Diaper Rash and Yeast Infections

Willow hardly ever gets diaper rash and if she does, it's cleared up quite easily with the liberal use of butt paste. However, last week I noticed a rash on Willow's bottom that butt paste didn't seem to take away. Talking to the teachers at her daycare, they mentioned that a couple of the other babies in the room had a yeast infection. I knew that yeast infections weren't contagious between babies at daycare so I decided to e-mail my Pediatrician.


I told her in the e-mail that the rash was concentrated in the anus area and wasn't getting better or worse. It didn't seem to bother Willow at all, but she's not really good at communicating at 15 months old.

According to Dr. Alan Greene, Yeast is by far the most common type of organism found in a diaper rash. The organism is quite prevalent and thrives in warm, moist skin. Yeast involvement should be suspected in any diaper rash that has not improved dramatically with 72 hours of appropriate therapy. Current or recent antibiotic use makes a yeast infection even more likely, since this reduces the amount of the skin's 'good' bacteria that fight infection. Classically a yeast rash is beefy red with sharp raised borders and white scales. Small satellite lesions surround the main rash. Even without the classic pattern, however, yeast is often present.

Yup, that was it!!

Willow's doctor got back to me within the hour, which is one of the reasons I really love the Pediatrician we picked, and told me to try putting Lortimin on it. And the bonus is that it's available over the counter (OTC)!!

While Lotrimin is typically used to treat athletes foot, jock itch and ringworm, it also can be used on babies who have a suspected yeast infection.

It can be difficult to know when to call your doctor about diaper rash. Heck, I call my doctor what seems like a lot since Willow is my first and only child and I am by no means an expert. Here is some advice from the Children's Hospital at San Diego:

Call Your Doctor Now (night or day) If:

• Your child looks or acts very sick


• Bright red skin that peels off in sheets


• Large red area with a fever


• Age under 1 month old with tiny water blisters or pimples (like chickenpox) in a cluster


• Age under 1 month old and looks or acts sick in any way

Call Your Doctor Within 24 Hours (between 9am and 4pm) If:

• You think your child needs to be seen


• Pimples, blisters, open weeping sores, boils, yellow crusts, red streaks

Call Your Doctor During Weekday Office Hours If:

• You have other questions or concerns


• Rash is very raw or bleeds


• Has spread beyond the diaper area


• Rash is not improved after 3 days of treatment for yeast

Parent Care at Home If:

• Mild diaper rash and you don't think your child needs to be seen

And some Parent Care at Home suggestions:

1. Change Frequently: Change diapers frequently to prevent skin contact with stool. It may be necessary to get up once during the night to change the diaper.


2. Rinse with Warm Water: Rinse the baby's skin with lots of warm water during each diaper change. Wash with a mild soap (such as Dove) only after stools. (Reason: Frequent use of soap can interfere with healing). Avoid diaper wipes. (Reason: They leave a film of bacteria on the skin).


3. Increase Air Exposure: Expose the bottom to air as much as possible. Attach the diaper loosely at the waist to help with air circulation. When napping, take the diaper off and lay your child on a towel. (Reason: Dryness reduces the risk of yeast infections).


4. Yeast Infections: If the rash is bright red or does not respond to 3 days of warm water cleansing and air exposure, suspect a yeast infection. Apply Lotrimin cream (no prescription needed) 3 times per day.


5. Raw Skin: If the bottom is very raw, soak in warm water for 10 minutes 3 times per day. Add 2 tablespoons of baking soda to the tub of warm water. Then apply Lotrimin cream.


6. Sore or Scab on End of the Penis: Apply an antibiotic ointment 3 times per day (reason: a bacterial infection that can cause painful urination).


7. Diarrhea Rash: If your child has diarrhea and a severe rash around the anus, use a protective ointment (barrier ointment) such as petroleum jelly, A&D or Desitin. Otherwise these are not needed. Caution: Wash off the skin before applying.


8. Expected Course: With proper treatment these rashes are usually better in 3 days. If they do not respond, a yeast infection has probably occurred.


9. Call Your Doctor If:
   


• Rash isn't much better in 3 days on treatment for yeast


• Your child becomes worse

Lotrimin is super easy to apply and doesn't smell so I have been putting it on before she goes to bed so it's on there all night! And, the rash is now history! Lesson learned? Keep the Lotrimin handy.