Erosive Diaper Rash

I would start REAL potty training.
That means getting rid of the diapers, putting him in real cotton underwear, and taking him to the potty.
I started all my kids around 22 to 24 months. We went every half hour for the first day or two, then every hour for the next several days.
Yes there were messes and accidents but there was no pushing, no rewarding, just lots of praise when they went and nothing but a gentle "oh well maybe next time" when they didn't go.
Honestly it's like training a puppy. You train THEM, you don't wait for them to be "ready." Facts about potty training from around the world confirm this.
Just have a relaxed and positive attitude and most importantly, BE CONSISTENT. You will all feel better once he's trained (especially him, poor little guy!)

He's 3...perhaps you could start him on potty training by letting him know that if he goes in the potty, nothing will stay on his bottom and hurt it. He knows when to go....so let him go in the potty.

Does he get any pain medication? Maybe an occasional dose of baby ibuprofen will give him enough confidence to use the potty. I feel for you and him. My DD screamed herself purple when she was newborn, her rash was so bad. I cried with her. We had to seek a doctor's help.

I second the Miralax suggestion and the Pediatric Gastro.

Giving him too much fiber can actually be causing part of the problem. Miralax is a softner unlike a suppository. We give my daughter her dose in either her OJ or a glass of chocolate or strawberry milk. She loves it, and when she starts having problems, will ask for her 'go juice'. It isn't an instant in 20 mins type of result like the suppositories. It can take a few hours to a few days to get her system right again.

I have been through this with my child from just a constipation aspect, not the diaper rash aspect. We have been to the ER at 3a because she was holding it for 6 days and was shaking out of fear of the pain and wouldn't go.
She has also taken to eating vanilla Activia yogurt. The live cultures in the yogurt are great for this type of problem.

You don't mention what you are using to treat the diaper rash. Aquaphor? Vaseline? Desitin Cream (pump, not tube) Those are all ones that we have used and they worked well for us.

As for the going out in public, we take extra clothes with us every where we go.

As for being deprived of being able to go out to eat, my newest trick is the Carside to Go - Outback, Olive Garden, etc. I call and place a pick up order and take it home to eat.

Poor boy..well poor all of you! My daughter, who is now 18, has such a sensitive bottom, that she would get yeast infections and the rashy part you describe. Disposable diapers became her worst enemy for days on end..well any diaper really, but they made things infinitely worse, so we went on cloth diaper benders, medicated creams, yogurt slathering, whatever was recommended by anyone at that point. This started when she was very young and went until she was finally, reluctantly, potty trained a few months before she was 3.

As she got older, she would hold her poo as well, but it was always a losing battle for her as it was not solid. She had sensitivities to foods that were not consistent from month to month, so it was hard to track it. Ultimately it was just her system as she still has some struggles today (she is 18 now).

Things did not show any improvement to this ongoing issue for us until she was potty trained. It really was the first time in her life we had a better handle on the raw, open sore skin that her bottom would become from one minute to the next. She could be fine for weeks, then BAM, we were in booty hell for the next 2 weeks again. Then it was trying to control her diet, watch for triggers (she never did learn to like the taste of milk until she was at least 10 and we reintroduced it to her), and do things like no bubble bath, only sensitive skin items like laundry soap (no dryer sheets or fabric softner) and only cetaphil lotion, etc. She never liked the idea of sleeping bare bottomed, but we did try that as well.

I wish you luck...its awful to see our children in pain....

EDIT~ I do home daycare and actually see much of this excessively bad erosive rash pop up in kids, where they become bloody and sore for days from one change to the next. Many get an ointment prescribed by Dr's called, elegantly enough (on the prescription!!) POOP GOOP. Apparently it has Maalox, I think Nystatin and something else maybe in it? But it works like a CHARM!! Maybe its a local thing, but I got it for my daughter, and now current daycare kids still get it. Sometimes its thick and pasty, other times its more runny, so maybe each pharmacy makes it different? But it helps a
lot!

Hi L.,

My heart goes out to you. So I have only two bits of advice from experience as a mother. Diaper creams, and ointments typically do not take care of diaper rash; cornstarch works wonders!

Secondly, only when your little guy experiences painless BM's will he learn to trust that it is not going to hurt.

I would recommend using cornstarch on your fingertips to apply between any times that are not supposed to be the ointment times. Ointments etc. hold heat and moisture in EVEN if they have healing properties, and it IS appropriate for some types of rashes, but I would like to wager that you will see much quicker results with the introduction of cornstarch. Be sure to apply it to your fingertip before applying to his bum because you don't want it flying around int he air so that he inhales it.

