15 day old extreme nappy rash help

[CloeAndJack]

This has probably been posted 1000 times but I'm having a huge struggle with my 15 day old son.
Since near enough day one he has had a nappy rash on his bum which has been getting progressively worse and spreading up to his legs. He also has acne around his eyes/forehead quite badly but don't think that's relative.
I've been doing warm water and cotton pads for the past week, I have to resort to gently using a cotton bud to try get his bumhole clean because it's the only way I can get near it without him somersaulting or locking his legs straight mid air.
First tried bepanthem, then sudocrem, then metanium to no avail. The midwifes said it was nappy rash, the health visitor said it looked thrushy so he has been prescribed clotrimazole and that doesn't look like it's working either - can only put that on max 3 times a day. He was 9lb12oz, is now 10lb10oz and taking between 60-120ml of aptamil every 2 hours, it used to be 3 hours. I am putting him into size 2 nappies now, going from Pampers to Aldi ones to see if this helps. I have tried no nappy time as much as I can but when he is peeing once every half hour it's really difficult and I can't watch him constantly.
By the time I feed him, burp him, multiple nappy changes, I have half an hour if I'm lucky until he wants his next feed. He's only 15 days old and I feel guilty because I'm at my wits end because he is so sore, it's almost his whole bum at this point and he has a complete meltdown during nappy changes. He was a very content baby before this got to this stage. I try to make his changes as quick as possible but he's as strong as anything with his thrashing then when I go to put the new nappy on he pees and I have to start all over again and I'm scared incase I'm not cleaning him enough incase that makes it worse but I'm still gentle, trying to pat more than rub. I have to sit him in front of a fan heater which is enough away from him during the nappy changes aswell as this seems to settle him slightly even though the temperature in the house is 21 degrees, so he is very pampered. Lol.
His poos have went in the past week/few days from being yellow with solid green grit and not terrible smelling to now very liquidly yellow, hardly any grit and they smell atrocious. He whines and almost cries before doing either a poo or pee too and is extremely gassy from his bum end.
He is extremely uncomfortable, will hardly settle now, squirms constantly and I feel awful.
Also if he does a poo say mid feed after having 60ml, he then wants another 120, is this normal since he's emptied his bowels?
I'm phoning the doctor on Monday.
I'm worried now incase it's a milk allergy.

Has anyone got any tips or suggestions? I would really appreciate it.

Regards,
C

I agree with contacting your Doctor on Monday.

Have you tried a different brand of nappy? Some babies react to particular ones.

Otherwise keep him without a nappy as much as possible.

If you're using an oil based barrier cream like metanium, then use oil on cotton wool instead of water to wipe away poo gently - a fine film of metanium should stay in place. The other alternative is a squeezy bottle of warm water to squirt over the bum area to get it clean. This should be more comfortable for him.

If it's very messy sit him in a bowl/baby bath of warm water with oats in a sock squeezed (colloidal oatmeal) which may be soothing and then just wrap in a dry warm towel whilst you're feeding him (can put a soft face cloth to catch anything and replace frequently if he poos a little bit whilst feeding)

I think I would phone 111 to try and get him seen by an actual GP, especially if it’s spreading to his legs.

Do you mean a GP just called you on Monday? What did they say? This sounds like a GP appointment is needed as severe nappy rash can easily get infected. Sudocrem really stings on broken skin, I find Vaseline more effective. He needs to be throughly examined by a GP though, not just a phone appointment. I'd be down there every day until this was sorted, no baby this young should be suffering with nappy rash like that. Sounds awful for him bless him-- and must be so stressful for you too.

PS I think you're right, I'm seeing some possibly red flags for CMPA.

With those symptoms I think it very likely that your ds has an allergy to cow's milk protein. At any rate, that's the first thing I'd want investigating.

That does sound like quite a lot of milk for a 15 days old - if he's uncomfortable/in pain he might be sucking for pain relief rather than hunger.

"Remember, breast or formula is the main source of nutrition for the first year of life. Newborn babies may drink small amounts to start with, but by the end of the first week of life most babies will drink around 150–200 ml of formula per kg of the baby's weight per day until they start solids at around six months old" NHS website

He’s only a newborn and if the rash is spreading to his legs it’s ok to call OOH GP today about the rash and then own GP on Monday about CMPA

Try Proshield it’s amazing stuff - though I’ve never used it on a newborn so ask health visitor or gp first if ok.

Sorry to hear that- poor little thing and poor you- very stressful for you both. I don’t know about milk allergy or the gastric side if it, but the only thing that helped my son was a medicated (Gp prescribed cream) then practically constant bare bum time during the day. I lay him on top of baby mat / towel and open nappy, with a face cloth and open him to catch the spray of wee. The good thing is that it started to heal in a few days.
once healed, I could only ever use cotton balls and water- never wet wipes/ nappy wipes.

I agree with others.

i think cmpa is a real possibility and I would be seeing a doctor too

Lassers paste is brilliant for nappy rash.

Sounds a lot like my daughter. It was cmpa and other allergies

That's not normal nappy rash. Your baby needs to see a GP. Don't be fobbed off with a nurse or health visitor- you need to see a Dr.

My milk allergy son pooped about 9 times a day, almost with every feed we'd hear the tell take squish of a wet and eventually mucusy poo. Calmed down when on the right formula prescribed after being diagnosed with it.
He didn't get a rash, not sure why but his bum would be red so we'd give him nappy free time every day to let the air get to it. Nice warm room and some tummy time at his age for a while to let it breathe. Also didn't use cotton as its fibres can catch on sore skin, just a cool wet wipe to soothe any potential soreness.

