I'm Back.

I would like to apologize to all my readers for my long absence. After my family moved to Utah we experienced quite a few changes. There have been some pretty tough times over the last two years, and when push came to shove I had to let go of my blog for a while. I am thankful to all of the emails and letters of support I have received over the last couple years, and I do apologize for how few I was able to respond to. I have recently moved back to the city of San Francisco, and have resumed my career in child care.

As a quick announcement, I have recently contracted with Day One in San Francisco to teach my Infant Acupressure techniques in their San Francisco location. The first class will be held on January 26th 2012. For more information, or to register, please visit their site.

Thank you all for your continued support and interest. As before, I am interested in any feedback or questions you may have for me. Happy parenting!

- Naomi

5 tips for treating diaper rash.

I am often asked what type of treatment I would recommend for diaper rash, my response is immediately, "what kind"? Many first-time parents are not aware that there are different kinds of diaper rash, so this question comes as a surprise to them. There are quite a few different kinds of diaper rash, and for each one there are distinct things that will work better than others. So for my tips today, I will focus on 5 of the most recognizable types of diaper rash, and the treatments that I personally have found to be most effective. Commercial treatments for diaper rash usually do a great job of covering the bases for several types of rash, but can sometimes have serious drawbacks if used on the wrong rash at the wrong time (what I look for in commercial brands can be found here). For example, Boudreaux's Butt Paste is a great natural ointment for the most common bacterial rashes, but if your baby has a chemical reaction rash or other weeping or bleeding diaper rash, it can cause a painful stinging sensation, and actually exacerbate the rash. If any ointment you are applying to your baby's rash seems ineffective or looks like it is actually causing your baby increased discomfort, discontinue using it at once and ask your pediatrician for advice.

1. For an acidic reaction diaper rash use yogurt, baking soda and Aquaphor.

This rash is purely a reaction to the heated contact between sensitive baby skin and acidic waste. Acidic waste can be caused by reflux, colic, and high acid content in breast milk as well as diarrhea. This rash looks similar to a rug burn, red and raw and will sometimes be bleeding slightly. The first order of business with this rash is to neutralize the acids, Yogurt is a soothing natural antacid, as is baking soda, and mixed together they make an effective paste. Or you can "wash" your baby's behind with yogurt followed by some sterile cool water and then powder the whole undercarriage with the baking powder. At the next changing (which should only be an hour or two later), be sure to use a sealant-type product like olive oil, Aquaphor, or Bag Balm to create a barrier between the stinging effects of urine, or further burning from another acidic bowel movement.

2. For a bacterial diaper rash use bamboo cloth, hair dryer and cornstarch.
This type of rash is one which thrives on a warm moist bottom. Bacteria are everywhere, but at times the balance between good and bad bacteria gets a bit off, and the result is skin irritation. This rash is a cousin to the bed-sore, and similar treatments are effective in treating it. This rash looks bright red, has an unpleasant odor and is probably weeping (oozing a fairly clear and slightly sticky liquid). There is probably more than one affected area, most commonly one quarter sized weeping area on each cheek. Keeping your baby clean and dry is the most effective treatment for this rash. Wash your baby's rear with cool sterile water using a soft naturally antibacterial bamboo wash cloth. Pay special attention to the deep crevice-type areas, since they are commonly effected as well. Use a hair dryer on low to make sure every part of your baby's booty gets completely dry. Apply cornstarch powder over all of your baby's rear and use bamboo cloth diapers (because bamboo is naturally anti-bacterial), if you have some, until the rash goes away.

3. For a diaper rash caused by an allergic reaction, use yogurt, baking soda and olive oil.

This rash is a combination of allergic-type hives and an acidic reaction. When a baby's body detects an undesirable element in the stomach, like an allergen or dangerous bacteria, it gets rid of it the fastest way it can. Often this means vomiting, but sometimes it means diarrhea. And because your baby's food has been forced out so quickly there is still a large amount of stomach acid in it. The allergen in the waste is giving your baby hives, and the acid is causing the hives to burn. This rash will look almost like your baby has little blisters on his bottom, but the bumps will be hard and not fluid-filled. Also, the bumps will only appear in areas where your baby's skin has come into contact with the waste. The entire area of waste contact will be red too, not just the bumps. To treat the acid, use yogurt (unless you are concerned that the allergen might be a dairy product) or baking soda, or a mixture of the two. Continue to change your baby's diaper regularly, and administer a sealant such as olive oil, Aquaphor or Bag Balm to protect your baby's hiney from further exposure to the allergen. The allergic reaction should go away on it's own, just make a mental note of possible food sources for the reaction and have your baby tested for allergies at your next visit to the pediatrician.

4. For a rash caused by a yeast infection, use yogurt, air, Bag Balm and (at times) an anti-fungal cream.
This rash thrives on sugar, and it will eat it where ever it can find it including in the living skin cells of your baby's sensitive bottom. This rash is particularly devious, because if you treat it with corn starch, the yeast, which love natural sugars, will thrive. While your baby's rear may be fairly red all over, what helps in identifying this rash is the red bumps that are in areas not usually too affected by diaper rash, like above the genitals. The red bumps are usually small and mainly visible outside of the crevice-type areas. Sensitive tissue will be red and swollen, but fairly dry to the touch and there might sometimes be a whitish "cheese-like" substance in some of the crevices of your baby's genitals. While your baby always has yeast bacteria present in their body, certain things, like antibiotics, can destroy the bacteria that usually feed on the yeast. These bacteria are highly concentrated in yogurt, and yogurt makes a great treatment for this kind of rash. Make sure your baby's bahookey is clean and dry, for long periods of time. This type of rash usually responds well to the "air-it-out" method. Try giving your baby some tummy time, on a changing pad instead of a quilt, with no diaper. Then, before nap time apply a generous coating of plain unsweetened yogurt to the affected area. For night sleep, I would recommend not applying the yogurt, but use a sealant like Bag Balm instead. Try using a super absorbent disposable diaper just until the rash goes away, because they will be able to keep your baby's bottom drier than other types of diaper. If the rash does not respond you can also apply a topical anti-fungal over-the-counter cream, ask your pediatrician for the appropriate dosage and dosage schedule for your baby.

