Diaper Rash with Diarrhea

Awesome advice from the Ask Dr. Sears website...
http://www.askdrsears.com/html/11/T081400.asp

DIAPER RASH

When your beautiful baby is born, her skin is often perfect in every way. It is softer and smoother than it will ever be again. You are dismayed when she wakes up and her bottom is red and irritated when you change her diaper. What happened! What did you do wrong? Absolutely nothing!

ALL BABIES HAVE DIAPER RASH!
There are many misconceptions about a baby's bottom:
It is supposed to be perfectly smooth and rash-free
Diaper rash is abnormal
Diaper rash is a sign of food or formula allergies
Diaper rash means the baby has bad diarrhea or a yeast infection
Having a diaper rash is a normal part of being a baby. There are many ways you can limit the amount of rash, but from time to time it will flare up again.

WHY BABIES GET DIAPER RASH
Start with ultra sensitive skin, add the chemicals and moisture of urine and stools, cover the area with a diaper that rubs back and forth, and you have diaper rash. This damaged skin is susceptible to the invasion of bacteria and yeast, which can make the rash worse.

SEVEN WAYS TO PREVENT OR MINIMIZE DIAPER RASH
If your baby does not have a problem with diaper rash, then you don't need to be too strict with these preventative measures. However, if you are constantly battling rash, here are some helpful hints to minimize it:

1.Change diapers frequently - at least every two hours in newborns. You can space this out as baby starts to urinate less often.

2.Change poopy diapers right away - this is a lot of trouble at first since newborns often have small, frequent stools. This will slow down as baby grows.

3.Try different brands - if using disposables, another brand may fit a little better and cause less friction.

4.Rinse cloth diapers - add a half-cup of vinegar to the rinse cycle. This helps remove alkaline irritants. Your diaper service can also do this.

5.Wipe well - be sure to wipe all the stool and urine away.

6.Use unscented wipes or just plain water - these are less irritating. You can even rinse out the wipes with water, although this takes more time.

7.Diaper rash cream - some lucky babies don't need any. More sensitive bottoms need cream with each new diaper. There are two basic types of barrier creams:
Petroleum ointment (Original A & D ointment) - this is an excellent preventative every-day ointment. It's less sticky and less messy.
White zinc oxide - this is thicker and may be better for babies who are more prone to rash.

FOUR WAYS TO TREAT DIAPER RASH FLARE-UPS
No matter how diligent you are with the above measures, your baby will still have a rash from time to time. Here are some tips to treating those rough spots:

1.Wash off bottom with water - don't wipe the sore areas. Instead, use a bulb syringe to gently wash baby's diaper area.

2.Gently dab or pat away any remaining stool. Blot baby's bottom dry.

3.Let it air out - leave the diaper off for a while, with no diaper cream on. Lay baby on a towel (with a waterproof pad underneath to catch accidents) with her bottom up. Do this as often as you can. This will help dry out the rash, which is important for the healing process.

4.Diaper cream - when you do put the diaper back on, use generous amounts of cream. Here are some suggestions:
Zinc oxide - for the moderate rash.
Acid mantle - this is a brand name sold in stores. It is outstanding for moderate diaper rashes. Can be used with zinc oxide over it.
Butt paste or Triple paste - there are a variety of creams that a pharmacist can mix up for you that contain a variety of ingredients. These are good for severe rashes. One brand that is already mixed is called Triple Paste. Ask your pharmacist for some. It is non-prescription.
Clotrimazole anti-fungal cream - for stubborn rashes, yeast may be involved (see below). You can add this over-the-counter cream to help.
Hydrocortisone 1% cream - you can put this over-the-counter cream on twice a day beneath any of the other creams to help with severe rashes. It will help with the inflammation. Don't use this for more than several days at a time as long-term use can damage the sensitive skin in the diaper area.
Soothe and heal by Lansinoh. This pure lanolin ointment is excellent for soothing sore bottoms.
Mix your own - if you can't get a prescription, try mixing these together in the palm of your hand, then apply to baby's bottom:
Zinc oxide
White petroleum ointment
Acid mantle
Aluminum acetate (Burrow's solution)
If you cant find Acid Mantle, then use Lansinoh (a lanolin ointment). It is available in the diaper cream section of drug stores.

