Although the cause of PUPPP is not known, it can be speculated to be contributed by abdominal stretch due to baby size. Overly stretching the skin might have exposed tissues (not normally found in circulation) to the immune system and that caused an allergic reaction. There is no medication to stop the rogue immune reaction. However, anti-histamine can be given to reduce the symptoms, e.g. itchiness and eruptions.
Some mothers had to go through the itchiness from 2 weeks to several weeks.
Things that exacerbate the rashes are
- Bathing in hot/warm water
- Seated for too long (heat seemed to increase more rashes)
- Scratching increases severity
Doctor would normally prescribe
- Anti-histamine to relieve itchiness, but it doesn't seem to mask the itchiness completely. However, a mild relieve is better than none.
- Calamine, which is composed of zinc oxide and ferric oxide (see Wikipedia). Its anti-itch property has been debated, and doctors seemed to discourage its use because the solution can dry up the skin and could potentially worsen the recovery. My wife seemed to prefer this solution rather than the steroid based medication as she is worried about the harm of steroid on baby during breast-feeding (although doctors said it's not harmful).
- Steroid based cream for topical (skin) application, e.g. Elomet (R) Mometasone furoate by Merck.
Home based remedies are as follows
- 2.1% (v/v) sodium bicarbonate (or baking soda) in bath water. E,g, 2 ml in 100 ml or 2 cup in 100 cups (or 1 cup in 50 cups [3.125 gallon]) of water.
- Oatmeal bath, and how to prepare the bath is described "How to make an oatmeal bath" (by WikiHow). Taking a dip in oat bath provides the minerals and nutrients needed to rejuvenate the skin, especially one that is "sad".
- Epsom salt (or Magnesium sulfate) bath. The concentration in the bath is not fixed and some just guess the right concentration to use. Although the bath is normally at higher temperature, it is not advisable to take a dip in warm bath especially considering that rashes tend to get worst with higher temperature! Here is an instruction on how to prepare Epsom bath (Scdlifestyle)
- For Chinese, there is a necessity to increase body heat by consuming herbs that will increase body temperature. Although it helps in the postpartum (after delivery) recovery process, there should also be a need to balance it to help alleviate the rashes. A nurse suggested that drinking buttermilk or plain yogurt could help (See buttermilk as cooling drink by MediManage). I am giving my wife coconut drink to cool her body but drink moderately as breast-fed baby might have runny stool if too much of this drink.
- Other suggestions are Aloe Vera gel and cucumber puree. I wrote down these two because there has not been report of anyone being allergic to these health food.
- There are those suggestions that should be used with care as some might be allergic to the ingredient, e.g. lemon juice might exacerbate the skin condition and banana peels might be harmful to some people. Those interested to experiment (with own risk) can refer to this site, "Home Remedies for Rash" (by HomemadeMedicine).
Tips
To apply calamine solution is quite tricky, we initially used cotton balls to apply the medication on the skin but most of the solution is soaked up to the cotton. I tried to squeeze the solution out and re-apply it on my wife's skin numerous time to avoid wastage. Today, I got a small spray bottle (from Daiso Singapore) to try to apply the solution on her skin by aerosol. I filled a small volume of the calamine to the spray bottle and dispense the aerosol enough to cover her affected skin. It worked, but the aerosol caused the whole room to be smelly. Also, care should be taken to prevent inhaling too much of calamine! For your information, read about zinc poisoning, (MerckManuals) and iron poisoning (CDC).
For now, I just hope my wife will recover next week. Seeing her in this state makes me feel helpless...
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