor. It sounds awful. Your poor girl.

Coconut oil is amazing with nappy rash, but I don't know about how it feels on broken skin, so would be cautious until sores have healed.

We swore by Metanium when ours had bad nappy rash, it was a miracle cream, if you haven't tried it, I recommend you do.

Hope it heals soon.

Poor poppet. Metanium is great as it dries out and promotes healing.

Can you try your DD on a potty a little bit, or a toilet training seat? At least it wouldn't get quite so stuck against her skin. Many 2 year olds aren't ready for full on training but if you could catch a few poos it might help a bit.

If she is hurting when she defeates, then maybe ask advice here about constipation - there are supplements which will soften her stool, diet can help, lots of fluid and fruit. While the weather is warm do try to spend sometime nappy free outside as UV may help her to health.
My sympathy OP - my DD had a bout of thrush and every nappy change was awful

Rather than a medicated cream try an olive oil based barrier cream. carefully dry the skin after cleaning it then smear a very thin layer of barrier cream onto it. A thick layer will encourage the skin to sweat under the cream. Medicated creams will burn on raw skin.
Waitrose do a cheap olive oil based cream 'Bottom butter' which does not sting.
Take her the GP to make sure she hasn't developed a secondary bacterial infection.

Steroids should not be used on broken skin. It is possible that the nappy rash is infected and the steroid is making it worse.

I found sprilon better than metanium plus you don't have to touch them to put it on, it's thin and breathable just amazing stuff.

Agree with everyone else - metanium is magic!

Hope you get this sorted - sounds awful for both of you.

Poor her, poor you. We use coconut oil which has healing properties, so I've heard, and has done very well for us. However, we had an awful, awful bout of nappy rash in the hot weather and the only thing that had any kind of effect on it was breast milk. I tried it because I'd heard you could use it on eye infections, and I was desperate. It really helped, though I don't know if it's practical for you.

all the barrier creams sound like a good idea, but for actually washing her skin, try this.
Make a cup of chamomile tea, and put a couple of spoons of honey in it. Leave it to cool, then use that with cotton wool to do the cleaning of her bottom.
I've minded children with severe eczema and nappy rash, and even tepid water made them scream, but they called this mixture my "special nice" because it was so gentle. (You could see her all tensed up and I had to hold her still to take her nappy off the first time, but when the chamomile / honey mixture actually touched her, she relaxed all over, it must have been very soothing).

YY to Metanium (get the yellow, medicated stuff though, not the white stuff).
Also, definitely use plain cotton wool soaked in tepid water, squeeze the excess water out. ALL wipes have chemicals in. Our DD gets awful nappy rash when she is teething, we just use cotton wool & water, & Metanium, & it clears up fairly quickly.

I also second getting a swab taken, turned out dd4 had strep A

Change her food - cut out all brown bread (the 50/50 stuff ok). Porridge for breakfast - maple syrup too if it helps, lots of water & diluted juice at meals. Also strawberries/kiwi fruit/pineapple rings/apples & wet fruit, (No bananas) for pudding. Also veggies like carrots/brocoli/ potatoes. She needs soluble fibre & lots of drink. No wheat bran weetabix etc which just dries the poo out. Can you get her eating dried apricots ? If so maybe 3-4 of those.

Great advice ref rash but agree, time for pretty pants & potty training. If you do the above, her poo will get better & using a potty/toilet for poos helps too.

Hope this helps - my dd1 suffered & doing the above made a massive difference. In fact, it completely resolved it.

Oh and yy to chamomile wash and cotton or fleecy wipes, and a swab for infection.