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recurrent staph diaper rash


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I've never had this with the other kids, but DD 11 months keeps getting staph diaper rashes. We are no longer using cloth diapers. She bathes in the sink which gets cleaned with bleach. No one else has rashes. 

 

But when she gets an upset tummy (usually from teething) her bottom gets sore, and then she gets a bacterial rash. Bacitracin no longer works, has to be polysporin or the prescription mupirocin. Is this normal? 

 

It clears up pretty quickly/well now that I know what to use on it. But it seems odd?

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I have one (my current youngest) who was and is more prone to diaper rash than the others.  I think he just has more sensitive skin, plus when he eats certain things, esp. fruits and vegetables, he gets rashy (he also got rashy when he was very young and I ate fruits and vegetables).  I've never had rash problems with any of the other kids.

 

So I'd say here are my various advices going by what worked for him, which may or may not work for yours:

 

1. Change diaper brands.  I hate to say it because I don't normally go in for name brands, but he gets no rash with Huggies and does rash with everything else, including the natural brands like Honest or Seventh Generation.  

2. Vaseline (or whatever you use) at every change, regardless of rash status.  This has made a huge difference.  I think having that barrier prevents the rash in the first place a lot of the time.

3. I check him constantly, constantly, for diaper dirtiness or wetness.  I go through a zillion diapers a day. If he sits in a dirty diaper for 5 minutes it will rash.  2 minutes might rash if he's eaten something reactive.  Seriously I don't even want to think about what I spend on disposable diapers, it makes me nuts.  

4. For a while I didn't let him eat things that had any acid in them, hardly at all.  Even like blueberries would give him a rash.

 

I think if you prevent the diaper rash in the first place (if you can) then you won't have as much trouble with the secondary bacterial infection.

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Make sure she gets dry between diapers. So, if you can manage to let her go bare-bottomed for a few minutes between diapers, great. Also, you can use a blow dryer on low to get the bum all the way dry. Coat with butt paste.

 

Agreeing with eternalsummer that rash prevention is your best bet. As soon as the littlest rash appears it is time for airing out the baby without a diaper.

 

(I had this with my now-2-year-old and these were the steps my Filipino doctor recommended.)

 

Emily

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I know with staph rashes sometimes the recommendation is bleach baths. I know it sounds insane, but it is like pool water. Sometimes it is the best way to get it all killed. Bleach concentration changed awhile back, so you need to make sure you’ve got the right ratios. https://www.webmd.com/skin-problems-and-treatments/bleach-baths-for-atopic-dermatitis

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Our oldest had recurring staph diaper infections and it turned out to be MRSA! We followed the children’s hospital protocol for treating it (which was pretty time-consuming and overwhelming!) and it went away and never came back! Has she been tested for which type of staph?

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Is it actually staph? Is it always related to a teething moment? Does she usually have a specific teething toy? Does it ever occur the day after eating a new food? Spicy food? Have you had a yeast problem (thrush) since she’s been born?

 

Just trying to trouble shoot with you!

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Is it actually staph? Is it always related to a teething moment? Does she usually have a specific teething toy? Does it ever occur the day after eating a new food? Spicy food? Have you had a yeast problem (thrush) since she’s been born?

 

Just trying to trouble shoot with you!

 

It's definitely bacterial, although I guess it could be something like strep rather than staph. It ONLY responds to antibacterial ointment. Not antifungals, not regular diaper rash cream, not heavy duty diaper rash cream, not baking soda baths, not oatmeal baths, not air drying, not cloth diapers, etc. The ONLY thing that clears it up is antibacterial ointment. It's classic impetigo look when it gets bad. Thankfully I know can recognize it before it gets quite that bad and clear it up sooner. 

 

No specific toys, but yes to teething. No spicy food, but I do think fruits and acidic foods may have an effect. No thrush or yeast at all, and it definitely doesn't respond to various anti fungal creams including prescription and over the counter. 

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Have you mentioned it to your ped? My only concern would be that I was now breeding antibiotic resistant bacteria. But if it only shows up at a specific time, I am back to thinking it’s something ingested... Sorry for the lack of help :p

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Have you mentioned it to your ped? My only concern would be that I was now breeding antibiotic resistant bacteria. But if it only shows up at a specific time, I am back to thinking it’s something ingested... Sorry for the lack of help :p

 

Two different urgent care doctors. First one misdiagnosed it as a yeast rash (and charge $200 for the bad information). Never cleared up with the yeast meds so on a whim I tried antibiotic ointment and it was visibly better in hours. Next time she got it I used the same meds (bacitracin) and no issue. Third time bacitracin didn't work, got worse, was very obviously impetigo type rash. Did another urgent care and was prescribed mupirocin, which worked great. Now she has it again. I couldn't find the muprirocin when it started so used polysporin and that seems to be working fine. Going to save the mupirocin in case we get resistance to this I guess. 

