Severe diaper rash as indicator of allergy? Update #24

[cristeen]

He's had a recurring severe diaper rash, open bleeding sores that i can't get to heal. At this point i'm thinking their appearance coincides w a change in his formula, but i'm not sure. But we've tried everything else i or the ped can think of, and theyre just not healing.

He reacted to beef the first time he ate it. And the one time he had plain (raw) milk, he was up all night screaming. He's been on a milk based formula since 7 mos, but we're transitioning to another brand because the first one changed their recipe to include corn syrup solids, and i think thats when the rash cropped back up.

So if i get him off this formula (but onto what?), how long can i expect it to take to see a change in the rash? And how will i be able to tell if the problem really was that formula... Since we're risking the same problem w any other formula?

He's almost 16 mos, and eats a fair bit, but is so not ready to give up his milk.

I could really use some advice from BTDT mamas.

The only other things hes reacted to were oranges and green bell pepper. But he seems to tolerate other citrus and other peppers fine.

[tanyalynn]

Diaper rash in my DD was something I totally missed, but in retrospect, that fact that her bottom was always red and I always had to use a thick layer of ointment or it would be horribly painfully raw, was a symptom.  I didn't figure out that she had food intolerances til she was 3.5 yo though, so I don't know exactly how long it should take to clear up.  Though I guess DS got diaper rash from soy, and after the really bad exposure (when I figured out soy _was_ a problem), I think it started looking better w/i 48 hours and was quite a bit better in 4-5 days? 

You think the corn syrup solids are the culprit?  Hmm... I don't know how many easy-to-get formulas don't have corn syrup solids.  For a while, I was giving the kids a rice-based Metagenics powder--it doesn't have enough fat to be an infant formula, but it is meant for kids, and some additions would bulk it up--my son was a toddler when I used it, I don't remember how old exactly.

[DevaMajka]

If he's reacted to other foods, I'd say food sensitivity for the diaper rash.

Ds2 had a "diaper rash" that ended up being a reaction to sweet potato and some other stuff I haven't entirely figured out yet. Sweet potato made it really bad, the others just moderate.

Could it be yeast? I just realized that what was left of ds's "diaper rash" went away after I used GSE to treat thrush in his mouth. Could be coincidence, but worth mentioning.

[cristeen]

Tanya - i dont think the corn syrup is the culprit. I changed formulas because the safe one changed their recipe to include CS. I think the culprit is the milk, and this formula may be using a slightly different process on their milk. Either that or its the brown rice syrup, but hes shown zero reaction to rice the couple of times hes had it.

Deva - we've tried clortrimazole and nystatin both. The portion of the rash that is red crusty flaky skin responds to it, but the open sores dont. I get the sores to start healing every night, but as soon as he poops in the AM, they open right back up. His poop seems to be very reactive w his skin. At this point hes screaming w diaper changes... Hed rather sit in the poopy dipe than have me wipe his butt it hurts so bad.

[kjbrown92]

What about going to an elemental formula?

[cristeen]

We've tried one elemental and he reacted to it.

So last night i took him off the suspect formula, gave him a bottle of BM and then the known safe formula. No screaming this morning. His butt's still raw, but it looks better than it did last night. We only have maybe a months worth of this formula left. Combined w the BM in the freezer i might be able to stretch it to 2. Which i suppose gets us to 18 mos. Guess thats what i'm gonna hafta do.

[DevaMajka]

It sounds like something in the formula. You'll definitely have enough safe formula and bm to see if it goes away on it. That will give you a good idea of how to progress from there.

Has he reacted to plain cow's milk?
 

Originally Posted by cristeen 

His poop seems to be very reactive w his skin. At this point hes screaming w diaper changes... Hed rather sit in the poopy dipe than have me wipe his butt it hurts so bad.

When ds has a messy poop, I stick him in the shower and spray his bum with the hand held shower head. If you don't have a hand held shower head, I bought mine for something like $10 or $15 and installed it myself (also needed plumbers tape). Or if you don't want to do that, there's been a couple of times that ds stuck his butt right under the faucet. That would at least eliminate any rubbing/friction.

 

[fruitfulmomma]

My daughter was like that and it was caused by foods high in salicylic acid. Her skin was literally melting off when she pooped. 

[cristeen]

Originally Posted by DevaMajka 

It sounds like something in the formula. You'll definitely have enough safe formula and bm to see if it goes away on it. That will give you a good idea of how to progress from there.

Has he reacted to plain cow's milk?
 

When ds has a messy poop, I stick him in the shower and spray his bum with the hand held shower head. If you don't have a hand held shower head, I bought mine for something like $10 or $15 and installed it myself (also needed plumbers tape). Or if you don't want to do that, there's been a couple of times that ds stuck his butt right under the faucet. That would at least eliminate any rubbing/friction.

