Monday, June 17, 2024

Diaper Rash

This is an INFORMATION page, verified by physician

Diaper rash or Napkin rash is the general term used to describe any rash (dermatitis) that affects your baby’s skin in the nappy or diaper area. It typically affects babies between 3 and 15 months of age and is relatively common. In most cases, it is usually mild and self-limiting. Although if it is the first time your baby has a diaper rash, or the rash looks sore, you may feel worried.

Why Does Diaper Rash Happen?

Generally, diaper rash occurs when the skin under the diaper becomes irritated. Often from the contact of urine and faeces or from the skin staying wet or moist underneath the diaper. This moist warm environment underneath the diaper can also provide a site for infection, such as yeast (candida) or bacteria.

Diaper rash may be more likely if your baby has an underlying skin condition such as eczema. Changes in diet (such as the introduction of solids) can lead to a change in stool frequency. Stool pH and may also contribute to diaper rash. Sometimes, Diaper Rash will occur for no identifiable reason at all.

Sometimes, there may be an underlying medical condition. If the rash is severe, persists or is recurrent, it is important to see your paediatrician.

How Can I Prevent Diaper Rash from Happening?

Diapers, whether disposable or cloth, need to be changed regularly. This is to avoid the skin becoming wet. Diapers should also be changed as soon as the diaper becomes soiled with poo. Try to change the diaper before and after sleep too.

Modern-day cloth nappies have become a popular choice for parents. There are different types of nappies with different inserts to improve absorbency. Before making the investment, it is wise to do some internet research. Chat with friends for recommendations.

When cleaning cloth nappies, use a warm water wash with good quality detergent. Double rinse cycle and our bright Cayman sunshine to dry the nappies. If you notice the diapers smelling of ammonia, you may need to troubleshoot. A build-up of ammonia can lead to diaper rash.

You may wish to use a light barrier cream (zinc oxide based) with nappy changes. This is not essential if your baby’s skin looks normal. DO NOT USE talcum powder on your baby. It is not safe due to the risk of baby inhaling the powder into their lungs.

It is best to use either a soft cloth and water to gently clean the diaper area. Or water-based disposable wipes (99% water-based). Let the skin air dry or gently wipe dry before putting on the diaper. Cotton wool balls and cool, sterile water can clean your newborn baby’s bottom.

Allowing your baby to have nappy free time so the skin in this area as the opportunity to breath is important. The best time to do this is during tummy time or before or after bathing.

What Do I Do When My Baby has Diaper Rash?

Use a thick zinc oxide based diaper cream (you can buy this at supermarkets or pharmacies). This will glide onto the skin to form a barrier to protect baby’s bottom. With each diaper change, it is important to gently clean the area removing any urine and or poo. It is not necessary to remove all the zinc oxide cream. When the area looks clean (other than the residual barrier cream) apply more barrier cream on top. The cream can then be fully removed during bath time.

Give your baby as much nappy-free time as possible.

If the rash has not improved within 2-3 days or is getting worse you should see your paediatrician.

You should see your paediatrician as soon as possible if your baby shows signs of infection. Signs of infection may include:

  • A very red painful rash,
  • Blistering or crusted lesions,
  • Small red spots extending away from the rash,
  • Baby looks unwell
  • Baby has a fever.

Until you have spoken with your baby’s doctor please do not use any over the counter steroid treatment, such as hydrocortisone.

More Advice on Diaper Rash

It’s also worth checking out help, advice, and any diaper rash posts in our Baby Facebook Group. It allows you to ask questions, gain access to basic advice and share experiences with others facing the same new experiences. You can join here:

about the author

Dr Sarah Newton
Dr Sarah Newton
SPECIALIST GENERAL PAEDIATRICIAN & NEWBORN CARE - Dr Sarah Newton (MMBChB, FRACP (paeds), DCH) is a general paediatrician with the Royal Australasian College of Physicians, tertiary level trained in highly respected paediatric and neonatal centres in Australia, New Zealand and Singapore. Her specific interests include neonatal care, complex diagnoses and developmental follow up.

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