Nappy rash but only at nursery

[nurseryproblems]

Hi all, I really need some help please!

My 18 month old daughter is at nursery 3 days a week. She's always had dry ish skin, but after a couple of patches of stubborn eczema she's now fine at home. However, as soon as she goes back to nursery after her four-day break each week, she has really awful nappy rash. Her poo also seems to be a bit looser. The skin itself is red, blotchy and some rash-like spots, after just the first day. It seems to get worse over the three days, and then in the days at home it clears up.

So it's obviously something that's different at nursery. We've tried eliminating specific foods, changing wipes etc. I'm having a meeting with the manager this week and I'm looking for people's ideas or experiences please as to what it might be, or what I need to ask!

So far I have thought of these things I need to know/ask for:

• An exact ingredient list for their meals (I have a meal plan but it's quite vague, e.g. spag bol etc).
• Exactly what she has for snacks
• What drinks she has and whether she's drinking enough (she has free access to water at home. That makes her sound like a pet rabbit but you know what I mean!)
• What brands/types of wipes, creams, soaps they're using
• Any soaps, sanitisers or creams staff are using on their own hands
• Maybe types of towels they're using to dry them if they get wet etc?

Can anyone think of anything else please? Have you had any "aha" moments where you've worked out what was causing this kind of thing?

Any ideas much appreciated!

Are you providing nappies or are they? So is it the same brand of nappies?

For us they weren't as quick at changing a dirty nappy as we were at home. I spoke to the manager and they made a new routine where the staff would check much more regularly and record that they had done so... totally solved the issue. I think they checked every hour. Felt like they should have been doing that anyway, but a conversation really helped.

Main question would be what cream/wipes they are using if you don't have to provide your own.

Regarding what she food she has and drink, I would assume your told this daily?

Out of everything you've listed it'll be the cream/wipes.
Start taking your own.

They need to use your wipes and cream: even of you provide them it's not unlikely that they change lots of nappies in one go and use the first pack of wipes for everyone.

Also less frequent nappy changes.

Sorry to clarify, we have always provided nappies and they do use them. We asked them to start using our wipes because they use a different kind, but I'm not entirely sure whether the message isn't being passed on to all staff and they're using their own wipes sometimes. We don't actually provide the cream but they tell us they use Sudocrem and Metanium if needed, which is exactly what we do at home so we left that.

Re the food, we keep asking but the sheet they fill in at the end of the day keeps becoming vague again. That's definitely one thing I'm going to insist on with the manager, because the difference in the poo is making me think there's at least some aspect of the food/drink that's not agreeing with her.

Thanks for the point about the frequency of changes, I will bring that up too.

Definitely check wipes. It is probably easier to use a generic tub than check every child's bag.

Also are they putting cream on a little too enthusiastically? Modern nappies are designed to wick away wee, but too much cream can act as a waterproof barrier and stop it working. Especially if there are longer intervals between changes.

If its the same nappies I would check the wipes and as pp said, that they aren't using too much cream

How are they cleaning the change mat and is it dry before changing them? I'm allergic to a lot of cleaning material and passed it onto my ds and found he was ending up with a rash at nursery. Ended up they put a paper towel down also and it helped, also frequent nappy changes, from memory unless dirty it tends to be on a schedule they are changed.

I'd be checking frequency of change (that was my first thought) and Wipes

Will be the frequency of changes 100%

Random but do the staff wear gloves when nappy changing, could it be a reaction to the gloves?
Is she having a lot of fruit on nursery days? That always makes DD nappies a bit looser and irritated.

Thank you everyone. I didn't know about the cream stopping the nappies working, I will check that.

I don't know whether they use gloves either, thank you, I will check!

I'm not sure it's the fruit only because she absolutely loves fruit and eats it all the time at home, so I'm guessing not that.

Thank you so much, please keep any ideas coming, this is exactly what I need! FTM so it's relatively new to me!

I was expecting to say not changing frequently enough when I read the title but if her poo is looser then I can only think it must be food related? Is there a chance she's eating something like the paint or play-dough? Or sand?

6464zz This is why I was looking towards the food. But I'm willing to try anything to be honest! I will check re. paint, sand etc.

Thanks to Pp who said cleaning materials too. I'm writing it all down and will literally check everything!

Assume she's fine with cows milk? I know a lot of nurseries give milk with meals and snacks.

Lots of the nursery food will be tomato based as it’s cheap. It can be quite acidic, so could be that.

I wonder if it’s that they’re not as quick to change a nappy as you would be at home. My DD sometimes has a bit of a rash but never awful

How long she may have been sitting in a dirty nappy?

My boy came home from nursery the other day and I think he must have done a poo quite a while before pick up, I didn't smell it because I had my mask on in the building then we went to the playground for a bit. When I got home and changed his nappy the poo was quite dry and his skin was so so red and had little sore red blotches forming 😞
Poo really upsets the skin.
We never have a problem with nappy rash at home, I've hardly ever had to use sudocream on him but since he started nursery they always tell me he has a rash and note on the handover sheet that they've used nappy cream.

We also had this and it was just that they were leaving soiled nappies on longer than we would. It stopped when we potty trained (dd1 at 2 and dd2 did it herself at 20 months - we did the oh crap method which worked well for us!)

@girlabouthome

Will be the frequency of changes 100%

Was going to say this.

It’s not often but sometimes he gets a really red bum and it hasn’t ever happened before. But with up to 3 baby’s each I can see how it’s different to me when I was just on my own in the house with him. I could tel by his face he was pooping let alone smell it 😂 they can’t devote the same attention unfortunately

Is she having milk at nursery? Ïf so is it the same that she has at home? How is it prepared and stored?

Definitely ask about when nappies are changed. It was my first thought when I read the OP.
It might not be enough for your dd.

She is fine with cows' milk, she doesn't drink it much just out of preference but she has breakfast at home, which is cereal and cows' milk with fruit.

One of the things we tried previously was eliminating tomatoes from her diet, so I don't think it's that, although I will keep it in mind.

I think the frequency and use of cream are chiming in my head, because now I think about it, there have been several days when we pick up and they say she's just being changed - I'm wondering whether they're doing a quick check before she leaves and finding that she's been sat in it maybe?

They also note that they use cream on pretty much all the changes and I very rarely use cream at home, so another thing that just didn't occur to me. Thank you.

Ask about gloves and also if they are sitting her on a toilet/potty.

With my daughter it was the gloves. We went through everything and only clicked when she started getting the rash on her ankles too.