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4-month-old's rash gets better at night, worse during the day

Aug 2006

My 4 month old daughter has a very mysterious diaper rash that seems to get better the longer she is left in disposable diapers!? She sleeps very well though the night so she is in a disposable (she has always slept in disposables) for about 12 hours every night, and when she wakes up she has almost NO diaper rash. As the day goes on, the diaper rash gets worse and worse and she was bright red on her labia area (not on her bottom at all) by bedtime. It has gotten a bit better since we have taken her out of prefolds and are using disposables (and the one bumGenius!). We also stopped using all commercial wipes (which we would only use out of the house, at home we use washcloths and warm water), and the A+D that I used to smear on religiously with each of her 8+ diaper changes I was doing daily. She has always been aired out for 2+ hours everyday. All of this came on in the past month, even though we have been doing all of the above with no changes since birth. I cut all dairy out of my diet (I'm exclusively breastfeeding), and it made no difference. I have had no other changes to my diet.

Our pediatrition was a bit perplexed by this and told us to stop using the commercial wipes and the A+D since those are two things that wouldn't be happening overnight, but that I was doing a lot of during the day. He also prescribed a powder called Nystop that we are to use 4 times a day -- and to only change her 4 times a day! (Unless she poops in which case I change her immediately of course, but she only poops once every other day or two). I air her out for .5-1 hour in between each changing. Things have gotten a lot better with her in the disposables, the limited changing, and the Nystop, but it still does seem to get a bit worse as the day goes on. My next step is to change the detergent I am washing the wipes in.... Has anyone had any experience with such a bizarre diaper rash problem? Any advice?

If anyone has any input to either question I would greatly appreciate it. Thank you so much - BPN is wonderful! Nicole


First, make sure the rash isn't a yeast infection.

We cloth diaper using mostly prefolds (also some pocket diapers and AIOs) during the day and disposables at night and had a persistent diaper rash problem when our daughter was first born. We didn't use commercial diaper wipes but only paper towels and warm water.

We eliminated the rash problem when we applied diaper cream to her bottom before bed-time every night and also changed her disposables during the night when possible. Even though disposables can hold a lot of liquid, you still need to change the diaper frequently. Every time she woke up for a feeding, we changed her. In the morning it's also best to clean your baby's bottom before putting on another diaper.

Also pre-wash your cloth diapers and double-rinse. Use less detergent so nothing is left on the diapers. No fabric softener sheets, use some vinegar in the rinse cycle.

Our daughter is now 7 months and has not had a diaper rash again .
Quynh


Hi there. I used a cloth diaper service for my son for a year and a half, and they do not use really hypoallerenic detergents and the diapers themselves were sometimes scratchy, however, my son never had diaper rash until we would go on vacation and have to use disposeables. So, I hated to use disposeables because that is when he would get rashy. I do know that with the cloth diapers, you have to change them way more often than the disposeables because the urine isn't wicked away. The rash that you are describing and the powder that the MD gave you points to a fungal infection, like jock itch. My son developed that after switching to disposeables full time. Like you say, bright red and uncomfortable looking. Upon our Dr.'s advice, we slathered him with a half-and-half mixture of anti-fungal creme and cortisone (both over the counter) 2x a day for 2-3 weeks. But fungal overqrowths take a long time to respond- at least 2 weeks from the time you start treating them. Don't give up yet, it just takes a while. In the meantime, don't put any more A&D on her, that only keeps the skin moist and compounds the problem.

After you are done with the Nystop, just start using a cornstarch powder or let her air and use no cream. I don't know about the BumGenius diapers, they were not available then, but I pretty much just stuck to cotton prefolds, and was happy with those. One thing, are your other diapers all-in-ones or do you use a diaper wrap? It might not be the diaper, but the diaper wrap that is not breathing and keeping things too moist. I would be happy to talk to you about diaper wraps as I think I have pretty much tried all that were available in 2004- and yes, that did get expensive. lou


My guess is you need to ''strip'' your prefolds, there is likely something in your wash, or accummulated washing, that has built up on the cloth. I wash with ''all free and clear'' or Kirkland's equivalent regularly. Every couple months I add about 1/4 cup baking soda to the wash with vinegar to the rinse cycle. The baking soda/vinegar helps to remove any buildup there might be. Oh and no fabric sheets in the dryer! rash free
Regarding the diaper rash question: Your daughter may have a yeast infection; it is possible the disposable diapers keep her dry enough for the yeast to slack off, while cloth diapers, being less good at wicking away moisture, allow it to flare up. Check the rash -- does it look slightly raised where it is red?