 

Yes, he reacted to raw cow's milk.  He was up that entire night screaming from what I presumed to be stomach cramps.  The first time he reacted to milk was actually (homemade) tapioca pudding that I shared with him.  He can tolerate butter, cream and fermented milk (yogurt), and small amounts of cheese (I limit him to 1 oz/day of mozzarella or cheddar).  Any more than that and we see reactions - 2 oz of cheese caused severe constipation with screaming.  The tapioca caused a burn on his butt. 

So it's only been 18 hours or so, and his butt is already healing.  He's had 2 poopies and zero screaming.  So it's looking more and more like that was the culprit all along.  Don't know why it took me weeks to put 2 and 2 together. 

As for the shower - this kid hates the tub.  I wish we had a shower stall because he does fine at the Y.  I do have a friend who uses the diaper sprayer on her kid's poopie butt, but that water's ice cold.  Not sure he'd stand for that. 

Thank you ladies for talking me through this.  I was pretty convinced before I even posted, but just despairing a bit. 

Fruitfulmomma - how do I find which foods are high in salicylic acid?  Because that's what this reaction seems like.  It just eats through the skin. 

[DevaMajka]

Originally Posted by cristeen 

Yes, he reacted to raw cow's milk.  He was up that entire night screaming from what I presumed to be stomach cramps.  The first time he reacted to milk was actually (homemade) tapioca pudding that I shared with him.  He can tolerate butter, cream and fermented milk (yogurt), and small amounts of cheese (I limit him to 1 oz/day of mozzarella or cheddar).  Any more than that and we see reactions - 2 oz of cheese caused severe constipation with screaming.  The tapioca caused a burn on his butt. 

So it's only been 18 hours or so, and his butt is already healing.  He's had 2 poopies and zero screaming.  So it's looking more and more like that was the culprit all along.  Don't know why it took me weeks to put 2 and 2 together. 

As for the shower - this kid hates the tub.  I wish we had a shower stall because he does fine at the Y.  I do have a friend who uses the diaper sprayer on her kid's poopie butt, but that water's ice cold.  Not sure he'd stand for that. 

Thank you ladies for talking me through this.  I was pretty convinced before I even posted, but just despairing a bit. 

Fruitfulmomma - how do I find which foods are high in salicylic acid?  Because that's what this reaction seems like.  It just eats through the skin. 

 Ah yes. If he reacts that way to some dairy, I'd guess you're right that it has something to do with the way the dairy is processed in the new formula. And about it taking 2 weeks? I'm sure we've all been there! (I'm still there, I'm sure. lol)

YAY that he's healing already! I'll keep my fingers crossed that dairy is the "only" food reaction left!

Bummer that he hates the tub. J loves the tub, so it works out really well for us!

Before you look at sals, if it were me, I'd really focus on dairy. Sals are in so many fruits and veggies, and it's really hard emotionally and nutritionally to take them out. My advice is to look at the dairy, and see what happens. If you still have problems, I'd food journal and if you see a relationship with sals fruits and veggies, THEN maybe try a low sals diet. But IMO it definitely shouldn't be a starting place (ask me how I know).

Here's a list of sals levels in some foods- http://www.zipworld.com.au/~ataraxy/Salicylates_list.html

[fruitfulmomma]

http://salicylatesensitivity.com/about/food-guide/ is a good starting point, but I agree with pp about focusing on dairy first if that seems to be a trigger. Sals is a *really* hard one to deal with because they are in so many foods. I would give it at least two weeks totally dairy free including the butter, cheese, etc... and see how what happens. If that doesn't totally clear it up then you might look into sals. Honestly, I am not sure I could do low-sals and no dairy. That is one of my staple foods.

[Koalamom]

My kids got rashes from probiotics, just like what you are describing.  Alot of it is sals food issues, but my dd is not reacting any more at3 yrs of age (and after seeing a wonderful naturopath).  I would almost be tempted to wear from formula and switch to a bone broth formula or somehting if he is reactung to it.  But what am I saying, my ds is 18 months and he wont let go of the boob.

[cristeen]

So, a bit of an update but another conundrum also...

I've been giving him a lot of diaper free time and going coverless the last 2 days (thankfully it warmed up enough to do that), so I can get him changed immediately, or just strip off the dipe and let him wander for half an hour before I figure I'm pushing my luck.  The bleeding sores are about half healed - we have half as many as we did, and they're all noticeably shrinking.  But this obviously is not the only problem we're having. 