With the rest if your post about the smell, my sons also reeked, as did his gas, and the extra feeding was an attempt to soothe the silent reflux when the acid would rise and cause discomfort to him. One day we realised he'd had 34 ounces at only a fee weeks old but my husband and I were feedinggb on demand, we downloaded a shared app after that to track and tot up!

My son never had the cmpa rash so don't let gp fob you off if he doesn't tick each box, I took my son to a&e I was so worried with his symptoms when they peaked at 3 weeks, screaming all day in pain. Paediatrics gave him omperazole foe reflux then 3 weeks later the health visitor finally said he has cmpa after I showed her pics of his nappies with mucus and a dot of blood in one, but the had all said it was normal before :(

Hi, my baby was similar and it was CMPA - her stools were acidic which I think is what caused the soreness - within a week of swapping formula it has healed

Poor love! I'll bet you anything it's an allergy to the milk. It might not necessarily be the milk protein itself - different formulars affect different babies in different ways, just to complicate everything! It definitely isn't 'normal' though and it needs investigating asap.

A couple of thoughts. Sudocream has lanolin in which some people are allergic to.

Although it's counter intuitive, beware of puttting too much cream on as it essentially waterproofs the nappy, leaving waste on the skin, instead of letting the nappy soak up urine.

Hope you get it sorted.

I agree with the other posters but I would use Metanium on his bottom. The yellow one - it’s amazing and your pharmacy will stock it. It’s very very good.

I immediately thought cmpa.
Lots of fresh air so going without a nappy as much as possible and choosing the brand of nappies carefully. Pampas seem to cause the least trouble.

My little boy had CMPA and whenever he had dairy (formula or me eating it when breastfeeding) he'd get horrendous smelling poos that sort of burnt his bum. He got so bad he had open wounds it was awful. We then got on top of it with prescription formula (nutramigen) and it was ok until he went to nursery and they kept giving him dairy so he would get constant bouts of diarrhoea and really severe nappy rash. I'd definitely look into cmpa. He had all the symptoms you're describing. Good luck I know how awful it feels xx

Not read the whole post but wanted to jump in quickly before I go to bed to mention my DS had the most awful nappy rash which ulcerated and eventually bled when the skin wiped away. I was heartbroken, actually broken, I'd been back and forth to GP who just suggested 'sudacrem' 'bepanthem' 'metanium' 'plenty air time' 'steroid cream' 'CMPA formula'.
I ended up there in tears when he was 5 weeks old , the day I saw the blood, and I asked to be referred to paediatrician. From here paed's referred to paediatric dietician almost immediately. Dietician immediately said this is lactose intolerance. He was put on a lactose free formula and it literally took about 5 days for his stool to firm and the rash was gone within a week. Like a miracle.
If you're getting no answers from GP then I 100% recommend you ask them to refer to paediatricians

We saw the GP in the end and Timodine cream was prescribed and worked. Hope you find something to help.

Hi everyone, thanks for all your suggestions, not had time to read through them all as I've had a trip to A&E with him tonight after a call to 111.
The doctor said that he has extreme nappy rash and he thinks the likely cause is indeed a milk allergy.
The rash being caused by his diarrhea, which is pretty much when now eating a bottle, it's coming straight out him every feed. It's yellow, extremely watery and has a really harsh smell, not a normal poo smell that he had around a week ago.
I've to speak to my health visitor on Monday, the A&E doctor is sending over a plan to my GP and he's to go on a 4 week plan on the prescribed feed.
I'm a bit annoyed that he has to suffer his normal formula until then because I feel like I'm knowingly poisoning him.
I've to put him on puppy pads as much as I can to air him, put on his canasten 3x a day with metanium on top as a barrier cream but wash my hands inbetween each cream as to not spread the rash. I've also to wash my hands inbetween going from his bum to his front if he has an emergency pee in-between as I tend to start at the top and work my way down so that way is fine, just not the opposite. The metanium is to be put on every poo change, I think if he has a pee then it's ok to just dab that off with a dry pad then get new cream the next poo/clean.
No tub barrier creams as there is a risk you are putting the germs back into the tub then transferring it back onto his bum the next time. Only tube creams.
In regards to the milk allergy there is no test and it's just trial and error to see if that helps.
I'm hoping this works and it clears up as I feel awful. I feel as if I've neglected him however I have tried everything up to this point. Think I will be having even less sleep now, will have to watch him 24/7.

Hopefully this might help someone else if it actually works for me, will have to wait and see. Basically like covid all over again, will need some moisturizer for my own hands...

If anyone has a suggestion on how to deal with the peeing situation when airing a boy???? I have seen those tee pee things but not sure if they would be a waste of money as he would need one every half hour.

Thanks again everyone!

Oh god, it sounds like you and your little man are going through the mill! I don't know, could you get a different formula in Boots tomorrow?

Not sure if it will work in this situation but having had 2 girls and then a boy, I was concerned I'd get peed on, so at nappy change time, I stuck a wipe on his willy, and that did the trick!

Hope you get sorted on Monday. He's so little! xx

I forgot to mention that because he hasn't been vomiting his feed back up, it's just the odd "normal" spit, and that he wasn't covered in eczema that are normal symptoms of milk allergy that it did have the doctor scratching his head and asked another for a second opinion however they both think the only thing it could be is a milk allergy as he doesn't have a fever or anything else wrong with him except now the bad diarrhea which has only been bad since yesterday and he's a bit nasally and congested which is also a symptom of milk allergy and he's been like that since birth but I was told that was normal no matter how many times I asked different people.
So just because your baby doesn't have ALL the symptoms of something doesn't mean they don't have it so don't let your doctors fob you off.