All Things Rashy

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brnicholas

New member
I’m a resident physician in primary care, and I have a great relationship with our pediatrician so not looking for medical rashy advice, more just experienced Mommy input and CD advice - I’m a newbie to CD. :)

My LO is 5wks and we are dealing with a really stubborn diaper rash. It’s been as bad as having a few open sores. The sores are healing but now she has major rash butt again. This has been going on for a few weeks at this point. Contact and Yeast dermatitis. I have a call in with our Ped about some Rx antifungal cream as nothing is working.

Other background: LO is a seriously heavy wetter AND she poops ALL the time. A lot. We change diapers constantly it seems, and of course as soon as we change her she immediately goes again. Overnight she goes 2-5hrs between feeds/changes. 5hrs is uncommon, 3hrs is more her usual.

We were using Osocozy prefolds and one Alva NB Pocket. Contact rash started. We added fleece liners - she soaks them; rash persisted. We added diaper cream and liners - no improvement, then her rash worsened. She then developed the open sores. We have now been using disposables for over a week and no real improvement. Her sores were healing well and I thought we were getting better, then the yeast rash flared back up BIG time.

We have tried 3 diaper creams (Bordeaux Butt Paste Red tube, and green tube, and Honest Co diaper cream), Vaseline, and today switched to Lanolin. We have tried Pampers disposables (HORRIBLE), some spendy natural ones (maybe Honest Co? Can’t remember atm), and Huggies. We have also tried 3 brands of sensitive skin disposable wipes, and cloth wipes (just water). Frequent changes, baths, daily airing out.... Nothing helps.

At this point since we aren’t getting better and we are going through disposables like mad, I REALLY want to go back to cloth. But I don’t know what the best protocol is with cloth and rashes...

TLDR LO has persistent contact and yeast diaper dermatitis not improving with several interventions.

My questions are:
1) when can we go back to CD (does the yeast rash need to be gone)?
2) if we go back to CD before her rash resolves, do I need to sterilize the CD somehow? (I just restripped them per FluffLove University, and got softener to change our wash routine for our water hardness on recs from a prior thread. We haven’t used them since this so they are currently well stripped and sanitized).
3) if I do need to sterilize them, how and how often should this be done?
4) can I use ANY diaper cream/ointment with CD if we use fleece liners? (Our pocket has a microfiber insert). Or do I still need to stick with CD safe creams?
5) same Q’s above, but RE cloth wipes
6) anything else I should know about rashes and CD/cloth wipes?

Other thoughts and input welcome! :)
 
UPDATE: So I never did hear back RE the antifungal cream for LO’s bum. My Ped called in sick and the other Ped in the office never called me back. :/ I was going to give it 2 days and if I didn’t hear make an appt BUT (or should I say - “butt!” Haha) by the time those 2 days passed LO had already started to improve big time! 😁

Thanks to all for the suggestions! We are fully back in cloth (yaaaay!!!! So sick of disposables), with a new wash routine, and things are going so well.
We did a few nights of disposables using a TON of red tube Bordeaux (it really is so much better than the green tube) mixed with a ton of Vaseline which really helped keep the diaper from just absorbing it all off. During the day we used Lanisol. With each change I also ran her bum under the water in the sink for a minute or two after wiping her up (to remove any residual chemicals from the disposable wipes) and let her fully air-dry. That combo worked like a dream to help heal her up in 2 days!
Once the bulk of the yeasty infection was gone, leaving just contact dermatitis and her little healing sores, we switched back to cloth during the day, then after a few more days went back to cloth at night too (diapers and wipes, using just water with the wipes. My PP squirt bottle works perfectly to give her a little spray-off and then wet a cloth wipe - I would highly recommend it!).
With the CD we are using fleece liners with MotherLove Diaper Balm during the day, and Wedela with Calendula at night. I swear there’s something magical about calendula - it’s an ingredient in both products, and MotherLove Nipple Cream which absolutely saved me the first 2 weeks of BF. Anyways with that new routine she has looked better and better every day and we are now almost completely rash/irritation free! Thank you all for the wonderful input!!!! :)
 
@brnicholas It looks like the bleaching questions have been answered.

For my favorite super bad rash non-cd safe cream go-to, I really had good luck with Dr. Smith's. Its expensive, but it cleared up my kids rashes quick and was painless. I swear Desitin would make them scream in pain and this stuff didn't. I also use Angel Baby bottom balm (cd safe) for regular beginning of redness or if it looked like either of the kids were just beginning to get a touch of a yeast rash.

Another thought I see is that you're changing on average ever 3 hours? Especially with prefolds, I would change every 2 at least. I used pockets primarily, and added another microfleece liner to add another layer of stay dry material. My kids both were prone to yeast if they had any kind of extra moisture against their skin.
 
@brnicholas Just chiming in with a diaper cream suggestion: calmoseptine. This stuff is the bomb, we pull it out whenever there’s a rash that lasts longer than a day or two (not cloth safe, though, so needs a liner or ‘sposies!)
 
