Stubborn severe nappy rash! Nothing works..

[Trinacham]

Wondering if anyone else has had this issue as feel so alone in this. It seems like most people have luck with just simply applying Metanium cream and after a couple of days it's gone. No such luck here. Here's what we've tried so far...

Sudocream

Metanium

Went to doctor after neither of these made any difference.
Doctor prescribed an anti-fungal+steroid cream to be used for 7 days. After I put the steroid cream on, I apply Metanium to act as a barrier, on doctor's advice

After 3 days I went back to doctor as it was worse than before
Doctor now prescribed just a steroid (I can only use this for a further 4 days as can't exceed 7 days with the steroid use) and I've now cut out dairy (I'm EBF) as we think baby may have an intolerance (he had a very watery poo today)

This brings us to today, where I'm starting this thread. Rash is still here after 2 days and I can't see any improvement. We have to stop using it on Friday so there should surely be a noticeable difference by now.

Other points
Baby has very regular bowel movements - think this plays a major part in why it is so stubborn, the skin doesn't have much chance to be dry and heal before the next bowel movement

I do nappy free time as much as possible, as long as he's in a happy mood (sometimes just cries and screams when nappy is off)

Using pampers. The sore area is confined to his bottom, groin area is fine and all creases are fine, so almost certain it isn't a reaction to the nappy. The sore area is only where his poo touches, which leads us to believe he has an intolerance and the poo is burning his skin.

We use only warm water and cotton wool, no wipes.

Any help and advice, or just anyone who has been through this, would be great to hear. Baby is only a month old and he's had this for over a week now. He doesn't appear too bothered but it looks so sore. Hoping it doesn't feel as sore as it looks. If even steroid cream doesn't work, I'm wondering what else the doctor can do. Feel like the options are running out and it's worrying me.

foodallergynottingham.co.uk/news/are-you-sure-its-lactose-intolerance-and-not-delayed-cows-milk-allergy

There's some info on it there. I think the lactose in breast milk in CMPA causes acidic poo which causes the nappy rash.

Have you tried different nappies DS was fine with Pampers pure but the babydry caused a horrific reaction same with Aldi nappies, we started using kit and kin and eco Naty and everything was fine. I think some disposable nappies have a lot of chemicals. We used the child's farm nappy cream each time and the yellow metanium on the occasions he had a reaction to the nappies

Trinity ointment?

Dd had thrush from her bowel which caused horrendous nappy rash. Finally worked out it was mushrooms that caused it and the woman in the health food shop recommended neem oil to put on her skin. It was vastly improved in 24 hours and completely clear in 72.

I didn't find metanium any help, but bepanthen cream was much better and cleared up rash.

Another one who suggests changing the nappies to one without gel in. (Like a better for the environment type)

Personally I found 2 things that helped was a thin layer of egg white on top of the rash (I found this a bit of a faff to have around but it did work)

Or
Cut a muslin square into 4 make some chamomile tea and drop the squares into this. Leave it to cool. Then put the 4 pieces still wet but not dripping wet into a tupperware type storage container. Next nappy change put the wet chamomile soaked strip into the nappy. No other cream. You should see results within 24 hours. So one worth trying.

Was with water only and also use reusable cloths or cotton wool. No wipes at all

Not sure if it's still available but Bottom Butter always worked wonders for us

Aldi's have reusable nappies atm in the middle aisles

Definitely change to Naty or a similar brand. Pampers always gave mine nappy rash. The best thing I found to clear it was Burt’s bees nappy ointment, although that won’t help if it is thrush. Hope it clears soon, I always found bad nappy rash to be such a worry

My DS had persistent nappy rush...
I got best results with a warm bath and then let thecarea air dry. (He had plenty of nappy free tummy time!)

• bum bath after a dirty nappy (flannel and use dermol 500 as a soap)
• change nappy after each wet/dirty nappy - e.g 12 times a day
• dry, dry, dry, dry the skin after each nappy change - use muslin clothes or a soft towel. Skin needs to be 100% dry before nappy goes back on - don't use tissue paper (it leaves bits behind)
• buy dermol 500 - behind counter and chemist - can be used as a soap. Suitable for newborns, check with pharmacist any interactions between any cream and the steroids you're using before applying
• does baby have rash where milk touches in other places- e.g chest, chin, side of mouth, behind neck (anywhere spit up or dribbles go?) If baby has a cmpa this would be very likely.
• don't self diagnosis a dairy allergy, get a referral. Dairy is in everything - bread, cakes, sweet, soup etc Very rare in ebf babies.

