Special Needs Sunday: Severe Diaper Rash

When Jenna was an infant, we were constantly fighting battles with diaper rash. Actually, that term doesn’t even begin to do justice to the problems she had. It was more like perpetual-raw-and-acid-burned-bum-and-labia syndrome. We’re talking about problems so severe that she would have open, raw and sometimes bleeding places on her skin. Poor little thing. As a result, she spent a lot of time on her tummy with her bare little bum sticking up in the air and a light shining on it (a trick we learned in the NICU). Here’s a sad picture of her little raw butt airing out in the NICU. Doesn’t she look miserable? If you click on the picture, you can see the raw, redness of her tiny little tush.

Here’s another (Yes – I’m sure she’ll kill me someday when she’s in high school, but it’s just a butt!)

It’s quite likely that she had more problems in the diaper area because of her intestinal issues. She was much more prone to diarrhea, and because everything moves through her super-short intestines much faster than it does for the rest of us, her poops are a lot more acidic. Even with constant diaper changes, the sensitive skin down there does NOT like to have acidic yuck on it.

We tried about every product available. At one point, we were even prescribed a cream/paste that they use on burn victims (we weren’t impressed). One thing we learned very quickly: products with zinc oxide (i.e., MOST BABY DIAPER CREAMS!) were a no-no. For some reason, they seemed to intensify the redness and rawness. I couldn’t believe how many diaper creams contained zinc oxide! Apparently, it must work well for most other kids. So began my quest for an effective, safe and gentle diaper cream. We needed something that would work as a barrier against the diarrhea and acid, and we needed something that would help heal.

Here’s what we found that worked:

• Hydrocortisone Ointment – we used when the first signs of redness started appearing, and only until the redness subsided. We used ointment instead of cream for its barrier properties.
• California Baby Calendula Cream – we followed up the Hydrocortisone Ointment with this for about a week. Now that she doesn’t have as much trouble, this is what we use at the first signs of redness.
• Alba Multi-Purpose Un-petroleum Jelly – when she doesn’t have a rash going on, we use a thin coat of this at every diaper change as a barrier. We always use it overnight, when she’s in one diaper the longest length of time. If she has a rash, we apply one of the other products first, and this one lightly on top.
• Lanisoh – Also used this for a while with some success instead of the Alba product as a barrier.

Occasionally, the rash/burn would evolve into a yeast infection, and we found over-the-counter Lotrimin (or its equivalent) mixed with the Alba Jelly to be effective. I should also mention that we keep a soft, clean cotton diaper with our diapering supplies and pat her bottom dry EVERY time we change her.

When the rash was at it’s worst, we stopped using baby wipes and used soft, cotton squares (like what you find in the make-up aisle) dipped in water with a drop of tea tree oil (which is good for a million things – I LOVE it!). We would pat her dry and place her on her tummy with a positionable floor or desk lamp beside her shining right on her tush. It worked best to lay her on a large continence pad for ease of clean up. We tried softly patting over-the-counter liquid antacid on the area and letting it air and dry, but we never really noticed that this sped things up.

Let me stress that this information is not meant to replace the advice of a doctor. These were our own experiences and solutions, and they may not be what works for you. I’m sharing them because they might give you an idea you hadn’t thought of or something else to discuss with your doctor. Please know that any persistent diaper rash should be discussed with your doctor to rule out more serious infection or fungal problems.

Finally, here’s a site with some good diaper rash information.