 

I'm wondering if now if maybe my tube of diaper ointment is contaminated? I have random half filled tubes here and there around the house and diaper bag, I wonder if some have been contaminated so when she gets irritated skin and I start using them I'm giving her the bacteria?

 

I'll throw them all out and start fresh. 

 

Oh, and when she got it the first time, her brother had impetigo on his face (only time I've had a kid with it) that cleared up with mupirocin. Also an urgent care visit. Because my kids only have issues after office hours and on weekends, lol. 

Edited by ktgrok
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According to my ped (a million years ago because my youngest is 13) the teething causes baby's stool to be looser & more acidic.  This causes the initial skin break down (open sore rash) and once that happens bacteria moves in.  Once the bacterial infection was cleared up by an antibiotic ointment, he had me use a cotton ball to apply Mylanta to baby's bum and lt it dry before diapering. I did this for the entire time they were teething, and it worked for us.  If I missed the first drooly signs of a tooth coming in baby would have a rash. 

 

It's worth a try, right?  

 

Nothing is worse than an uncomfortable baby.

 

Amber in SJ

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When my ds had impetigo for the second time the dr told me that about 30pc of the population are permanently colonised with staff and that ds was most likely a silent carrier who is flaring up when he gets a bug bite or cut.

 

So it's possible that Bub is carrying the bacteria and then when she gets nappy rash and a small break in the skin it breaks out.

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Get thee to a doctor that will culture...says the health care person in my family. I would think the urgent care could culture as well--they usually culture urine for UTI confirmation.

 

But echoing all the other MRSA people--bleach water, hibiclens, washing protocols for MRSA for the whole house/family. It can live just about forever on things like blankets and towels. If things clear up, hopefully you won't have to go crazy on it more than once.

 

You will want to know if it's MRSA or staph if it keeps happening. As mentioned, some people colonize it, and if she happens to, then you will want to know which one it is.

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My oldest girl had horrible, horrible diaper rash. We too gave up the cloth diapering. She was so sore her bum would bleed just taking the diaper off. At one point she was on three different perscriptions simultaneously.

 

What helped the most was letting her go diaper free as much as possible. Like, hours at a time. I got pretty good at reading her cues as to when she would need to pee, so we didn't have a ton of accidents. And even then, a happy baby with a healthy bum was worth it.

 

She potty trained herself around 18 months, I think because she didn't have to wear a diaper. I put her on the potty once when she needed to go, and after that it took about four days for her to be fully trained, daytime and nighttime.

 

That being said, she *still* gets sore and needs goop for her bum. At age eight, it's a lot less frequent, but it was pretty regular up until she was six or so. She has had several UTI's as well.

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Yes, this is my only baby to ever have a bleeding rash! I was heartbroken when that happened. Now I am much better about catching it quickly.

 

Someone mentioned strawberries and those might be a factor actually. 

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I have some of this, and was just thinking I could use it. 

 

The other thing that was recommend to us was to put antibiotic cream inside of nostrils and to trim all fingernails back closely and to swab those with antibiotic cream as well.  We also had to bleach our bathrooms, towels, and bedding. It was a ton of work, but it resolved the problem.......

 

She had picked up MRSA originally from a scrape at a wading pool.

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dd19 was prone to diaper rashes no matter what we did.  They would bleed they got so bad and it had nothing to do with our care of her.  She has just always been really sensitive like that. 

 

what worked for her.

 

Sunshine on a dry bum.  I would strip her naked and lay her in the sun in the back yard (opening up skin folds to expose her to light) and let her crawl all over an old comforter to get some daily sunlight to her tush when possible.  If she was napping, (heavy sleeper) I would strip her bottom naked and lay her in the puddle of sunshine in the doorway (open back door with no screen to block rays).

 

I rinsed her bottom in the bathroom sink when possible instead  of using wipes.  Even if she was just wet, i rinsed her off.  A peri-bottle worked great for this. If I used disposable wipes, I rinsed them first with warm water to get rid of the chemicals and to use as much liquid on her bottom as possible. (more rinsing off and less rubbing). ......for you little one, you may even try a tiny amount of plain dial soap in the water  and then rinse really well.  A kitchen sink sprayer may be easiest to do this with. 