@brnicholas You’ve gotten some good advice here. So I’ll add this, osocozy didn’t hold enough liquid for us. We switched to Green Mountain Diapers and they hold more. You can layer with hemp also, which holds the most.
 
@jeff144 Oh that’s good to know! If we do prefolds past NB stage I’ll definitely go with GMD. I don’t want to buy a whole new stash in NB size though. :/
 
@brnicholas We did size medium and folded the top over with the newspaper fold. That makes it a bit smaller. We pad fold now for my 2.5 yr old. We newspaper folded when he was 3 mos.
 
@jeff144 We’ve been having to do that with the NB prefolds. LOL We are just now getting to where we can sort of get away without the extra folding down. LO is a little one. :p
 
@brnicholas Everyone has already mentioned the bleach, so I’m going to tell you what else worked for my daughter when she developed a bad yeast rash when she had a month of diarrhea.

Firstly, I let her air out as much as possible. Every chance I got, her little butt was uncovered. Also, I gently dabbed her dry with Viva paper towels at each change.

Her diarrhea was so bad, I couldn’t keep up with cloth and switched to disposable for a few weeks. I bought them large so nothing rubbed. Pampers irritated her and the netting would stick to her ulcerated skin. Huggies Swaddlers and Dewoor Diapers were both well tolerated.

As for diaper cream, I feel like I’ve tried it all. I don’t think there’s a magic cream, just choose one with zinc and layer it on thick like you are frosting a cake. After applying antifungal and a thick layer of cream, I added a top layer of petroleum jelly to help keep the diaper from absorbing the cream. I typically don’t use powder, because of the respiratory concerns, but when I needed extra staying power overnight or for car trips, I very carefully topped it off with powder.

When it started to clear up I switched creams to the Weleda White Mallow diaper cream.

I use bleach in the wash every couple of weeks now.

Hope it clears up soon!
 
@christhomas2 We had the same issue with Pampers - they were so awful! And I love the idea of Vaseline over the diaper cream to keep the diaper from absorbing it all - that’s a big problem we’ve been having too.

Overnight is an issue - she pees so much that disposables are full, and prefolds are soaked through. I may consider the powder at night idea if we keep having issues. Any concerns with powder and cloth?
 
@brnicholas It’s super important to air dry their butts. Be sure it’s fully dry before using diaper cream. It will seal in the moisture making it worse. Diaper cream should be a barrier from pee and poop. We pay dry then use a diaper to fan the butt.

We also have done naked time in the baby bath tub covered in towel. Easy to clean. As they get older we moved to the bathroom with bath crayons. Air is your friend.
 
@brnicholas Agree with most of the above, especially bleach and water wipes. We split the difference in my home by using cloth for pee and Kirkland wipes for poops. Before kid started solids we used cloth for poop too. And occasional disposable wipes for out of the house. That way most wipes are cloth but now that her poop is like an adults I don’t have to rinse it in the toilet before washing.

Good luck! Rashes are so tough to see your baby hurting. Really lay on that cream!
 
@brnicholas I have no advice for the diapers but my son has had very bad diaper rash on an off his whole life (6 mo). When he was your kid's age he had sores that bled. We had to dunk his tushy in water and pat it dry instead of wipe. We figured out that any baby wipes cause massive irriatation and we have been making water wipes with coconut oil from paper towels for several months now. Our system is water wipe, pat dry with paper towel, vaseline everything. If I don't vaseline once he gets an angry rash. Its all about finding out whats good for your kid. For ours any regular diaper creams just made it worse.
 
@brnicholas First, I sympathize--I don't have experience with yeast rash, but my LO had rash and two tiny persistent sores/scabs where his cheeks meet, for weeks before he was 2 months old. As first time parents, we felt like disappointments and worried that we were causing LO discomfort with cloth.

But after seeing no improvement with sposies and petrolatum-based creams, we landed on Burt's Bees maximum strength diaper paste (40% zinc oxide), which was thick and not easy to spread. Generous layer every change. Then we did a barrier on top of either Vaseline (in sposies) or coconut oil or Earth Mama Angel Baby Bottom Balm when we eventually felt the rash was not spreading and could move back to cloth. For poop, we gently dabbed off poop, instead of rubbing with the wipe. We used fleece liners every time with our cotton prefolds. Wash routine was FLU approved detergent + borax for hard water.

After 3-4 weeks of this regimen, it started to clear up. By two months, he was rash free. At first it didn't feel like we were making progress, but his bum slowly improved. We're at 1.5months of cloth exclusively and phased out the zinc oxide paste, with no return of the rash.

Keep persevering and don't lose hope!
 
@brnicholas Not yeast, but with other rashes Boudreaux's (any color) never really did anything for us. Much better luck with Triple Paste (not cloth safe) and even better with Weleda Diaper Care Cream which is cloth safe, but may cause zinc stains.
 
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