Is my baby ok?

December 19, 2009 1:47 PM

First Child Filter: My 3 week old son had a diaper rash which we treated with diaper rash ointment. Now it has gotten weird and we don't know what to do. Please help!

Most of it around his anus and buttocks cleared up. He also developed small red bumps around his entire groin region, and the area in the folds of skin between his scrotum and thighs became very raw looking and the skin appeared to be peeling a little. We tried to treat this the same way. Now, in addition to the bumps his penis has developed a white coating that will not wash off, and there is a white coating on the irritated region in the skin folds as well. Could this be a yeast infection? Everything I google about this mentions the red bumps, but nothing mentions the white coating. I know YANAD, but if you have experience with this sort of rash or problem, I'd love to hear about it. Also, I know that antifungal creams should be used on a yeast infection, but we're snowed in and the drugstores will probably be closed until Monday. Is this urgent enough to dig out my car and drive across town? Thanks in advance!

posted by lodie6 to health & fitness (21 answers total)

Really, this is why you have a pediatrician! You should call the doctor immediately and tell the person on call exactly what you've told here. I wouldn't use an anti-fungal cream on a newborn without a doctor's advice.
posted by keener_sounds at 1:53 PM on December 19, 2009

Are you breast feeding? It could be an allergic reaction to something you're eating.
posted by crunchtopmuffin at 1:55 PM on December 19, 2009

And to 2nd keener_sounds, yes, this is exactly what pediatricians are for. They expect to get calls about just this sort of thing from new parents!
posted by crunchtopmuffin at 1:56 PM on December 19, 2009

I'm calling, keener. My pediatrician mentioned that if he got a yeast infection I should use antifungal cream, otherwise i would not be considering it.
posted by lodie6 at 1:57 PM on December 19, 2009 [1 favorite]

Call the doctor. This could be a bacterial infection instead (my daughter had one, at 7 months, diagnosed by culturing it). In fact, this sounds like a serious rash, and if your doctor doesn't offer to culture it, ask. Infection can spread so, so quickly in a baby that tiny. Call the doctor.
posted by palliser at 2:01 PM on December 19, 2009

Oops, glad you're calling. Anyway, keep in mind that bacterial infection is a possibility, too, and could require oral and topical antibiotics.
posted by palliser at 2:03 PM on December 19, 2009

Wow, a paediatrician for nappy rash? America is so different to Australia.

Sounds like a thrush like rash. (You might have it too.) I'd try the yeast cream. If you bathe him, use only water and dry really thoroughly. Change his nappy very often and don't let his bottom get too hot. If you have to wipe his bottom because of poo, use water on a cloth.

If there was no improvement over another day or two, in Australia, we'd go to our Early Childhood Clinic nurse, or see our family doctor. Alternatively, pharmacists are fabulous fonts of information too.

The very best of luck. Don't feel bad. Most babies get some kind of hideous nappy rash in their lives, at least once.
posted by taff at 2:13 PM on December 19, 2009

This is a great opportunity to use the Rash O Rama! Does it look like this (NSFW, unless you work in a baby butt factory)? Diaper rash with yeast infection.

I don't want to tell you not to call the doctor, 'cause when in doubt, call the doctor, but when this is what I saw, we tried some OTC Lotrimin and it did the trick right quick.
posted by chesty_a_arthur at 2:21 PM on December 19, 2009

If you can, let him have some diaper-free time by setting him up on something you can wash/dispose of if he pees on it. Letting the rash dry out between changings can help a lot. But otherwise, change frequently, air dry (or use a hair dryer on low/cool - don't burn him!) and use a heavy zinc-based cream. But check with the doc, of course.
posted by otherwordlyglow at 2:25 PM on December 19, 2009 [1 favorite]

Re 'something you're eating' -- that page is a pile of wives' tales -- The idea that certain foods in any mom's diet will cause gas in her baby is incredibly persistent but is not founded in research -- don't let it freak you out.

Nth yeast. Gory pic with white parts on the rash. Personally, I would drive across town. No amount of zinc or diaperlessness did anything here, but it started clearing up right away here with an OTC antifungal.
posted by kmennie at 2:50 PM on December 19, 2009

Absolutely call your doc!

