Diaper Rash

[GirlMomma]

At the first diaper change Monday morning, I notice DCB has a really, really bad diaper rash. I put cream on it him and move on. I spoke to DCD about it & he said DCB’s 2 year molars are coming in and he had loose stools over the weekend. Tuesday, DCB still has the bad rash and a loose stool here. I put cream on him and update DCD at pick up.

This morning, DCD brings him and advised me to pat him clean because it’s not any better. At diaper change, DCB had diarrhea. I clean him up and pat as best as I could, put the cream on. Afterward I notice DCB is putting his hands down his pants (not his diaper) like he’s trying to soothe it. Should I send him home for a couple of days?

[Cat Herder]

That sounds like a virus to me. I'd send home.

[Valerie928]

Oh no, I would have sent him home after I heard the words teething and diarrhea. Uh no. Unfortunately it sounds like a virus. I hope no one else catches it.

[Cat Herder]

Here is an article on the teething and diarrhea myth from colgate. Are Infant Teething And Diarrhea Related? (colgate.com)

[Cat Herder]

A great share for parents.

[e.j.]

I've also noticed that acidic/citrus foods seem to cause diaper rashes and loose stools for many of the kids here. When I check to see if the kids have eaten oranges, pineapple, tomato sauce... anything like that, they usually have. The rash tends to clear up quickly once both the parents and I stop serving those foods for a few days.

Also, when my own dd was little, she had a bad diaper rash that wasn't getting better no matter what I tried. It would improve somewhat until the next bm (which was loose) and then we'd be right back at square one. I brought her to the doctor and at the very end of the appointment as we were getting ready to go home, the NP asked if she could test her for Strep "just to rule it out". It turned out that's what it was. It may be worth suggesting they have him seen if the rash doesn't go away soon.

[GirlMomma]

I didn’t know it was a myth! 🤯 I hope it’s not a virus. I will exclude tomorrow if there is another loose BM, his last BM today was much firmer.

I told mom different tips my ped told me to take care of it - but now I’m afraid she’ll think I’m trying to parent her child 🙄 I just don’t want to exclude him for that but I can tell he’s uncomfortable

[GirlMomma]

e.j. the parents and I both push fruits and veggies. Thank you for the info!

[Snowmom]

In this job, it's very important to separate the emotions (read:excuses) out of all business decisions. Business decisions should be black/white.

Train yourself to strictly follow your policies without exception. This is being fair to all the clients you enroll.
If you allow one family to attend with diarrhea, then you should really allow ALL children with diarrhea to attend (or at least they think you should)- kwim?

Repeat: "This is group care. We make decisions and policies based on the welfare and best interest of the group as a whole".
"We exclude children based on illness symptoms, regardless of any possible causes".

Diarrhea=home. Cough=home. Fever=home. Vomit=home.

[GirlMomma]

Thank you Snowmom!

[GirlMomma]

Alright everyone, it’s been one week. The BM’s were more solid by Tuesday afternoon. By Friday, the rash was cleared up.

Here we are, Monday & DCB has had THREE loose, acidic BM’s again… I know what they had with dinner last night. This last one caused some redness that I know will turn into a rash. When I mentioned to dad last week that maybe we should cut down on the fruit for a couple of days, he said that mom wouldn’t be too happy if we did that… What?! 🤯 So I guess it’s more important to let this child have loose, acidic BM’s so long as he gets his daily fruit?

[Cat Herder]

Maybe he could stick with apples, pears and bananas and cut out the citrus? Peaches and pineapple are the worst for it. Also, I send home after the second loose stool. They can figure out the cause or they will miss a lot of work as motivation.

[GirlMomma]

Cat Herder I think I’m going to send home the rest of the week if this keeps happening.

[Mary Poppins]

This definitely sounds more like a food intolerance than a virus to me. Poor guy, why wouldn't they want to adjust his diet if it's causing him so much pain and discomfort? Maybe explain to them if he keeps getting loose stools then none of the nutrition is being absorbed and is just passing right through, literally. Ugh.

[GirlMomma]

Cat Herder and Mary Poppins well what I was trying to get DCD to understand was to maybe follow a BRAT diet for a day or two and that’s when DCD told me that DCB was wanting an orange with dinner. I explained to DCD that any progress we made with the diaper rash would be ruined as soon as he passed any acidic fruit. So DCD told me to cut out the grapes because mom wouldn’t be happy if we cut it out entirely 🙄

I will try to be clearer in explaining the that the nutrition isn’t being absorbed like this.

[e.j.]

I wouldn't necessarily suggest they cut down on all fruit - just citrus fruit and acidic foods like tomatoes and tomato sauce. It doesn't necessarily have to be forever, either; just for a week or two to see if the rash goes away. If they add citrus back in to his diet and he gets another rash, they'll know that's probably the cause and can decide whether to eliminate it from his diet or just cut back until he no longer reacts to it. (My own kids were 3 before they could eat citrus foods without getting a rash and that seems to have been true for the other kids who have had the same issue but maybe they just have to limit how much they give him rather than cut it out entirely.)

I have a kid now who is about 2.5 years old. When she started getting those burning rashes, I mentioned the citrus thing to her dad. He was pretty skeptical but I stopped serving her citrus/acidic foods here at day care just in case. Each time this kid came in with a rash, I asked what she had eaten. Each time, dinner at home or meals on the weekend included citrus fruit. At one point, she had been home over the weekend and came back in with another rash. When I asked what she'd eaten, he told me, "Definitely not citrus foods!" I asked what she did eat and he told me, "We had spaghetti and meatballs." I asked, "With tomato sauce?" He hesitated and said, "Oh! I didn't think of that. Maybe there is something to your theory!" He and his wife stopped giving her citrus and tomato based foods at home, too, and her rashes went away. With a few exceptions, she's been rash-free since. Once in awhile, she'll pop another rash and sure enough...she's had an orange or something with tomato sauce in it but the rashes aren't nearly as bad as they used to be.

[GirlMomma]

e.j. Thank you for the suggestion. I forgot tomatoes could do it too. If the parents aren’t receptive to the suggestions you have all mentioned, then I’ll do what CH said and exclude and let them deal with it.

It’s so bad that he doesn’t want me to wipe/pat his bum, he cries and fights me until he’s cleaned up. I feel horrible for him 😭