BABY NECK AND FACE RASH PLZ HELP!!

[TheTealFox]

Please can someone help me figure out what is this rash??? What’s causing it? I’m a first time mum and I don’t understand how to make this rash go away I am trying everything I can possibly think of, such as keeping the neck as dry as possible, using a hair dryer (cold air) to dry it out after a bath, changing bibs constantly throughout the day, stopped using his fred and Flo and Johnson’s baby bath wash products and switched to aveeno baby oat bath soak sachets, have changed his detergent to non bio with no fragrance in it. When the rash first appeared we were given clotrimazole which didn’t help at all so we went to the doctor and were given fucidin H cream which was an antibiotic cream and had both fusidic acid and hydrocortisone in it, we were told to contact the GP again if the rash didn’t clear up in 10 days, whilst my LO was on the antibiotic course his rash was improving but not completely going away and once the course had stopped the rash came back and was a lot worse than before, then we were given canestan cream which again did nothing but make it worse, now we were given a steroid cream called trimovate and also Flucloxacillin to give orally. His rash again was improving with the antibiotics but once the course ended on Friday the rash came right back and looks like how it does in the pics that I’ve posted. The Gp suspects it’s CMPA and prescribed us SMA althera which I have been giving to him since yesterday morning so it’s been a day but the rash has went so much worse than how it was yesterday. So I want to ask does this rash indicate that my LO has a CMPA?? I am so confused because if it is CMPA then shouldn’t the symptoms be improving instead of getting worse?? Am I just being impatient? I’m fed up of being worried sick and crying thinking about how much pain my LO is in. Please can someone help me figure out what’s going on and guide me on what I should do??

thank you for your reply! I’m a first time mum and I feel completely devastated thinking it’s something I’ve done. My baby does have bad reflux and also has very foul smelling nappies and farts and hates lying on his back after his feeds and ends up fighting with the bottle during every feed. I am so clueless and just feel so guilty.

You aren’t clueless. It doesn’t mean you are any less of a mum because you are a first time mum - you know your baby. Clearly the fact you are posting on here shows how good a mum you are. X

I just saw this but thank you! It means a lot!

My DD is also CMPA and I remember how awful it felt at first, when everything felt so difficult. If it is the milk, it can take quite a lot longer to clear up I'm afraid. You're also currently using an extensively hydrolysed formula which does still have broken down milk proteins. So you may notice an improvement only for it to get worse again. In that case, you may need an amino acid formula. Honestly it all feels so terrifying and difficult but it is perfectly manageable if it is that. And soon enough it'll be second nature!

For now, I'd ditch all soaps etc for the bath. Just plain old water is grand for sore skin.

The prescribed formulas do have rep for tasting awful, but I never found my DD minded. And we tried a few! Too little to know much different I expect!

Good luck OP. I promise it doesn't always feel this daunting!

Thank you for your advice! I will definitely look into bicarb baths. My baby also has wheezing a lot and his farts and poop nappies are very foul smelling. My baby is gaining weight well as well but was a low birth weight baby. And I’m glad to hear he can tolerate it now, makes me hopeful that my baby will also be able to tolerate it eventually if he does have CMPA that is.

Thank you for all your advice and kind words. It means a lot.

Dd had a similar problem when she was a baby and was diagnosed with cmpa and a soya intolerance

we had a urgent paeds referral and they prescribed her neocate formula and also supported us with a dietician for weaning etc

I would push for neocate and a referral to paeds as you need to see a specialist rather than keep trying lots of things on such young skin

Thank you for your advice! My GP did say it is eczema but eczema has a trigger and he thinks the trigger is the cows milk protein in his formula milk so he thinks he’s CMPA. Im hoping his rash clears up soon I just can’t stand to see him in pain any longer.

The formula that has been prescribed has lactose and hydrolysed milk protein. Some babies can tolerate hydrolysed milk proteins so that is why, i think, it was GP's first call. My daughter when was a baby couldn't tolerate even hydrolysed milk protein formula. Her rash was like your baby's. Another thing you bear in mind is that soya proteins chemically similar to milk proteins. Severe milk allergy can also be hand in hand with soya allergy and egg allergy. It could be that the prescribed formula doesn't suit your baby as the composition of ingredients/proteins does not agree with the little one. You need to go back to GP and ask for alternative formula.
Another way to check, which may not work on your baby but did on my daughter, is if you put a few drops of milk on the inside of baby's arm and let it sit there for a few minutes. If rash appears it is most definitely an allergy. No rash doesn't indicate no allergy but if its there you would definitely know that's what it is.
It takes a good few weeks for the milk traces to leave the system so don't expect immediate relief of the symptoms after a day or two.

My son had this when he was around 2 month old, I breastfed though and never thought it was any type of allergy. I just bathed his face in breastmilk every day and it disappeared. He is 2 now and does have eczema, mostly on his legs and arms, but the face rash has never come back !
Are you wearing perfume? If he's snuggling into you/family members I would be mindful of all products on those close to him. And I second those saying to switch detergents. I use the plainest of the plain and that helps.

Also, reading through some comments, if you're using vaseline, and cream from docs, and flour, and other things, the skin won't know what's going on. Let it breathe, just water and dry, maybe some cream on if its super dry. But try sticking to one thing instead of many, you won't know what's making it worse/better. Hope he feels better soon x

This looks like an allergy to their milk 😩

It takes time for allergy symptoms to improve. My daughter was breastfeed and we saw a difference in about a week, a bigger difference in two weeks but due to multiple allergies didn't reach symptom free until about 15 months.

