A rash around the mouth and genitalia could signal Acrodermatitis
enteropathica, a zinc malabsorbtion disease, for which breastmilk or
zinc supplements is the usual treatment.  The rash is usually brought on
by weaning from the breast, or at about 3 weeks of life in formula fed
infants.  If untreated, severe diarrhea (which may be fatal), hair loss,
and irritability, and failure to thrive result.   The rash can become
secondarily infected with candida.  In rare cases, mom's milk might be
deficient in zinc.

In this particular case, the rash could also be contact dermatitis from
the formula. If the baby is very allergic to cow's milk and the mom is
consuming it, the baby could react mildly to cow milk proteins in the
breast milk, and more severely to getting the cow milk formula
directly.  Mom could try an elimination diet if the baby continues to
have the rash with a return to exclusive breastfeeding, and baby's zinc
plasma levels are normal.
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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