Basic Butt Care/Diaper Rash |
There is nothing quite as cute as a baby’s little butt and nothing quite as sad as when that cute little tush is covered with a rash. With any rash, it is worth playing detective to see if there is an obvious source. A new diaper brand, a diaper that is too tight, a new soap or detergent can all be culprits. Believe it or not, once your little one is old enough to be eating solids, acidic foods such as citrus and/or berries seem to be connected with diaper rash flare ups. But the fact is, most diaper irritations are simply caused by your baby's delicate skin being in contact with irritating stool and urine. Even with the most careful parents, rashes happen. It is much easier to prevent a rash than to treat it, so it is worth some effort to avoid rashes in the first place. The basics of prevention include:
After the wiping, I like to blot the damp skin with a tissue, this helps make sure that the area is completely dry. That simple tissue can also find leftover pieces of poop that were hiding in the creases. You would be amazed what is lurking in all the little crevices. You will see that the tissue will actually stick to the skin when it is still tacky from being wiped. Keep gently tapping the tissue until it no longer sticks. Some people use a warm hair dryer to get the skin dry. Both methods work well. Having some ‘diaper off time’ and letting the tush get some air is key. Give your little one some time with no diaper for several sessions a day. Babies are less likely to fuss for this if they are kept warm, so try to have a cozy place for this to happen. Lauren and Adam actually blew some warm air from the hair dryer on baby Elliot the other day during some ‘air time’ and he seemed to love it. The combination of the noise and the warm air kept him pretty happy. A short session of indirect sunshine through a window is also beneficial if you have the opportunity. Of course your little one is going to take this opportunity to pee and poop all over the place. Using the blue absorbent pads (you can actually get them from a pet store) or a towel can help contain any mess. Have a washcloth or a pee-pee teepee handy. Don’t underestimate the ability of poop to squirt impressive distances. Boys of course are the most likely sprayers, but don’t count out your little daughters in their ability to make a mess. Another good preventive measure is to add a splash of apple cider vinegar to the bath water. I don't have an exact amount because tubs vary greatly, but somewhere around a ¼ cup for a normal tub full of water. Keep your baby well hydrated; concentrated urine is more irritating. You may hear diaper creams also referred to as a barrier cream; this is simply because they are creating a barrier between the skin and the irritating pee or poop. Once your baby is giving you a longer stretch at night, I would suggest that it is now time to start automatically applying a barrier cream. For preventive care I don't have a favorite, there are lots of wonderful brands. The Environmental Working Group, EWG, is always a good source of information. They have rated some of their favorites. They do a deep dive into every ingredient and rank them accordingly: Dr. Den’s favorite is one called Emily Diaper Soother. If you are local, you can get it directly from her. My daughter Lauren really likes Tubby Todd. It is a bit pricey, but it works really well for Elliot If you already are dealing with a rash and the cream that you are using isn’t doing the trick, here are some options that I especially like: Bag Balm is a standout, with a good rating from EWG. Originally used by farmers to soothe cows irritated udders, I have seen it clear up some stubborn rashes with remarkable success. Another favorite of mine that is not quite as highly rated by EWG, but is still fine to use is Calmoseptine. This is a cream originally used for ostomy care. I have found it very effective for some of the more raw skin situations. You can also make your own concoction by mixing together an assortment of ingredients. I learned about this from an old baby nurse that I worked with in a NICU back in NY. This is especially helpful for rashes that appear to be associated with food sensitivity or teething. Take a clean container and add equal parts:
You may have heard of a prescription cream called APNO (all purpose nipple cream.) This is a combo of antifungal/ antibiotic and a steroid cream. When I was working at Noe Valley Pediatrics we would have our local Walgreen’s compound this for the most severe rashes. A rash that is severe enough to require this, also likely needs an appointment to evaluate it first. Beyond the common diaper dermatitis, there are some other potential causes. Once in a while a rash can be caused by yeast. Yeast thrives in warm, dark moist areas. It is no surprise that a diaper area (and nursing bra) is the perfect breeding ground. Yeasty rashes can look very spotty or very red with distinct borders. They also like the creases and can spread outside of the diaper area. The prevention and treatment are similar to the ways we would treat a standard diaper rash. The air and apple cider vinegar are even more important but usually not quite enough to get rid of it. For suspected yeast I am going to add an antifungal cream to the mix. Over the counter creams such as Lotrimin (used to treat athlete’s foot and jock itch) is fine. There is not a baby version. After the air time, add a thin layer of the antifungal cream and follow with whatever protective cream you prefer. Do this three times a day. It takes a week or so to get rid of it completely, but you should start to see a difference within a day or so if you are on the right track. Some rashes get so raw that the poor little bottoms bleed. I would put a thin layer of Neosporin on any open, sore areas, also three times a day (sometimes it feels like a little paint by numbers kit...a little of this here, and a little of that there.) If there is absolutely no improvement after a couple of days, it is worth having an evaluation. Your doctor will most likely always want to see any diaper rash that is pimply or oozy. Some very red diaper rashes are caused by bacteria. Strep is the biggest culprit for this. One more thing to consider. Evivo is a probiotic that is given to the baby. They have some impressive clinical data that shows that Evivo reduces bad gut bacteria by 80% and restores the baby’s natural fecal PH. 72% of mom’s using it report a decrease in diaper rash. Okay, get that tushy out for some air ( sorry about your carpet!) If you need some more diaper changing tips. Check out this previous post. The photo on top is courtesy of Jake and Shachar's baby Noam's epic poop episode that actually got the walls and the lamp. Don't say you haven't been warned. |
No comments:
Post a Comment