IDENTIFYING SPECIFIC DIAPER RASHES
Here are a few diaper rashes that can be more than just irritation from the stool, urine, and diaper. They usually require more specific therapy:

1.Contact diaper rash - this is simply the regular rash as discussed above.
Appearance - flat, red, irritated skin. When severe, skin will peel or blister and slough off.
Treatment - as described above.

2.Intertrigo - this is a specific rash that occurs within the skin folds and creases around the diaper area where the skin rubs together.
Appearance - Heat and moisture mixed with urine cause a red, burn-like appearance.
Treatment - regular white petroleum diaper ointment.

3.Yeast rash - when the skin is damaged, yeast from the intestines can invade the skin. This especially occurs with antibiotic use or prolonged rash.
Appearance - it is a red, raised, patchy rash with sharp borders, mostly over the genitalia but with satellite spots sprinkled around the diaper area. Click here to view a picture of a yeast diaper rash.
Treatment - in addition to the above measures, there are two commonly used anti-fungal creams:
Clotrimazole - over-the-counter. Apply 2 - 3 times a days beneath the other creams.
Nystatin - prescription. Not necessarily better, just different.
Acidophilus - this is a natural bacterial powder that fights off yeast. Click on it to learn more.

4.Impetigo - this occurs when bacteria invade the damaged skin.
Appearance - coin-sized blisters or red raised patches that ooze a honey-colored crust.
Treatment - prescription antibiotic ointment as well as the above general measures.

5.Seborrhea - an inflammatory condition that can affect different parts of the body, but can be especially severe in the diaper area.
Appearance - a big, red, sharply demarcated patch over the groin, genitalia, and lower abdomen. It can be more raised, rough, thick, and greasy than the other rashes.
Treatment - hydrocortisone 1% cream (over-the-counter) 2 - 3 times a day. Don't use more than a week unless directed by your doctor.

6.Allergy ring - a variety of foods can irritate baby's bottom, especially acidic foods such as citrus and tomato-based sauces.
Appearance - a red ring around baby's anus.
Treatment - discontinue suspected foods. Breastfeeding moms may need to eliminate foods from their diet.

WHEN TO WORRY
None of the diaper rashes discussed here are so serious that they warrant an urgent call to your doctor in the evening or overnight. They generally can wait to be evaluated and treated by your doctor's office the following day.

1 mom found this helpful

There are different types of diaper rash and if it is a yeast reaction, it is harder to clear up and might need something like Nystatin which you could get from your pediatrician. Also look carefully at whether any new foods were introduced recently that might have caused a reaction, that is often what happened with my daughter -- she would eat something she was sensitive to and develop a bright red "ring" around her anus-- poor thing, but it usually cleared up quickly by removing the offending food. A gentle bath with no soap (just clear water) and then allowing to air dry with some light sun exposure can help also. But the very best thing I found, this was a total godsend to me recommended by our pediatrician and is over the counter & fairly inexpensive, is called BAG BALM. I find it at Walgreen's usually near the adult lotions-- it is in a little square green box (tin) and has a cow and udders on it-- it was originally used as a cow udder cream! This has the consistency of a thick Vaseline-- and trust me this has been a life saver! It has kept our daughter pretty much rash free since we started using it, and we like it so much we just use it with every diaper change to prevent a rash. Love this stuff-- give it a try!

PS-- please do consider this stuff-- I thought it looked weird at first but it is so wonderful! Our pediatrician first recommended it for a rash similar to what you're describing, our poor daughter's skin was basically "raw" even though we were doing everything we could & being super gentle. This stuff worked so quickly and fast, I feel like I was in some kind of land of ignorance before using it! I had tried Desitin, Aveeno & a bunch of other things and nothing really helped.... hope everyone's better soon!

With my oldest the best thing was A&D ointment in the yellow and brown container. It would usually clear it by the next diaper change. It didn't work with my youngest and neither did anything else. Finally our pedit. recommend Dr. Smith's Ointment. I couldn't find it anywhere so the pharm. at Walmart ordered it for me. Works like a charm! Also, don't use wipes! If you can run her bum under water that works the best. If not use warm cloths and try not to really rub! Good luck!

Aquaphor works best.

When our little ones would get diaper rash we would use Triple Paste. It is made by Summer's lab and I believe they now carry it at walgreens and target. It used to be only available online. We used it with our son who was inthe NICU an allergic to the diapers. The diapers gave him a terrible rash. Since then we have used it. I sometimes mix it with a little a & d ointment. It really is a miracle for diaper rash. Hope she feels better soon!