If it does appear to be yeast, check with your pediatrician about a prescription medication. I've found that Nystatin is about the only thing that will help my son.
Karen


3-year-old with bacterial diaper rash

Feb 2004

My 3 year old daughter is still in diapers at night only. She has recently developed a bacterial diaper rash that is proving really hard to treat. The doctor said it was ''folliculitus'' and prescribed Cefzil. Afer 2 10-day courses of Cefzil the rash has gotten better but returns full force a couple of days post medication. Now he is recommending 4-6 WEEKS of eurithromycin (sp?). Ack, that sounds like so long for a little one to be on antibiotics. Has anyone else experienced this? What was the result? Any suggestions for alternative/homeopathic remedies that may help shorten the lenght she has to take meds?


When my babies had bacterial diaper rash, my pediatrician prescribed Bactroban ointment -- which always worked like a charm--I never was prescribed oral antibiotics. Worth asking about.... ann
You might want to ask your doc about Augmentin, which is a combination of two antibiotics, amoxicillin and clavulanate potassium. We had good results with it. - not a doc
I would got to see a homepath, such as Christine Cirvuello (spelling not correct sorry) in El Cerrito. or Jay Sordean on Telegraph near Whole Foods, of the Redwood Clinic. Both do work with children. That sounds like an obscene amount of antibiotics for a diaper rash and for such a little one I'd be worried about increased a! ntibiotic resistance if she needs them in the future, plus they are just so harsh on the tummy, etc. 3 y.o.'s can take acidophilus, we use powdered form a teaspoonful a few hours after the antibiotics (otherwise the antibiotics may kill most of the aci.) This could be done for a few weeks to help restore the healthy bacteria robbed already by having taken the antibiotics. You can also put a teeny amount of acidophilus right on the rash, this would be more effective if it is yeast but it's worth a try just in case there is a yeast infection/ rash caused , worsened, or as a side effect from all the antibiotics. If it's not painful to her (I don't think you mentioned either way?) then what is the possibility of not treating (ask a pediatrician)? I'd also ask a ped. why topical antibiotics are not feasible. Congrats. on your caution and good luck to you and your little one. Chris
! Christine Chiarello at the Hahnemmann Clinic in El Cerrito might be able to help you. She's a homeopath. For a pro-biotic diet to help your daughter build up the good bacteria that keeps the bad bacteria in check, try Nourishing Traditions by Sally Fallon. emikiten
I had a lot of trouble with repeated diaper rash in my babies - until a midwife told me this: Try putting corn starch powder in the diaper - just sprinkle it on the baby's bottom, and on the diaper before you put it on. About a small handful - enough to have powder everywhere basically! It absorbs the moisture, and somehow seems to work wonders. My poor son was red and sore for months before I found this out. I don't know if the rash was bacterial, but it was severe, and nothing else worked. Good luck, Janice
My son had a very stubborn condition when he was an infant, that made him miserable, red, raw penis, and ! of course peeing was excrutiating. I tried everything, and it kept coming back, until..Tea Tree Ointment. The Skin Ointment, not the oil straight, made by Desert Essence company. It's available at health food stores, Whole Foods, Berkeley Bowl, etc., probably also at many mainstream stores as well. It addresses both bacterial and fungal conditions, and the latter are quite stubborn, and sometimes misdiagnosed for the former. Good luck! kim
aside from doing all the usual diaper rash stuff - naked time, daily baths, air dry thoroughly after a diaper change (we use the hair dryer on low), you may want to try treating the foliculitis with antibacterial soap, and then selsun blue shampoo which kills germs that commonly cause it. even though the rash is not on her head, if the bacteria live there, they will recolonize suseptible areas - that maybe why it kee! ps coming back. but keep in mind that this is an ADULT solution - check first to make sure selsun blue is OK for kids. SDD
My two year old just got over an extended case of ''folliculitus''. In the end, we did a one week course of antibiotics (I dont' remember the name, but if you email me because you want to know, I can find out. It started with a C). Anyway, before that we tried everything (except a homeopath, which if this didn't work would have been my next step; but unfortunately, homeopath's are out of pocket!). We tried Neosporin, cornstarch, hydrocortisone cream. It just kept coming back, then some of the follicles were getting infected. Six months later, we did the oral antibiotic. Cleared it up almost all the way, then the rest of it cleared up on its own. Now I use Kiehl's diaper area ointment (not their diaper rash ointment, its different) to keep her skin well moisturized in the hopes th! at it will prevent a reoccurence. Its funny because she never had diaper rash problems until this. Anyway, the Kiehl's is great (works really well for my five year old who gets red in the ''diaper'' area frequently), but its pricey. Its available at Nordies but it lasts a long time. Good luck and let me know if you want the name of the antibiotic. hilary
By now 13 year old daughter had horrible diaper rash. We tried everything - everything! What worked was that we switched her to lactose free milk. I still don't know why it worked, but we noticed after visiting friends who only had lactose free milk that she drank during a weekend visit that things improved. Once we switched her, the diaper rash totally went away. She still ate other milk products - yogurt, occasional ice cream, but mostly frozen yogurt, with no further problems. She remained on the lactose free milk for years, we slowly moved her to regular milk when she was 7 or 8 and things are fine. If your child is old enough to be drinking milk you might give it a try. anon