 

When things were the worst I had my pediatrician write an RX for a pound size container of SSD cream.  It is what they use to prevent infection on burns.  Not cheap, but worked great to keep her bottom clear when she was at her worst.

 

I also used pure aloe vera gel instead of diaper cream. It absorbed in and allowed her skin to dry (unlike anything cream based that keeps it moist). I would buy it from a natural food store that is just aloe vera (not with preservatives etc).  I used it straight from a plant when I could find ones to buy in our small town.  

 

Honestly, i would ask the doctor for a culture to find out exactly what you are fighting. 

 

You might be able to play with your mupirocin a bit and mix it with a bit of diaper cream. 

 

((((((hugs)))) I hope you figure out something that works soonn.  I hated it when my babies had a problem I couldn't fix.  

 

Edited by Tap
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Yes, this is my only baby to ever have a bleeding rash! I was heartbroken when that happened. Now I am much better about catching it quickly.

 

Someone mentioned strawberries and those might be a factor actually.

Strawberries, blueberries, and oranges gave my babies bad rashes. So disappointing...

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I would sprinkle some acidophilus powder (from capsules) in the baby's food daily for a week or so to help establish helpful intestinal flora.

 

Over the counter antibacterial creams, soaps, or washes can make things worse in the long run. I'd see the regular pediatrician and use what s/he recommends.

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So, yay, it is almost gone! Like, if you didn't know there had been a problem you wouldn't even notice it, but if I feel carefully I can feel a few tiny pustules up in the crack at the top of her butt. So will keep using the ointment for another few days, but it cleared up SO much faster this time. I think because I caught it faster, and started using the antibiotic ointment right away. 

 

I think if it comes back again we'll go in and have it cultured. Will try to prevent from here on out. 

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At first I ignored this thread because I assumed you'd had a culture done and knew it was staph.  But it sounds more like it's just a bad rash & you don't know the reason.  Our pediatrician prescribed a homemade cream, but honestly the most effective thing has been Aldi's store brand diaper rash cream.  It contains most of the same ingredients (antacid, anti-yeast, anti-bacterial).  So I'd check Aldi first and see if they have any in stock.

 

I'll come back and post the homemade cream recipe later, it's in the nursery and I just put the baby down for first morning nap.

 

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The second doctor did say it was definitely bacterial. It has the classic pustules of impetigo. And the only response to antibacterial cream’.

I'm sure it is probably bacterial. It could be that the baby's stools are infecting any little opening in the skin because they contain bacterial strains that are difficult for the skin' normal flora to fight. So improving the baby's intestinal flora can help deter further bacteria to cause rashes. Using over the counter antibacterial creams for diaper rash is not usually recommended if it recurs at all. By changing around ointments, you can kill the beneficial bacteria on the skin, while letting the bad guys proliferate and become resistant
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Yes but have tried different brands, and have tried just using cloth with water. Nothing made a difference. 

Ugh.  So sorry.  

 

I remember our family doctor telling us not to use baby wipes or any soap with antibacterial in it because it prevents the regrowth of healthy skin.  That kind of stuff makes me crazy...

 

Sort of like how the steroid I use for eczema is fine in an ointment, but the cream-base they put it in has--you guessed it--HISTIMINES in it.  Good grief.  

 

I'm glad the little one is healing.

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Our pediatrician's recipe for "Magic Butt Paste" that worked when foster baby came out of hospital with bleeding rash.  This completely cleared it up in less than two days, though baby kept needing it for about a month.  I suspect this was because of the effects of prenatal drug exposure, but it also cleared up when we switched to a hypoallergenic formula, if you think allergies are a factor you might do an elimination diet.

 

1/2 tube A&D

1/2 tube zinc oxide

1 tube triple antibiotic cream

1 tablespoon Maalox

1 tablespoon lotrimin

 

Mix together, apply liberally (we used a spatula to put it on 1/8-1/4" thick).  The idea is that this will cure fungal and bacterial issues as well as neutralize acid and work really well as a barrier cream.  When really bad we would also do tummy time naked, on some towels, a cloth diaper and a waterproof picnic blanket, with a small fan aimed directly at baby's bottom.

Edited by Katy
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The wound care specialist I work with recommends no sting barrier wipes. It creates a sort of second skin- keeping it sealed from the air which greatly decreases pain & allows the skin to heal. I’ve seen it work wonders on some nasty skin breakdown. It usually lasts a day or 2 and then re- apply. I still use on my kids for turf bur from soccer and cuts and scrapes.

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