My older son used to get diaper rashes so bad, he would bleed (I blame the day care and not changing him enough and not cleaning his bottom good). I use 1/2 percent cortizone ointment on my kids when their diaper rash is red or even the slightest bit raised or bumpy. My pediatrician suggested it and it works great. Use the ointment kind (as opposed to the cream), it will stay on the skin longer. Usually the 1/2 percent is behind the pharmacy counter so you have to ask for it. (When they got a little older I used the 1 percent and it didn't seem to be a problem) The cortizone helps relieve the swelling. I also keep a hair dryer in the diaper table so if I have to I can make sure their bottom is REALLY dry. You can also use wet paper towels instead of the wipes. The wips could contain alcohol that could be irritating.

When my son got his first rash like you described, our homeopath recommended using Calendula salve. She also prescribed a remedy to take internally. That seems to help when he gets a really awful rash. Also, instead of wipes we use cloths in a water/vinegar solution (10% vinegar/90% water).

I hope you are able to find something that works for your daughter.

My pediatrician recommended a combination of Lotrimin (over the counter antifungal cream) and Cortaid (over the counter hydrocortisone). He said that it is a yeast infection but not a vaginal yeast infection. There are prescription strength ointments available also, but this worked really well for my daughter. You have to continue to use the cream even after the opening seems to heal to prevent it from coming back. A size of a pea in the palm of your hand for each of the ointments - mix them together - and put a thin film on her bottom. God bless your family.

Try Cornstarch, my son had a few diaper rashes when he was about 10months old and that seemed to help.

I know this might seem like a silly thing, but once when my daughter developed diaper rash, I went out and bought different diapers (a little more expensive) and that helped clear it up.

I also noticed that the cheaper (and I mean the really generic brand) diapers also made the rash worse and kept it from clearing up.

Rice is another good thing to help with the after effects of diarrhea, along with bananas.

Butt Paste, usually found at Wal-Mart is a good rash cream to try, too. I've used both and sometimes just a change in cream helps.

Hoping this helps.

I see you have already gotten tons of responses to this. I use Triple Paste for diaper rashes. Every now and then my sons bottom gets bright red and has an open sore, as you have described with your daughter. It clears up over-night with Triple Paste. You can get it at the grocery store in the baby care aisle, or Babies R Us if you can't. It's kind of pricey, but well worth it! Good luck!!

Definitely stop using wipes immediately. Rinse her bottom with lukewarm water (just above cool) and gently pat dry.

We also use calendula cream by Weleda and it's amazing. Healed a terrible diaper rash that lastes WEEKS with other creams.

Also, try giving her rice. This clears up diarrhea really fast. Blueberries are another natural remedy...you can blend some with the yogurt.

So sorry she's feeling this!

M -

If Desitin is not doing it (and it should start to work immediately), then try a different kind. I had one baby that Desitin worked on, but the rest needed other kinds... A&D Ointment being the most successful for more than one of mine. You seem to be doing the right things, otherwise.

We just had this with out 1 yr old due to diarrhea due to antibiotics. The rash was glow-in-the-dark red and she cried when she peed, when I cleaned it etc... It helps to rinse the wipes so there is no soap in them and to use soap only if there is poop.
If you can rinse her in the tub for diaper changes, that is better as there is then no friction on the irritated skin, then pat-dry. My daughter learned really quick to hold onto the tub or the bar so I could rinse her.
For us, all the regular diaper creams did not help. The doctor gave us a perscription for "Aquaphor with Questran" and that improved everything over night. We used the perscription for 3 days or so, but the worst was over after the first night when her skin really got a start on healing.
In regards to the diarreah the Dr told us to give her bananas or apple sauce or potatoes as that stuff binds in the gut. No apple juice. I also gave her the Prunes and Applesauce baby food, sometimes mixed with rice cereal. The mashed potatoes were a big hit in her book :)

I hope your daughter gets to feeling better soon and that some of this helps!

D.

There is something you can get from your doctor, it's a mix of aquaphor and something else. Call them Monday and ask if you can just pick up the script instead of going in. That worked better than anything and cleared it up within a day.

Make sure it's not a yeast diaper rash. Nystastin works quickly to resolve this type of diaper rash. Dark, moist areas are great breeding grounds for yeast and regular diaper rash cream won't heal it alone.