Persistent diaper rash in 8-month-old girl

Jan 2003

Our 8 month old daughter has had a rash for more than 6 weeks now. It is 2 oval shapes of red on each of the fat folds just to the outside of her labia. We think it is caused by irration from the 'runners' of the diapers. Here is what we have tried so far: all different types/sizes/brands of diapers(including cloth), we do not use wipes (just water and cloth or tissues), we have tried all the different creams(desitin, A&D, bag balm...), we have not put her in anything that would cause pressure in that area (exersaucer, doorway jumpers etc...). We finally went to her doctor who said, oatmeal baths 3/per day, cut out the 'runners' on the diapers, and put on hydrocortizone 1% cream. This has helped only very slightly and now she wants us to use lotimin cream, which I really do not want to do. Am I missing anything? Should I try vit. E or aloe? Any suggestions would be greatly appreciately. Thanks Andrea


The only thing I've found that will really clear up a diaper rash for my children is Nystatin Ointment. It's an antibiotic cream, available by prescription, so I use it sparingly with regular diaper cream only when the situation defies the usual procedures. The pediatrician also recommended various mixes of cortizone, Lotrimin and other over the counter preparations. None of them worked, which was just as well, as something about smearing an athlete's foot cream on my infant girl's genitals didn't really sit right with me. KMS
My son gets diaper rash fairly often (sensitive skin) -- esp. if a food doesn't agree with him. The way we get his skin to heal? Lotrimin (generic: Clotrimazole). Not sure what your reasons are for avoiding it, but the reason your doctor has suggested it to you is because it works! Seems like you'd want to try it, given your daughter's situation . . . The other thing we do is pat cornstarch on the diaper area with a cotton ball after cleansing his skin to make sure it's completely dry -- then comes Lotrimin, then Desitin. L.
Andrea, PLEASE! have your daughter cultured for vaginal strep (for which hydrocortisone will do nothing); I assume that your pediatrician has already ruled out yeast?? Concerned mom and physician
Air that bottom out! The best thing for the rash is no diaper at all. If you can, let your daughter go without for as many hours a day as possible. It's messy, but the air really works. Have you tried Aquaphor cream? It's a good barrier cream, as well. Good luck! anon
My son had the same problem when he was 5 months old (he's 7.5 mos now). I finally got rid of the problem with a combination of the following:
-- very frequent diaper changes (10 to 14 diapers per day)
-- with every diaper change, applied Desitin Creamy with Aloe and Vitamin E - this worked better than any other ointment I tried.
-- bathed him at least once a day (I think this got him more thoroughly clean than just washing the area with a wash cloth and water).
-- let him ''air out'' after his bath by going diaperless for at least an hour. Fortunately, my son only poops once a day, in the morning, so I'd wait till after that. Of course, it was still a bit messy, but I put him down on a big old blanket, which I washed afterwards. Of course, at 8 months your daughter may be more mobile than my son was, so this could be more of a challenge.
-- hydrocortisone cream - the rash was already getting better by the time I started using this, but I think it might have helped. Good luck! -- mama of a rash free baby
When my daughter was an infant she had a pretty bad diaper rash a couple of times that necessitated using lotrimin combined with hydrocortizone cream. We also cut out wipes just using viva paper towels (as recommended by the advice nurse)and water. This worked extremely well to clear up the rash and made my daughter much more comfortable. Good luck. Hannah
If it is fungal infection, all the treatments you have tired will not work. Especially if desitin and hydrocortizone have not worked, there is a good chance it is fungal. This is an area that could be moist, and perfect for fungus. Try the fungicide (Lotrimin), you will know in a few days- if the rash gets better, then finish the treatment (it may be several weeks). Fungus can stay under the skin for weeks, and the rash may re-occur. The treatment is better than having a persistant fungal infection- especially if it spreads. Lisa
Sounds like a yeast infection. My daughter had a rash that did not clear up with diaper cream and I used good old monistat cream and it cleared up within a few days. I think yeast infections are harmless but I would take her to the docter regardless. 6 weeks sounds like an awefully long time to let this continue-good luck! anon
Here's what works for us, although diaper rash is something that seems to come back often. I find vaseline works better (or at least just as well) than diaper creams and we use it pretty generously. Also, we use a little Cetaphil lotion on the wet cloth/paper towels we use to clean the area and then use a towel to dry the area well before re-diapering. And when possible, we let our child run around for a while each day without a diaper on. Good luck! anon
Hi. I have had the same problem with my son. He can get diaper rash so bad that he has open sores. The lotrimine really does help. According to my pediatrician, a lot of times diaper rash can be caused by a yeast infection, hence the reasoning for the lotramine cream. when my son's diaper rash gets really bad I usually do a combination of lotramine, cortizone cream and the zinc-oxide type butt cream. That usually helps the problem. I also use only water and paper towels to wipe up after a poopy diaper to help cut down on any irratation to the diaper rash. I have also had to use the zinc-oxide cream on a pretty regular basis to help avoid the major flare ups. Hope it clears up soon! Lisa
According to my acupuncturist, aloe is the way for the diaper rash. Sorry, no first hand experience yet to back it up.. jeong
Our 10 month old daughter had very bad diaper rash for about a week. We used a blow dryer on her tush at diaper changes to keep her very dry and changed her more frequently than usual. We also cut out her juice intake at that time so that she had less acid in her system. Balmex also helped. She is now clear and free. Good Luck
In incontinent adults matching areas in the perineal area are almost always fungus/yeast related. About 95% of these respond to over the counter antifungal medications that usually contain 2% miconazole nitrate. Surprised it didn't get worse with the topical steroid. Powder covered with ointment(to prevent washing off with urination) or ointment based antifungal applied daily and with each diaper change will usually resolve condition in adults in 2-3 weeks. If not or worsens, you should see a dermatologist. Anon
When my daughter was an infant she had a pretty bad diaper rash a couple of times that necessitated using lotrimin combined with hydrocortizone cream. We also cut out wipes just using viva paper towels (as recommended by the advice nurse)and water. This worked extremely well to clear up the rash and made my daughter much more comfortable. Good luck. Hannah
Our daughter had a long standing and very red diaper rash last summer and we tried everything. THe lotrimin (we used the generic - clotrimazole) was the only thing that worked and it worked so well and so quickly. This winter she had another very severe rash and again the lotrimin was the only thing that worked. I am not aware of any negative side effects of lotrimin and it certainly was what healed our daughter's bottom. Liz O.
It might be worth trying the lotrimin cream. If your daughter's rash is caused by yeast (a very common thing in young babies, especially if they've ever had an antibiotic -- my 20 month old son has had this happen several times -- although I don't think antibiotic is the only cause) none of the other treatments you describe will have much efffect. Only a medication targeted to yeast, such as lotrimin, will help. This is probably wny your pediatrician wants to try it. And I don't believe it will hurt the baby, so I don't think your reluctance is warranted. Karen
A simple remedy that a midwife told me - it's worked wonders for my very rash-prone children. Sprinkle some corn starch in the diaper when you change it - dust it over the diaper area too. A small handful - just let the powder go all over the place! Also, only use water to change the diaper, not any cream or lotion or baby wipes. They can cause the rash. After washing with cotton balls, gently dry, and then sprinkle this corn starch powder on. It worked well for us. And nothing else did! (Incidentally it also worked for the eczema I had on my hands for fifteen years.) Janice

