In a message dated 2/6/2004 11:50:51 AM Eastern Standard Time, [log in to unmask] writes:

> We have a mom and baby we are working with - same story heard around the
> world - too much IV fluids, edema, and engorged breasts with flat nipples
> (obviously from the engorgement) .  Baby was "restricted growth in utero'...Baby was tiny at birth just
> under 5 lbs. and gaining,

I've had a couple of moms with pitting edema in the feet and legs + major breast engorgement who turned out to have postpartum PIH/pre-eclampsia. (I know feet/leg edema wasn't mentioned re: this mom, though.) There is some recent evidence, I believe, that links fetal growth restriction/related placenta issues and PIH. While most moms probably won't have this, I'd want all to be aware there are reasons other than "too much IV" that can cause edema. If feet/leg edema is present, I'd refer back to mom's doc (and check mom's blood pressure and deep tendon reflexes if also in one's scope of practice, e.g. RNs.)



> the only problem is a bad diaper rash that is getting
> progressively worse. The baby is also "leaking' stools at almost every diaper
> change. Mom has been to the peds office every few days, they tried every
> combination of ointments and treatments, no wipes, changed diapers from disposable
> to cloth.  We reccommended acidophilus and breast milk as a paste also...
> Has anyone seen a rash
> that lasts two to three weeks and looks almost like a second degree burn.
> Could it be the thyroid meds the mom is on?  Any one
> have any ideas?

Any chance it's yeast? I've seen fiery red, perianal diaper rash many times with thrush/yeast -- even when none apparent in baby's mouth.

Karen G

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