Children who've had surgery to reconnect the bowel and allow stool (poop) to pass from the rectum will have frequent, loose stools after the procedure. This is likely to cause diaper rashes that can lead to skin breakdown. It is very important to protect the skin of the diaper area and minimize breakdown.

To care for your child's diaper area:

• Apply 3M No Sting Barrier Film once daily to clean, dry skin, usually after a bath. The film should be placed directly on red areas, including any rash or open sores. Begin at the anal opening, swiping out in a circle about one or two inches from the anus where stool may come in contact with skin. The product goes on wet and dries in about one minute. While it is drying, hold the buttocks apart and don't allow skin-to-skin contact until it's completely dry.



• Once the barrier film is dry, iLEX paste or homemade "butt balm" (see below) can be applied over the film. Butt balm should be applied thickly — about 1/8-inch thick — to the diaper area. iLEX should be covered with Vaseline.



• After each bowel movement, remove the stool from the paste but do not completely remove the paste from the skin. Reapply the butt balm or iLEX and Vaseline.



• Once a day, before your baby's bath, gently remove the paste with mineral oil and a cotton ball, being careful not to rub the skin.

To make butt balm, mix a large tube of Desitin ointment, one ounce of Stomahesive powder and 1/2-ounce of Nystatin antifungal powder together.

You will need to continue with this skin care regime until the skin is healed and the frequency of stool decreases. This will take several months.

Where to Find Supplies

iLEX is available from Medcon Biolab Technologies. To reach them call (800) 443-6332 or visit www.medconbiolab.com.

You can find your local distributor of 3M No Sting Barrier Film by calling (800) 228-3957.

iLEX is an over-the-counter product and no prescription is required. Stomahesive powder, Nystatin and 3M powder require a prescription and may need to be ordered from your local pharmacy or home care supplier.

Skin Care Tips to Remember

• You can give your child a tub bath two days after surgery. Soak the paste off, give the bath, pat the skin dry and reapply paste.



• Remember to use mineral oil and a cotton ball to gently remove paste or stool from skin.



• Always apply the paste thickly.



• If your child's skin is intact and his or her diaper area can be left open, you can dry the area with a hairdryer set to the low (cool) setting.



• Change diapers frequently.



• If your child eats solids, foods such as rice, cereal, applesauce and bananas may help thicken stool.

Call Pediatric Surgery at (415) 476-2538 if skin breakdown persists and there is no improvement.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.
Last updated June 17, 2010

This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.