In addition to the above, try using nappies which are a size bigger than normal. They will add more airflow for healing. A larger nappy will also guarantee not to irritate the rash further. It worked well for my son, I've always kept him in slightly larger nappies since.
posted by dimon at 2:56 PM on December 19, 2009

might be out of left field, but when my daughter had this at that age, I realized I was wiping up (towards genitals) rather than wiping down and away. Stuff gets between the folds of the flesh and well, shit happens. Dunno in your case but sometimes the little things help in prevention.

CDM
posted by Country Dick Montana at 3:36 PM on December 19, 2009

If you can, let him have some diaper-free time by setting him up on something you can wash/dispose of if he pees on it. Letting the rash dry out between changings can help a lot.

These underpads are perfect for just such an occasion.
posted by buggzzee23 at 4:20 PM on December 19, 2009

I should also say the underpads won't cure the current rash, but will go a long way in helping prevent a recurrence.
posted by buggzzee23 at 4:22 PM on December 19, 2009

Seconding Lotrimin. Our nurse recommended it for us. Cleared it right up.
posted by rabidsegue at 5:28 PM on December 19, 2009

I am leaning towards yeast infections - due to the side effects of chemo my daughter had many and they were just as you describe. In addition to whatever medicine your doctor recommends, I highly suggest some no-diaper time. Get some air down there.
posted by bunnycup at 6:15 PM on December 19, 2009

Nthing no diaper time. Also, a generous application of cornstarch may make her more comfortable. Warm room, absorbant pads, let her sleep naked or play or whatever she wants to do. For hours. Moisture + a close confined area = rash, yeast infection, anything you can think of. Do call the pede, but unless she seems to be in distress that can probably wait until Monday. Instead of wiping her after she pees/poos (which can cause distress) give her a good rinse with tepid (ie: body temp warm water, not hot) water poured over her (not rubbed!!) (We used a turkey baster to get folds of skin clean). Then corn starch and let her air out. A friend's pede recommended using diluted white vinegar (40% vinegar 60% warm water) in a spray bottle and said friend said it worked well to discourage the yeast, but I'm a little wary of that stinging like crazy on the broken skin.

Be extra careful that she doesn't touch anywhere the rash is and then put her fingers in her mouth, and wash your hands super-extra carefully after touching the rash. You don't want to be fighting thrush on top of this.

Good luck.
posted by anastasiav at 6:52 PM on December 19, 2009

Once it has abated, consider if it is the diaper - my and some other friend's children were very sensitive to the dyes and absorbent gels in paper diapers and switching to modern cloth diapers (absorbent interior, water resistant exterior) was the solution.
posted by tilde at 4:40 AM on December 20, 2009

All good advice here, and most reiterated here: http://www.askdrsears.com/html/11/T081400.asp, with a few more ideas for what to put on it. If you don't have anti-fungal cream specifically for lady parts/diaper rash -- the one made for feet has the same stuff in it (and is often cheaper - grrr) and our doctor told us it was okay to use, just in case you have any of that lying around the house. But also really, really recommending lots and lots and lots of diaper-free time. Anastasiav's advice up until the vinegar part is exactly what we did. And larger diapers. And when it came down to it in the end (har har), I had to change my diet a bit - but you're probably not there yet. It wasn't about gas - it was sugar, and caffeine, and certain food allergies going through my breastmilk. To this day, my daughter can't eat red grapes or raisins - at five she'll still get a bum rash from them!
posted by peagood at 6:48 AM on December 20, 2009 [1 favorite]

Yeah, it is probably yeast. (Although a photo would help). Does his poo smell yeasty?

Don't worry, diaper rash cream + a little vaginally-formulated anti-fungal should do it.

Make sure that you are eating tons of yogurt if you're breastfeeding and hold back on the bagels and other yeasty foods. I don't know if there is any science behind this, but when my kid's poo was smelling yeasty at that age, yogurt and less yeast seemed to help.

I'd also suggest posting this to LiveJournal's Parenting 101 community. Those parents are great at diagnosing stuff.

(If it makes you feel better, last year I called the ped emergency line - not the nurseline on December 26 about smegma.)
posted by k8t at 9:09 AM on December 25, 2009

PS - is the white coating smegma??? google it and see if it looks like what your kiddo has. My son (11/15/08) had smegma at Xmas last year.
posted by k8t at 9:11 AM on December 25, 2009