Diaper Rash
Source: American Academy of Pediatrics
Diaper rash affects most babies, but it is usually
not serious. Below explains the causes of diaper rash,
steps you can take to help prevent it and how to treat
it if it develops.
What is diaper rash?
Diaper rash can be any rash that develops
inside the diaper area. In mild cases, the skin might
be red. In more severe cases, there may be painful
open sores. You will usually see a rash around the
abdomen, genitalia and inside the skin folds of the
thighs and buttocks. Mild cases clear up within 3
to 4 days without any treatment. If a rash persists
or develops again after treatment, consult your pediatrician.
What causes diaper rash?
Over the years diaper rash has been
blamed on various causes, such as teething, diet and
ammonia in the urine. However, medical experts now
believe it is caused by any of the following:
• Too much moisture
• Chafing or rubbing
• Prolonged contact of the skin with urine,
feces or both
• Yeast infection
• Bacterial infection
• Allergic reaction to diaper material
When skin stays wet for too long, the
layers that protect it start to break down. When wet
skin is rubbed, it also damages more easily. Moisture
from a soiled diaper can harm your baby’s skin
and make it more prone to chafing. When this happens,
a diaper rash may develop.
Further rubbing between the moist folds
of the skin only makes the rash worse. This is why
diaper rash often forms in the skin folds of the groin
and upper thighs.
More than half of babies between 4 months
and 15 months of age develop diaper rash at least
once in a 2-month period. Diaper rash occurs more
often in the following instances:
• As infants get older-mostly
between 8 to 10 months of age
• If babies are not kept clean and dry
• In babies who have frequent stools, especially
when the stools stay in their diapers overnight
• When babies begin to eat solid foods
• When babies are taking antibiotics, or in
nursing babies whose mothers are taking antibiotics
• Infants taking antibiotics are more likely
to get diaper rashes caused by yeast infections.
Yeast infects the weakened skin and causes a bright
red rash with red spots at its edges. You can treat
this with over-the-counter, anti-fungal medications.
If you see these symptoms, you may wish to consult
with your pediatrician.
What can I do to prevent diaper
rash?
To help prevent diaper rash from developing,
you should:
• Change the diaper promptly
after your child wets or has a bowel movement. This
limits moisture on the skin.
• Do not put the diaper on airtight, especially
overnight. Keep the diaper loose so that the wet
and soiled parts do not rub against the skin as
much.
• Gently clean the diaper area with water.
You do not need to use soap with every diaper change
or after every bowel movement. (Breastfed infants
may stool as many as 8 times a day.) Use soap only
when the stool does not come off easily.
Do not use talcum or baby powder because
they could cause breathing problems in your infant.
Avoid over-cleansing with wipes that can dry out the
skin. The alcohol or perfume in these products may
irritate some babies’ skin.
What can I do if my baby gets
diaper rash?
If diaper rash develops despite your
best efforts to prevent it, try the following:
• Change wet or soiled diapers
often
• Use clear water to cleanse the diaper area
with each diaper change.
• Using water in a squirt bottle lets you
clean and rinse without rubbing.
• Pat dry; do not rub. Allow the area to air
dry fully.
• Apply a thick layer of protective ointment
or cream (such as one that contains zinc oxide or
petrolatum) to form a protective coating on the
skin. These ointments are usually thick and pasty
and do not have to be completely removed at the
next diaper change. Remember, heavy scrubbing or
rubbing will only damage the skin more.
Check with your pediatrician
if the rash:
• Has blisters or pus-filled
sores
• Does not go away within 48 to 72 hours
• Gets worse
• Use creams with steroids only if your pediatrician
recommends them. They are rarely needed and may
be harmful.
Which type of diaper should
I use?
There are many different brands of diapers.
Diapers are made of cloth or disposable materials.
After they get soiled, you can wash cloth diapers
and use them again. Throw away disposable diapers.
Research suggests that diaper rash is
less common with the use of disposable diapers. In
childcare settings, children who wear super-absorbent,
disposable diapers tend to have lower rates of diaper
rash. Regardless, of which type of diaper you use,
diaper rash occurs less often and is less severe when
you change diapers often. If you use a cloth diaper,
you can use a stay-dry liner inside it to keep your
baby drier.
If you choose not to wash cloth diapers
yourself, you can have a diaper service clean them.
If you do your own washing, you will need to presoak
heavily soiled diapers. Keep and wash soiled diapers
separate from other clothes. Use hot water and double-rinse
each wash. Do not use fabric softeners or antistatic
products on the diapers because they may cause rashes
in young, sensitive skin.
Whether you use cloth diapers, disposables
or both, always change diapers as needed to keep your
baby clean, dry and healthy.
Remember-never leave your baby alone
on the changing table or on any other surface above
the floor. Even a newborn can make a sudden turn and
fall to the floor.
Diaper rash is usually not serious,
but it can cause your child discomfort. Follow the
steps listed above to help prevent and treat diaper
rash. Discuss any questions you have about these steps
with your pediatrician.
The information contained in this publication
should not be used as a substitute for the medical
care and advise of your pediatrician. There may be
variations in treatment that your pediatrician may
recommend based on individual facts and circumstances.