Sounds like you are doing things right. I used Destin too but when my baby had diaper rash really bad (like you are describing) my pediatrician recommended using Balmex instead. And it worked in a few days. A number of my friends swear by Boudreaux’s Butt Paste. Good luck ...

first off, stop with the oatmeal and go to rice...the standard diarrhea solution is the b.r.a.t. diet (bananas, rice, apples, and toast). it will stop the runs quick. For the rash try Budrohes (sp?) Butt Paste. Ask at the pharmacy but its with the desitin products. Its amazing stuff.
Best wishes! These worked with all 5 of mine like magic!

The yeast rash might be right on point. Instead of using desitin, go buy an over the counter cream. Ask the pharmacist which would be best for a baby. Rub that on instead. And give the child yogurt to eat. It really can help with the stomach and clearing up that rash. If it's yeast, it will start to clear up almost immediately. For a yeast rash, desitin just makes it worse because it locks it in.

I HIGHLY recommend Southwest Lifestyle Antibacterial Cream. I have a friend who purchases it for his grandson. The child's pediatrician said to KEEP USING IT for diaper rash as well as eczema as NOTHING else helped the kid. Docs told the mama that it was THE best thing she could use on him.
www.southwestlifestyle.com. Click on Body Care on the left and you'll go to a screen of products including Antibacterial Cream. If you can't find it or have questions send me a message or call me - ###-###-####

Hi M.,

Your Dr can give you a prescription for butt paste-you just need to call and tell them what's happening. It is a fabulous concoction and should help pretty quickly.
E.

Hi M., Happy New Year!

With alot of experience..3 grown kids and 3 grandchildren (another on the way) this is a topic I have much knowledge in. My oldest granddaughter would have this reaction to diarrhea. There's a product called "bag balm" that was created for the teets(sp) of cows who's suckling calves caused great chafing. It's not funky smelling or anything you would associate with animals. You'll find it at K-Mart, Target, Walmart.etc. You can also ask a pharmacist..they're great for advice. Also, A&D because of it's healing properties was a favorite in less drastic situations. I didn't find Desitin to be a good choice with my brood. Letting her tushy "air out" is great,also. Way back when we had the "BRAT diet"..Bannana,Rice,Apple sauce,dry Toast (you can put a little jelly but no dairy). Pedialite will replenish the electrolites she's losing and that's a must. I wish you both well and I hope I've helped. R.

Hi. I would cut down on the yogurt. She might like one of the other people said she might have an infection.

You are doing all you can do for right now. Keep up greasing her butt as much as possible. The diarrhea must be cleared up first. It's acidic and is burning her skin. You might try rubbing some liquid Mylanta on just before greasing her up to help neutralize the acid. Sometimes the gut will stay irritated long after the initial cause of the irritation is gone. You'll want to follow BRAT - bananas, rice, apple sauce and toast to help firm up the stools. Some say there is a 2nd t in BRAT for tea, but I've found different teas have different effects on different people, and what works for most people (green tea), gives me the runs, so I don't bother with it for diarrhea. Pedialyte and water are good to keep her hydrated. Once her gut is back to normal, you'll be able to conquer the diaper rash. Air out her bottom as often as you can. Let her play in a dry bathtub for a bit every day. It's a rare child who goes from birth all the way to potty training without having this problem a few times in between. You'll get through this.

it sound like it may be an allergic reaction to some kind of food. Reactions do not always appear with the first introduction to foods. My son had no issues with foods until about 2yrs old when we discovered he was allergic to tomatos which he seemed to have no problem with before. You may want to try the elimination diet where you eliminate a food group at a time for a minimum of a week then reintroduce consistantly for about 3 days...if no reaction then that's not it so you move on to the next group and so on. As for getting rid of the sores and rash you can try putting straight cornstarch on the area...baby powder has perfumes and other additives that can further irritate. You can also try putting plain oatmeal (not the instant) in a nylon sock and putting it in the bathwater with your baby this will help soothe also. We also have used the aloe with lidocaine that you use on a sunburn. The aloe will help soothe the skin and the lidocaine will numb the area. If all else fails your pediatrician can prescribe some ointment that will clear it up in no time! Good luck!

Gosh I wish I can remember the name of the second medication that my son's pediatrician gave me for his rash. I know the first one was Nystatin cream. The second one was also a prescribed cream but they were given to us seperate in two different tubes. I would know it if I heard it. The doctor had us put it on him at the same time after each diaper change. It worked wonders. Usually it cleared up the worst rash after the first application. Nothing has ever worked the way this did. My friends, when I told them about it, praised it as well.