Speak with Health Visitor / midwives - go back to maternity ward, they usually willing to see baby within 6 weeks (I think?) They're more used to seeing things like this. A Children's doctor is better than a GP, so call your maternity ward at the hospital.

Hope your baby gets better soon!

My Dc no2 was horrendously allergic to disposables. Maybe try reusable nappies?

Also egg white as a barrier (raw) - suggested by elderly pharmacist and worked. Along with old fashioned zinc and castor oil cream.

We switched to cloth. Solved the rash quickly due to the lack of chemicals.

Also fleece liner for nappies and change the nappy v often.

I'd go back to the anti fungal only. As a near example my now 19yr old son got a spotty and red, sore rash on his face age 14. Nothing got rid of it for months, combinations of moisturisers, steroids, steroids with anti-fungal, antibiotic cream. You name it. Saw another GP who said it needed referring but in the mean time to go back to a basic canestan antifungal cream. It went in 2 weeks. Currently I have a baby (15months old) who's VERY prone to a fungal bottom rash. When it starts up I put on clotrimazole (canestan) 3 times a day or every time she poos. Usually takes 4/5 days to clear if I catch it early.

Pampers were terrible for my ds too. We found a brand he didn't react to and all was well.

Sounds horrid.

I’ve read that adding bicarbonate of soda to bath water and soaking for 5 minutes can help but would just check with HV first.

I found with my son two things worked really well:

Changing the brand of nappy. He had horrible nappy rash with pampers, but was much better with Aldi brand!

Cornflour! No-one else has mentioned this but it was a LIFESAVER for us. I had some in a plastic container and kept it in the nappy bag. Every time I changed his nappy I'd do a liberal sprinkle of cornflour all over his bottom. It makes a world of difference.

Reusable nappies with cheeky wipes cloths and water to wipe. You use fleece liner inside nappies

Ds has been in reusable since birth, never had any nappy rash except for the two times we travelled and tried using disposable for ease. Both times he was sore within 24hrs if using.
The last time we travelled I just packed all washable as we far better than he getting sore.
Also wet wipes - dh used a pampers one on face once a few hours after shaving, and said it really stung his face

We had this when DS2 was tiny, turned out to be the nappies, chemicals in them reacting with the poo, his bum was red raw, bleeding and weeping. Changed brands (to Tesco Own) and it cleared almost immediately!

Awww this sounds really awful and similar to my son in the first couple of months. He had what looked like blisters right in his bottom.
He also had very water poo and now I look back I suspect it could have been a mild allergy to dairy as he also possibly had silent reflux or some kind of tummy issue an didn't sleep very well!

We tried metanium and it didn't do anything , then tried sudocream and letting him lie with his nappy off a lot which was the magic answer for us. I think you just need to find the right cream. But I would say exploring allergies may help.

As they get older they poo less and less. My son would poo like 5-10 times a day the first few weeks then it gradually gets less and less which helps.
Good luck xxx

We're just finishing off with a nasty fungal infection. Had to have the strong steroids twice a day, used sudocrem applied with cotton wool so as not to introduce any bacteria to the cream pots and a week of antibiotics but we are finally down to a few spots in between her cheeks down from what looked like blisters all over her bum. It's taken us over two weeks to get here from initial diagnosis.

PLEASE do not put egg white on broken skin (as a pp suggested) as introducing a food protein onto broken skin is one way that consultants believe a food allergy can occur.

DS had horrific nappy rash due to CMPA and soya allergy so I had to cut out both whilst breastfeeding. It took a couple of weeks to clear from my system but after that the anti fungal cream and steroid were able to work as the poo wasn't so acidic. Also don't worry about using a steroid cream for longer than 7 days, it's better to use it until a couple of days after the skin has healed than to stop and the skin break down again (according to a consultant dermatologist at Great Ormond Street we saw).

Yellow Metanium works really well but only if you apply regularly and it if comes off with regular pops then it can't do it's job.

What worked for me was creating a barrier with lanolin. It's really thick but applies well if you let the skin get really dry first. It was the only thing that allowed DSs skin to heal. Vaseline and other nappy creams came off to easily.

I know it sounds bonkers but when my son had bad nappy rash and none of the usual creams helped , I tried calamine lotion which did the trick .