Best of luck!
T. Nelson CD(DONA)

It sounds awful. I'm sorry for both of you I would normally say to wait and potty train when he turns three, but in this case I would potty train right away. Cold turkey, no more diapers!

Have you been to an allergist? My son had severe and multiple food allergies, so we constantly fought the horrible rash. It was worse when he was exposed to something he shouldn't have. He would scream in pain and we struggled with him holding in his poop. Also, he was allergic to certain brands of diapers. Some diapers have more chemicals that others- I would look into that as a possible cause. He was allergic to dyes and fragrances. We went completely fragrance and dye free for washing and bathing, and it made a huge difference. We stopped using soap in the bath and noticed a marked improvement when it flared up. Even now that he is six, we just had an issue last night after his sister squirted soap in his bath water. His bottom broke out horribly was a mess afterward and we had to give him Benadryl. His allergies and sensitive skin is going to be a lifelong struggle for him. :(
Also Flanders Buttocks Ointment was a miracle. We applied it between changes and it helped as a barrier. It was hands down the most effective cream and I swear by it for anyone having this issue. It's not a well known diaper ointment, but your local pharmacy can special order it for you. I give a tube to every new mom.

I think the Muralax idea that someone else had is worth a try. I use it for my DD also. When she had a pretty bad rash that wouldnt go away her ped recommended a paste called Calmoseptine. You can buy it at Walgreens. We use it to this day for any issues that arise and it always works like a charm. Poor little fella, hope this all gets worked out soon. Prayers.

Have you tried miralax?

I had a similar conversation with my pediatrician and he said that kids will train themselves to hold it in if it is going to hurt. He said to give my daughter, just turned 3, a full cap of Miralax morning and night until she was having at least one easy bowel movement EVERY DAY for 2 weeks. He said it is vital for their insides and for their behavior training. He said that it has to just come out on its own so that they can't hold it in. I have a feeling that your little guy is actually constipated from keeping it in and needs to really be clean out so to speak. Especially since you said it is slipping out around him holding it in. The choice needs to be taken away from his body. Sorry to say that. Also, are you using disposable diapers? I hope so because I know that laundry soap on diapers can make it worse.

Finally, is there any chance that he is sensitive or intolerant to dairy? My daughter breaks out really badly in that area and gets constipated when she drinks cow milk. We have switched her to goat and she is doing so much better: no rashes, no sores, and no constipation or holding in.

Please go get a big bottle of the store brand of Miralax and start using it. Call your regular doc if you need to for a professional second opinion, but I can tell you that this works. But, the more you allow him to hold it in, the more he can make his backside sore.

I feel so bad for all of you! I know how hard this can be, I have been there and tried most of the things you are talking about. Please keep at it until he is ok. Potty training isn't the issue here, its control and pain. you need the Miralax to do what you need to. Oh, and its completely safe and inert, it just binds to water and gets things moving. I checked up on it a lot before I gave it to my little one.

"He is still holding his poop....."

Time, to be referred to a Pediatric Gastroenterologist.
They see issues like this all the time, with potty training children and per pooping or not.

Keep in mind, that "withholding" their poop, causes a host... of medical problems and emotion based issues. It is painful, thus that is the emotional problem part, and they will continue to withhold their poop, because it hurts when it comes out and also when they keep it in. Hence, it is a stalemate.
In the worst case scenario, the child gets blocked bowels, impaction internally, Encopresis etc.
Then Constipation... and it is very hard, to normalize, without medical intervention. And laxatives should not be used, without Doctor instructions or recommendation. These things are also often, over used.
You need to see a Pediatric Gastroenterologist.
All of this is PER our Pediatric Gastroenterologist, that we saw, for our daughter.

Then the diaper rash... he may have a yeast infection and it has to be treated as such. Yeast infections recur. As well. And causes bad, diaper rash problems.

My son was a late bloomer, per pooping. He was a bit older than your son in fact. But we went according to our Doctor. And when he was ready, he did poop, in a toilet. We didn't battle about it.
The main thing, is that the child poops. Even if that is in a diaper for now.
Because, if he cannot poop or will not... there will be medical problems because of it.
Encopresis (which is an involuntary leaking of poop), or stretched out bowels from holding it in, internally. And blockages etc. They would also need to do an x-ray to see.