sore bums

shelbabyrn · Jul 24, 2003

We use two different items. Questran with Aquaphor ( made by the pharmacy) and a relatively new product called ILEX. It works great for sore bums, ostomies, and excoriations. You only put it on once a day. We have had some really horrible diaper rashes and raw bums clear up in as little as 3 days.

Mira · Jul 24, 2003

Yesterday,I had a grumpy CLD big baby who for the first time looks lovely and settled within my shift,remembering what Corks has been looking into(Cavilon no sting barrier)I tried it on the baby`s sore bum and for 30mins she was so unhappy,I wonder if it was her old self or the trial I made,I should have tried it first on my hand with abrasion from too much handwashing.

Disablednurse · Jul 25, 2003

We have tried the new Aveeno cream put out by the company that does the oatmeal products for the oatmeal baths. The cream is great, comes off easy when wiping off the baby's bottom, but does not wear off easy, clears up diaper rash quick.

babynurselsa, RN · Jul 25, 2003

I like the questran in aquaphor. Another product I love is Resinol. It is actually ans OTC preperation that has a topical skin anesthetic. It is zinc oxide based but is pink. works wonders for a raw bottom.

corks · Jul 28, 2003

Mira, Hope your CLD baby has recovered. Alot of the Regional units here in England seem to be heading towards this Cavilon no sting, it is used alot in adult nursing for incontinence patients, alot of the feedback given to me are of creams that I am not aware of, it has certainly given me plenty of ammo to go to our pharmacy and tissue viability team with and I am grateful for all your imput. Has anyone seen any research re; healing in the newborn that they could direct me to, again I would be much obliged. Keep the faith, Corks

Mimi2RN, ASN, RN · Jul 28, 2003

Originally posted by gwenith
I'm sorry but I just had a mental image of some new medical resident walking in and looking puzzled ask "Don't O2 masks usually go on the other end?" :rotfl:

That did happen at our hosp. A travelling nurse used O2, doc was very surprised to find it at the other end LOL:roll

Mimi2RN, ASN, RN · Jul 28, 2003

We use BUTT Paste. It's a compound mixed by our pharmacy, contains Questran, Mylanta, and Aquaphor. It really helps when babies are starting to get red r/t Ampicillin squirty liquid stool.

CatRN · Jul 31, 2003

Hi there.....

I have seen Butt Paste, Triple Care Cream, Desitin, Aquaphor....etc. I have also seen a higher incidence of diaper rash with NICU's that use pre moistened baby wipes vs the gauze and H20. I personally think that prevention is the key to sore bums. Vaseline/petroleum jelly at every diaper change has seemed effective in preventing diaper rash as well as making meconium so much easier to wipe off. Sometimes we get obsessed with scrubbing each bit of meconium off that we forget that delicate baby skin is under that poopy toosh. Treatment that seems the best is exposing the skin to air. If in an open crib, wrap 'em up with bum out, put 'em prone and put a warming light to the toosh.....some nurses use blowby O2 which seems to work for some babies as well. Again, I do feel prevention is key here....some NICU's have policies that babies less than a 1000gms CANNOT wear a diaper, not even a weepie.....their skin must be exposed. Sometimes, those little bums can shoot poop clear across the isolette on the walls, and rub their feet in it. Makes for great fun for the nurse, but keeps that skin free from breakdown, I promise..... :-)

NICU_Nurse, BSN, RN · Jul 31, 2003

I have a question for you, and it may sound a bit silly, but my disclaimer is that I'm still learning.

Okay. Ready? (I'm a little shy to ask this out loud...LOL!)

Is there a LIMIT to the amount of diaper cream (basic diaper cream, like A&D ointment) that should be applied per diaper change? Do you do a teensy dollop (thin layer) or a nice little squirt? Do you only apply it to the creases, or do you spread it over the area in general?

The reason I ask is that I got into a discussion about this with another nurse as to exactly what is the "proper" way to apply this cream, how much, and how often. Between four of us in the nursery that night, all of us did it a little differently, in different amounts, and slightly varying frequency. I'm talking about basic, routine care as opposed to those severely chapped tushies that require special creams/formulations.

So, ultimately, I'm wondering: Is there any detriment to using more as opposed to using less? We were debating this and no one could agree. Thanks!

Oh, and on our unit, so far I've only seen the Aquaphor, Desitin, regular A&D, or the Questran mixed with Aquaphor for various conditions/states. Some parents bring in their own tubes of Boudreaux's Butt Paste, but our hospital doesn't supply this (it's a local favorite...don't know if this is only available in the South or not...).

NICU_Nurse, BSN, RN · Jul 31, 2003

NICUgal, can you elaborate on the generic Aquaphor and Bili light issue? I'm not familiar with this! :) Thank you! This thread is so informative.

CatRN · Jul 31, 2003

Kristi,

Depends on the cream you are using for the amount you are applying and again, it varies. Some people rub it in, while I prefer to let their own body heat melt it.....works like a charm. Some nurses feel the need to rub it off each diaper change, even if it is Triple Care or Desitin....which is to be left on.....rubbing sometimes rubs off more than just the ointment...taking some precious skin cells with it. All diaper rash ointments are designed to keep moisture away from the skin to allow the skin to heal, diapers on the other hand, trap moisture next to the skin....So, I still so let 'em go streaking! Hang those bums out air dry....warming lamp, blowby O2, whatever! Let 'em breath!

NICU_Nurse, BSN, RN · Jul 31, 2003

Cat, thanks! I guess I'm not the only one up this early! I was just wondering because I have no children, no anecdotal experience, just common sense, logic, and word from others. I have been using what I would deem as a generous amount (and again, I'm referring in particular to the A&D/Vaseline type ointments) per diaper change, making sure that the skin is adequately protected from moisture/stool. Another nurse (another relatively new nurse) was watching me, and she claimed that they only needed a teensy smear. I watched her apply it and felt that it wasn't enough to protect the bottom, so we all got into what ended up being an hour long discussion on how much is too much and the rationales for our different techniques!

Of course, if I was ever doing something that was incorrect or detrimental to the babies, I would stop immediately, but I was just wondering if what she said had any merit. I have been using a nice-sized dollop not only because it seems like adequate protection, but also to ensure that the stool is easily removed, especially meconium as you mentioned above. Just wondering! When someone attempts to call me on something, I can't help but seek multiple opinions to find out what the preferred method is. Thanks for the quick answer. :)