post partum rash ..??

Hi all,

My wife just had a c-section a week ago. We had a 8lb 10oz lil boy.
She had her 7 day checkup at the OB yesterday, the only one issue she
had was irritation around her incision. The Dr prescribed a cream.
Since yesterday it has spread to her thighs and chest.

The Dr also "examined" her inicision pushed and proded on things and
said everything looks great. He was the same guy who did the surgery.

I don't know if this is related to the c-section or if it's just a
hormonal sensitivity issue but it is a little scary since she just had
major surgery. Our first DS ended up being a c-section after 15 hours
of labor..and she had PUPPS before delivery.

She's also breastfeeding and so we didn't want to affect the baby with
medications etc.

Has anyone had anything like this before?

Thanks,

Kevin

wrote:
Hi all,

My wife just had a c-section a week ago. We had a 8lb 10oz lil boy.
She had her 7 day checkup at the OB yesterday, the only one issue she
had was irritation around her incision. The Dr prescribed a cream.
Since yesterday it has spread to her thighs and chest.

The Dr also "examined" her inicision pushed and proded on things and
said everything looks great. He was the same guy who did the surgery.

I don't know if this is related to the c-section or if it's just a
hormonal sensitivity issue but it is a little scary since she just had
major surgery. Our first DS ended up being a c-section after 15 hours
of labor..and she had PUPPS before delivery.

She's also breastfeeding and so we didn't want to affect the baby with
medications etc.

Has anyone had anything like this before?

Thanks,

Kevin

Hi Kevin,
I didn't have a c-section with either of my babies, but: I had PUPPS
before delivery with #1, and it got *worse*, not better, after the baby
was born. I don't want to go into too many gory details, but after
seven post-partum weeks of feeling as though I had poison ivy all over
my body, and countless tubs of cortisone cream and countless Benadryl
tablets, I eventually took a course of prednisone (oral steroids) to
clear it up. My dermatologist was breastfeeding her own baby at the
time, and was on the ball regarding what medications I could safely
take. Breastfed #1 till he was almost 2 years old. I had PUPPS again
with #2, but at the very least it was milder, and went away after
delivery.

If your wife's rash has gotten worse/hasn't gone away, I would
recommend seeing a dermatologist and finding out about proactive ways
to get rid of the problem.

Good luck!
Melania

Melania,

Thanks for your response... Actually we saw a dermatologist and he
prescribed oral steriods (13 day) and a cream (same one that prescribed
for rash), it's some kind of cortisone-type cream.

The rash cleared up a fair bit (no itching) after 6 days, so the
pediatrician recommended she stop the oral steriod. Last night she
felt the itching coming back but it wasn't too bad. This is 3 days
after stopping the oral steriods.

She started using the topical steroid cream but we still have to see if
it does anything or not.

The pediatrician did not recommend breastfeeding with more than 7 days
of oral steroid in her system as it impacts the baby's pituitary and
renal glands.. apparently. If it does resurface we might switch to
formula for a couple of weeks and then hopefully be able to switch back
to BM once the steroid treatment is done.

Kevin


Melania wrote:
wrote:
Hi all,

My wife just had a c-section a week ago. We had a 8lb 10oz lil boy.
She had her 7 day checkup at the OB yesterday, the only one issue she
had was irritation around her incision. The Dr prescribed a cream.
Since yesterday it has spread to her thighs and chest.

The Dr also "examined" her inicision pushed and proded on things and
said everything looks great. He was the same guy who did the surgery.

I don't know if this is related to the c-section or if it's just a
hormonal sensitivity issue but it is a little scary since she just had
major surgery. Our first DS ended up being a c-section after 15 hours
of labor..and she had PUPPS before delivery.

She's also breastfeeding and so we didn't want to affect the baby with
medications etc.

Has anyone had anything like this before?

Thanks,

Kevin

Hi Kevin,
I didn't have a c-section with either of my babies, but: I had PUPPS
before delivery with #1, and it got *worse*, not better, after the baby
was born. I don't want to go into too many gory details, but after
seven post-partum weeks of feeling as though I had poison ivy all over
my body, and countless tubs of cortisone cream and countless Benadryl
tablets, I eventually took a course of prednisone (oral steroids) to
clear it up. My dermatologist was breastfeeding her own baby at the
time, and was on the ball regarding what medications I could safely
take. Breastfed #1 till he was almost 2 years old. I had PUPPS again
with #2, but at the very least it was milder, and went away after
delivery.

If your wife's rash has gotten worse/hasn't gone away, I would
recommend seeing a dermatologist and finding out about proactive ways
to get rid of the problem.

Good luck!
Melania

wrote:
Melania,

Thanks for your response... Actually we saw a dermatologist and he
prescribed oral steriods (13 day) and a cream (same one that prescribed
for rash), it's some kind of cortisone-type cream.

The rash cleared up a fair bit (no itching) after 6 days, so the
pediatrician recommended she stop the oral steriod. Last night she
felt the itching coming back but it wasn't too bad. This is 3 days
after stopping the oral steriods.

She started using the topical steroid cream but we still have to see if
it does anything or not.

The pediatrician did not recommend breastfeeding with more than 7 days
of oral steroid in her system as it impacts the baby's pituitary and
renal glands.. apparently. If it does resurface we might switch to
formula for a couple of weeks and then hopefully be able to switch back
to BM once the steroid treatment is done.

Kevin

Hi Kevin,
That's interesting about the steroids - I took them for 10 days while
breastfeeding, based on my pediatrician and my dermatologist both
saying that while the steroids would interfere with the baby if he took
them directly, the prednisone molecule was too big to pass into the
breastmilk in any significant quantity. A quick internet search shows
the American Academy of Pediatrics has approved prednisone for
breastfeeding. A paper entitled "Medications in the Breastfeeding
Mother", published by the American Academy of Family Physicians, says
"Oral steroids such as prednisone (Deltasone) and prednisolone
(Delta-Cortef) penetrate into the breast milk poorly and are safe for
short-term use. When daily dosages exceed 20 mg, prednisolone may be
preferred over prednisone because it has only one peak in activity
while prednisone has two peaks in activity--one for the pro-drug
(prednisone) and the other for the drug (prednisolone). Infant exposure
can be minimized by withholding nursing for four hours after taking the
medication." I notice that they don't define "short-term use", but
since I've known people who've taken prednisone for months or years, I
am going to assume that less than two weeks is not considered long
term.

The same paper asserts that "In the early postpartum period, large gaps
between the mammary alveolar cells allow many medications to pass
through this milk that may not be able to enter mature milk. These gaps
close by the second week of lactation." This is interesting, and may
explain why my doctors wanted to try other treatments for as long as
possible before resorting to steroids.

Here's the whole paper, if you're interested.
http://www.aafp.org/afp/20010701/119.html

That may be more info than you need/want - definitely trust your
dermatologist and pediatrician, but also be aware that it is not easy
to stop breastfeeding for a period of time and then resume.

Out of curiosity, how suddenly did she stop the steroid? I was drilled
on not stopping suddenly, and indeed of my 10 day dose, had six days of
the regular dose and then four days of gradually reducing my intake, so
as not to shock my system.

Hope all is well and itch-free,
Melania