Stool and diaper rash

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Diarrhea and Bacterial overgrowth can cause very sore bottoms.

  • Many families recommend using Ilex for providing a moisture-tight barrier for red/raw bottoms. It can get expensive, but can be bought in larger containers from Ilex online, which doesn't waste as much as the tubes. Although it's not easy to wipe off, eventually it can kind of roll or peel off...it does take some effort. As long as you don't mind some residue for a day or so after using it, it will eventually wear off. We typically use it only during real problem periods.
  • Some people use Ilex in combination with Aquafor:
    • We have applied Aquafor directly to the problem area, with a thick layer of Ilex over top. It's easier to get off, but of course, it doesn't stick quite as well.
    • We would re-apply Ilex as needed during the day and then gob on the cvs version of aquaphor to prevent the sticking of the cheeks or sticking to the diaper. 
  • Other recommendations:
    • frequent "tushy" baths with aveeno oatmeal (or cvs brand), which can also serve to gently rub away any of the Ilex residue
    • Burt's Bees Diaper Ointment
    • Whenever Bo gets antibiotics, we immediately start using Vusion (an Rx Diaper Cream), the cheapo alternative is to apply any diaper cream with >10% Zinc and Nystatin. Apply this at every diaper change for the duration of the antiobiotic course and for the 5 days after. The worst diaper rash is usually due to yeast (the active in Vusion that makes it an Rx is the anti-fungal, miconozole or what you would find in Nystatin), and gives rise to red, flat plaques. We also found that commercial wipes made the situation worse. We use water and cloth wipes. And on most days, Baby Avalon Diaper Cream and Triple Paste spackled on at night.
    • From a mom on the yahoo short bowel syndrome group: (1).  Our surgeon gave us the recipe for a diaper paste we make at home and it works well.  Mix 70-75 ml's Maalox or any other antacid (I just get whatever generic brand is available, usually Equate from Wal-Mart) with 1/2 a tube of regular Desitin (the 4 oz. tube) and then add baby powder until it is the consistency of diaper paste.  Make sure the diaper area is DRY before applying and then sprinkle baby powder over the diaper paste.  We use this to keep his bottom from breaking down and it does a pretty good job but sometimes it just doesn't cut it so (2) when his bottom is actually broken down we order Sensicare from our Home Health Company.  You can probably order it from your local pharmacy too or you can get it from Bruce Medical http://www.brucemedical.com/senprotbar.html. This stuff is GREAT!  The last time he was on Antibiotics his entire bottom was raw and bleeding...ALOT, and Sensicare cleared it up in 3-4 days!  Now we always have a tube on hand and start to use it the minute we see his bottom getting the tiniest bit broken down and that little bit of diaper rash will usually go away in 1 day and then we go back to our home made paste.  We just always have to be sure that his bottom is DRY before applying anything and when it's broken down we only wipe off enough of the Sensicare to get the poo off, we don't wipe the skin clean because it just further irritates the rash (we were given this tip from a home health wound care nurse and it helped a lot).
  • Cloth diapering
    • While the literature for SBS kids may contraindicate this method of diapering, we have found it to work great. We have a service. Although it is spendy ($23/wk), because Bo blows through a ton of diapers, and the # of diapers we get is unlimited, I think we come out ahead if not even. He has only experienced butt break-down diaper rash 2x (both due to Vancomycin, and mommy forgetting the prophylactic Vusion treatment). Hospital and home nurses are always amazed at the patency of his bottom. We also eschew commercial wipes for cloth and warm water. Although he gets a paper diaper for overnight.