M.- Aquaphor worked the best for my girls when they would get that rash that opened up and bled a little bit. Sometimes I would put on the desitin first then add a TON of the aquaphor on top of it. If it doesn't clear up, the doctor can prescribe another cream that is basically aquaphor with a strong medication to clear up the rash.

Hi M.,
It's been a couple of days since you posted your request but I thought I give you my opinion anyway. I used to use "Corona" cream on my girls. It is for pet, actually but works wonders. Our Ped is the one that recommended it. You can get it at Farm supply stores. It is lanolin and comes in a red and bright yellow tube. I would apply it one time and that would take care of the rash. It really worked wonders. Good luck. I hope your little one is feeling better!
E.

Hi M., just wanted to drop you a note and let you know what we have found that is the very best I have ever used for diaper rash, I live with my granddaughter that I raised and her husband and baby and have raised 4 children of my own so have sure tried about everything, well when my little great grandson that is the one living here got diaper rash several months ago we of coourse tried the disitine route that is usually recommended and it didn't help much so I found this product called "Butt Paste" and thought it sure won't hurt to try it, I found it in Walgreens in the baby isle, well I'll tell you what it was like a miracle, it worked and it worked so fast that we couldn't believe it so another granddaughter's little girls got diaper rash from having the flu and of course like your little one the diarrhea started and so I went to the store and got some for her and took it over there and she called me the next day and said Grandma the diaper rash is all gone thanks to Butt Paste. We all swear by it now it is a wonderful product. I hope your little one gets better really fast, it's terrible when they don't feel good.
Good Luck
Grandma Rose

I got this from a care provider at my daughter's daycare when she was about 1yo, and I still swear by it to this day. Grab a cup or so of regular, white flour (yes, the stuff in your pantry) and throw it in a pan on the stove set on medium...brown the flour. It will smoke a little and smells like it's burning, because, well, technically, it is. Some of it will stick to the pan, it's best not to mix the stuck stuff with the rest, if you can help it because you'll have to pick it out as it will be too rough on her extra-sensitive bum. Anyways, all of the flour should be an even, light brown (think dry beach sand). Let it cool and then store in whatever you want(I use either ziplock baggy or small tupperware.) When the next diaper change comes around, wipe and air dry as usual and sprinkle the soft,brown flour on like baby powder...I sprinkle w/my fingers, making sure none of the hard, burnt stuff from the bottom of the pan gets on her and VERY GENTLY rub it on where it doesn't stick, and diaper as usual. I have NEVER had to use this for more than 24 hours as the rash would almost completely clear over night. And my daughter had horrible diarreah caused rashes that would be so bad she bled. I, too, used every cream that I could get my hands on and nothing worked until I found a little baggy of this in her diaper bag from daycare. I have never bought another tube of diaper rash cream again! I hope that I'm too late with this response and she's cleared up, if so, keep this in mind in the future. If you or anyone does use this, please let me know if it works for you or not. Sorry this is so long, but I hope it helps and your baby feels better soon!!!!

My children would get horrible rashes when I used diapers other than Pampers. With my first two I used cloth but with my second two, I used Pampers. I think they were allergic to other diapers. Anyway, I thought I'd throw that out there in case this doesn;t clear up. Good luck you you and your precious baby!

Butt Paste is the choice of diaper cream that seems to work with my babies tushies. My 3 year-old went thrught that stomach virus epidemic 2 years ago and had diarrea alot which made it tough on the tush. I used just warm water and toilet paper (use water instead of wipes so it doesn't sting as much)then I caked on the Butt Paste. The rawness heals up instantly and I think it has some kind of soothing/cooling in the Butt Paste because he always stopped screaming the second I put it on. So now, when I see the slightest redness on my infant twins now, I apply some to prevent it from getting worse. Works pretty well for me.

It might possibly be a yeast infection. The same thing happened to my son, and he would just scream & cry all day because he was in so much pain. Our ped. gave us some medicated cream to clear it up & told us only to use water on a washcloth to wipe since even alcohol-free wipes can burn. Good luck!

My 22month old son has had severe diaper rashes and the only thing that i have found that works wonders is auquaphor. made by eucerin. its awesone a little expensive but works great!

My doctor recommended using hydro cortisone cream 1% on the rash and it should clear up. That is as long as her diarrhea is gone. Use the BRAT diet for that Bananas, Rice, applesauce and toast. Hope this helps.