8-month-old with diaper rash

Jan 2002

Though we're long out of diapers, I used to use 3 things for diaper rash. Desitin was a great protection against further rash and the fish oil soothed the rashey skiin. Also vitamin E, but the best is probably air. Can be a bit messy at times, but letting them run around bare tushed I found to be the best healer of diaper rash. There are lots of homeopathic ointments too. Calendula is really good. Some kids are more sensitive and get rashes really easily. Diligence doesn't always work. Good luck.


I recommend squirting a little breast milk on the rash and air dry with each diaper change. All those antibodies are great for the skin. It will probably look better in a couple of days. katie
I whole heartedly recommend calendula lotion by Weleda. My daughter had a severe rash early on for about three weeks, and no amount of Desitin would help. We used the calendula by Weleda, and in less than 24 hours the rash was gone. Good luck! scott
Our doctor got us started on a miracle ointment. It is called flanders buttocks ointment. It completely clears up even the worst rashes my son had in one to three tries. It is our miracle ointment. It doesn't smell great, but it works. We couldn't find it anywhere around Berkeley, but got it on the web, under yahoo shopping. I definately recommend it to all who are having a problem with rashes. kristi
For us Weleda is a dream diaper ointment. Every time we've used it, it soothes our child instantly and the rash is gone in a day. It is a natural ointment and you can buy it at Whole Foods or on-line at Drugstore.com (it's cheaper on-line). Good luck!!! lori
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