5. For treatment of a chemical reaction rash use water, Aloe Vera, vitamin E and Petroleum Jelly.

This rash can be caused by harsh chemicals in diapers, wipes, ointments or even from your baby's own physical development. As your baby begins to grow and develop, chemical changes in her own body will sometimes cause reactions to substances that seemed perfectly safe before. The rash is sudden, bright red, and very dry. It is similar to the acid rash in appearance, but will not respond to the antacid treatment. Sometimes this rash will even have painful blisters. Think of it as a severe sunburn, on your baby's butt. Traditionally the single best way to treat this rash is to shield it from contact with harsh substances. I recommend cleaning it thoroughly and gently with running water, if possible, to minimize rubbing against the skin. Even very gentle cloths can feel abrasive to this rash. After you are finished washing, apply a coat of vitamin E and Aloe Vera, to replenish the skin's natural moisture and promote healing, then apply a sealant. Aquaphor and Bag Balm might be effective, olive oil though, is generally not strong enough. The best sealant treatment for overall effectiveness for this rash is usually petroleum jelly. It creates the best seal, keeping your baby's natural moisture in the skin, and keeping the waste or irritating materials from direct contact with the skin. I also would recommend transitioning to a more natural, chemical-free diaper and not using any perfumed ointments on your baby for some time.

There are several more types of diaper rash, and I will probably revisit this topic again at some point to cover them, but these 5 should be enough to get you through most of the types of rash that you will commonly encounter as your baby grows over the first year or so. I hope you find these tips helpful, and if you do I would encourage you to forward this site to any new or expecting parents you might know. Questions and comments are always welcome. Happy Parenting!

5 tips for effective use of cloth diapers.

Alright, yesterday I wrote about disposable diapers, so in the interest of being fair and P.C. Today I want to write about cloth diapers! Many of the positions I have worked in as a Nanny and as a child care professional have required that I be familiar with the cloth diaper and it's benefits. What my employers didn't always know was that in the 80's my mother practiced cloth diapering with my siblings, and as the oldest daughter of 10 siblings, I had my fair share of first hand exposure to the topic. I have quite a few tips and tricks to pass on to new mothers who choose cloth diapering. First of all, let me say, I admire you. I respect your choice, and I hope that my tips can help make it an easier one for you. Now for the tips...

1. Know the fold.
There is a certain fold that is the best for cloth diapering. Most cloth diapering sites will show you how it is done, but let me describe it loosely here. Lay the diaper flat with the thick part running from your left hand to your right hand horizontally. With your right hand fold in the thinner corners of the cloth diaper so that they overlap in the middle on the right side, making the diaper look like a blunted arrow with the wide end on your left and the blunt but pointier end on the right. Now take about 1 inch of the diapers edge on each of the 2 ends and fold them in towards one another. This is the diaper fold that will be best for preventing leaks for you and your baby. The large end goes across your babies behind, and the blunted point goes just under your babies belly button.

2. Change often.
One of the basic drawbacks of the cloth diaper is that they cannot hold very much liquid before they need to be changed. They do breath better than any other kind of diaper, but if you don't remove every wet diaper immediately, they will start to chafe your baby's bottom, and that chaffing is hard to get rid of. So do a load of diapers every night, or have the diaper service pick up the diapers as often as the y will, and be liberal with the changing of the nappy.

3. Baking soda satchel between diaper and cover.
This is a little trick that my grandmother used. she took a small cotton sack and filled it half way with baking soda, and slipped it in between the cover (in those days a cover was a heavy plastic thing with tight elastic at the legs) and the cloth diaper. It worked wonders for absorbing smells, and didn't run the risk of caking onto the baby's bottom or irritating the skin. If you have a sewing machine you can turn one of these out pretty quick.

4. Double up for over-nights.
Changing often is all fine and good until you try to get your baby to sleep through the night. Doubling the cloth diaper is the usual remedy for lasting 6 to 8 hours. However, I have a trick, (surprised?) Take some batting, used for padding quilts, and sew a strip of it to the underside of a regular cloth diaper's thicker inner strip, covered with a bit of breathable cotton. Next time you diaper your baby for the night still use two diapers, but have the batting sandwiched between the two. This will capture overflows just long enough to let them absorb into one of the diapers instead of running out the leg opening. If you still experience leaks you can flip the reinforced diaper over so the batting will start to slow the flow of fluid faster, but there is an increased risk of diaper rash.

5. Keep burp-cloths and diapers separate.
Never confuse the nappy's that you are using for your baby's behind, and those that you may use for your baby's face. Though there is very little chance that bacteria would survive washing and be able to cause your baby an eye infection or worse, there is still that small chance. Not to mention the chance that the sugars in your baby's spit up could VERY easily survive washing to give your baby a yeast infection. Simply devise a system (putting a small mark by a permanent marker in the corner of the diapers meant for the baby behind) that you can maintain simply and easily.

Over all, there is not that huge a difference between changing one diaper or another. The challenges you will face with cloth diapering will without question be worth the returns, and with a few tricky tips up your sleeve, those challenges might prove to be nothing more than a momentary distraction from the overall joy of being a mother. If you find these tips helpful, please pass them on to any new mothers or soon-to-be mothers that you might know. I relish questions and comments, so please don't hesitate to leave it if you have one. Happy parenting!