Usually we could see hints of an improvement within a couple of days of cutting out a food but it was usually 2-3 weeks to get to a place of minimal symptoms.

There are two proteins in milk caesin and whey. There are two types of hypoallergenic formula - extensively hydrolysed and amino acid. The extensively hydrolysed are dairy based but one of the proteins is broken down. You can be allergic to either or both of the proteins. This is usually why you are often asked to try two extensively hydrolysed formulas the first line of treatment will be a formula with one of the proteins broken down and the second line as the other protein. If they are allergic to both an extensively hydrolysed formula will still cause symptoms. Hydrolysed formulas are like taking a page of a newspaper and cutting it up. If you pick up some of the pieces you will still be able to get an idea of what the article was about. For some babies this is enough that they don't recognise the pieces as dairy proteins but for others they still recognise it as dairy proteins and will continue to react. This is where amino acid formulas come in, it contains all the building blocks of dairy but individual. To keep the analogy going it's like printing every word of the newspaper on separate pieces of paper. If you pickup any of the pieces you wouldn't know what the story was.

How is the reflux being treated? I wonder if that's irritating the rash too? My daughter had a rash like that due to reflux, dribble and allergies. She had a combination of a fungal cream, a barrier cream and treating the reflux and allergies. The combined approach of treating the rash and addressing the causes made the difference for us

Thank you so so much for taking the time to explain exactly what the different types of formulas are for CMPA babies. You have made it a lot more easier for me to understand so I appreciate it immensely. And yes I think his reflux might have had some part in making the allergy rash worse but since it’s happened I have tried to do everything to keep it as dry as possible but still the redness does not go down. I have been prescribed antifungals and steroid creams and also told to use a barrier cream such as Vaseline but none of the combinations have helped besides the antibiotics and steroid creams. It’s hard to tell if Vaseline is working when the rash doesn’t seem to be fading away with the other creams. I do lack knowledge on the whole Vaseline thing acting as a barrier though too so maybe I’m not actually using it properly or as much as I should be. Besides that my baby is currently on SMA althera which is the first type of formula they tend to prescribe when they suspect it’s CMPA.

Thank you for your opinion. It helps me to understand what’s going on more

Thank you! I will definitely do that!

Thank you for your help! And yes we do tend to wear perfume a lot and when he does skin to skin with me or his dad then maybe the perfume could come into contact with his skin. I’ll be mindful of this from now on thank you!
and yes I agree with the fact about letting the skin breathe, I was just being given so many things to try from the doctors and also being told from so many elders about what to use that I was so overwhelmed and didn’t realise it might be causing more harm than good.

Thank you for your advice! I will definitely try to see if the arm thing works or not with my baby. And yes my GP has said to wait a few weeks on SMA althera to see if his symptoms get better and if they don’t then most likely I will be given a different formula to try or referred to a paediatrician.

Thank you so much for your kind words and reassurance! I’ll keep in mind your advice and will definitely be ditching all the soaps.

How long has he been on the milk?
If zero improvement in 7-10 days I'd be going back mild improvement I might give it 14-21 days to see if it there's more improvement.

I think nutramigen would be the next step, it's another extensively hydrolysed formula but I think different to the althera. You could see if they could switch straight to an amino acid formula which would be neocate or alfamino but you may be asked to do two extensively hydrolysed first. If you search for cmpa treatment and the name of your NHS trust you might be able to find the treatment flow chart which will show you the criteria for when which milk is prescribed to give you an idea of what to expect.

We find hydromol a better barrier cream than vaseline it's very similar but slightly thicker.
How is the reflux being treated?

Hi! My little one also had quite bad skin. Sending you a big hug ❤️. We paid to go private to see a dermatologist and she was SO helpful in giving us the right cream etc. PM me if you want her details.

I don’t know will this help anyone with kids with skin problems but no harm in writing in with it 🤷🏻‍♀️..
My daughter had very bad excema as a baby
I happened to be watching tv one day & a dermatologist came on the programme..
She advised using a pop sock , not black as dye will run in water , so those natural coloured ones with organic porridge, run it under water In baby bath , there will be a lovely creamy texture , wash baby skin , hair with it .
I found it brilliant, takes away that angry red , irritation , really calms it …..

Hi there , he’s been on the milk since Saturday so it’s been about 3 days. The only problem is that if SMA althera doesn’t work out then I can only give him an amino acid formula next as all the other EHF formulas state that they aren’t suitable for kosher/halal/vegetarian/vegan diets I think and we fall under that group. I really hope the GP takes this into consideration if this happens but fingers crossed he just gets better on the SMA althera.
On the NHS guidelines for treating CMPA in the area I am in, it doesn’t state if they would trial 2 EHF formulas or not it just says the GP would prescribe an EHF formula and if the symptoms wouldn’t ease then an amino acid formula may be recommended.

Thank you ❤️

Thank you so much! ❤️

Ok, I'd probably try and get back to the GP at the beginning of next week if no improvement. If getting worse maybe Friday.

Neocate and alfamino would be your next milks. My daughter needed alfamino due to a coconut allergy and neocate has coconut in. There's also puramino but this is soya based and half of babies are also allergic to soya so I personally would avoid this if you don't want to risk having and change of milk

Be careful with using oats as they are one of the top14 allergens. A friend of mine discovered her son's oat allergy through using oat based creams on his skin. I was advised not to use any food based creams until my daughter had eaten then directly as there's some evidence that this can increase their risk of developing an allergy to that food.