I haven't given him any milk products to eat the last 2 days, not even using butter.  Yesterday he had some mortadella, edamame, apple, and I want to say banana (but I don't really remember - I have a cold, so everything's fuzzy).  Today he had some gf pancakes (almond butter, banana, egg) cooked in bacon grease, apple, mortadella, and I think he had some of daddy's meatloaf. 

Prior to this rash, which originally cropped up the first time around Halloween, he'd never reacted with a rash to anything.  The oranges and the bell pepper just caused the red ring around his anus and the milk just caused the stomach cramps.  But now that I'm getting him off the formula, he's still getting burns on his butt from something, everywhere the poopie touches is bright pink (but it's not opening up the bleeding sores anymore).  His poopies today have mostly been BM poopies, which is definitely a change, but they're causing burns, which is also a change.  This milk is from a donor we've been using for ages, and he's never had a problem with it before.  So, I'm wondering if by causing such a severe reaction we've weakened his resistance to his other allergens and now he's maybe not even tolerating the trace milk in the BM/formula? 

Oh, and on the formula front - I read the ingredients list.  The one we've been using all along has whey as it's first ingredient, followed by fats, and then milk.  The one we were transitioning to has brown rice syrup as the first ingredient, milk as the second, no whey at all.  I think that's why there's such a difference. 

Right now my plan is to get his butt completely healed and then I want to trial him with goat's milk.  Just so we know.  I have a pot of broth on the stove, and a freezer-full of bones to make more, so I'm going to be making/freezing that for a while, and we'll work on transitioning him to that if nothing else works. 

So, does anyone have any thoughts on the burning poops, and maybe sensitization to allergens?  I'm really a newbie at this stuff and could use any BTDT advice on this stuff. 

[tanyalynn]

Reactions often change as kids age, but also since you've just come off this really reactive time, other lower-level stuff that he may have tolerated in the past may show up extra now.  Intolerances seem to act like this a lot--I can see that when DS would get extra of, say, soy, enough to react, he'd be more likely to react to chocolate as well--not that the chocolate had soy in it, he's intolerant of the two separately, and if his allergen bucket fills with one, just a little of the other can make his bucket overflow.

That said... how much have you followed the threads on detox pathways and intolerances?  The way DS's bucket increases in size is by supplementing nutrients and getting his detox pathways moving along nicely.  The foods he's intolerant of seem to act like toxins, in the sense that both use nutrients to be excreted from the body.  If you aren't supplementing any nutrients now, a multivit with some B vits and some magnesium may help clear the reactions up faster.  An epsom salt bath would help with the magnesium as well--oh, not so much for a kid who hates the bath.  Thorne has nice multivits--they've got real folate and the forms of vits/mins are generally easy to use--B complexes, mineral supps, lots of choices.  You can open capsules and either dump the powder in a couple tablespoons of a strong flavored drink, or hide it between 2 layers of applesauce and just do it as one bite. 

[sublimeliving]

Is he old enough to get prick tests done? It was a nightmare for us to figure out all the allergies, so we had them done.

[Koalamom]

At 14 months ds hated baths.  We had to get alot of really fun bath toys and one day he decided he liked it.   You could try filling a basin or small tote and fill it up a little and let him sit in it while watching tv or something.  I know when my kids have reaction,s the epsom salts really help heal fast.  As knowing alot about these type of diaper reaction, I would expect more hrealing by nowm so I would suspect something ds has becen recently eating.  What about banana?  Or has your donor been eating or supplmenting with something new?

[cristeen]

Just a quick update ladies, and a thank you.  DS' butt is healed as of this evening.  The sores have been closed all day, and as of bedtime tonight, there's new skin over them.  It's going to take some time to completely fade, and he may bear scars for a while, but thank you for helping me figure it out. 

I'm about ready to trial goat's milk and we'll see how that goes.  It's not the end of the world if he can't have any, but it will definitely make life more interesting. 

[kjbrown92]

you might want to wait a little while on the goat's milk to make sure his skin his healed all the way. The proteins are very similar, and many people who react to cow dairy also react to goat dairy (we can't do cow, sheep, goat, or water buffalo dairy).

[DevaMajka]

Yay for a healed butt!!! I'm so glad you figured it out! So, you think it's dairy, rather than another ing. in the formula, right?

[cristeen]

Deva - his reaction to straight milk was really clear, as was his reaction to too much cheese.  So I have to assume that at the very least that was a contributing factor.  The only other unique ingredient in that formula I believe was the Br Rice syrup.  We can trial that at some point, but we're grain free, so it's no big rush.  It does appear though that the milk thing is a big deal, because he also reacts to beef.  I completely without thinking about it gave him some of my lunch yesterday and he was up half the night (which he did the last time he had beef, too).  So it looks like beef and milk are out for now, which is going to make life difficult, since beef is the basis of our diet.