Diaper Rash

Definition and Causes

Diaper rash is any irritation of the skin affecting the diaper area. It can be caused by many things including strong urine, stool, wearing wet or soiled diapers for long periods, loose stools/diarrhea, or irritation from soaps, perfumes, lotions, creams and commercial diaper wipes. It may also be caused by certain foods and bacterial or yeast infections.

Symptoms

Diaper rash is characterized by redness and puffiness of the skin. It may be limited to the buttocks or found in the anal, genital or groin areas. You may notice mild chafing on your baby’s thigh where the leg openings of the diaper have rubbed or redness in other areas where the diaper irritates the skin.

Prevention

To prevent diaper rash:

• Change diapers frequently and immediately after a bowel movement.
• Avoid diaper wipes. Use a washcloth with warm water and soap only for cleansing bowel movements.
• Expose baby’s bottom to air frequently.
• Protective ointments like Desitin or A&D may be helpful.

Home Care

As soon as you notice any irritation in your baby’s diaper area, take steps to clear it up. The earlier you take action, the less stubborn and severe the rash will be.

• Keep the skin in the diaper area clean and dry.
• Check diapers every 15 to 20 minutes and change the diapers as soon as your baby wets or soils.
• Clean the area gently but thoroughly using warm water. Stay away from disposable wipes until the rash clears up. Use a mild soap sparingly and only after a bowel movement. Thoroughly rinse soap from the skin with warm water.
• When the skin is clean, gently pat dry without rubbing. Pay special attention to folds and creases.
• Apply a layer of a nonprescription diaper rash ointment like Desitin, Diaperene, or A&D Ointment.
• Avoid tight fitting disposable, plastic covered diapers. Use cloth diapers (without plastic pants) if possible or the “cloth-like” disposables one size larger than normal.
• Expose diaper area to air as much as possible every day, especially after changing diaper.
• If using cloth diapers, launder with a mild soap such as Dreft. When the cycle is completed set your machine for an additional deep rinse. Add one cup of distilled white vinegar to the rinse water. Complete the cycle and dry as usual. Do not use fabric softener or softener sheets in the dryer.

If you followed the above instructions for a few days and your baby’s diaper rash is no better, or is now bright red, having large patches with sharp margins and small red spots nearby, your baby may have a yeast infection. This can develop when your baby is on antibiotics or any time he/she has a diaper rash. Once your baby has had a yeast infection he/she may be more susceptible to it again.

A yeast infection is treated in basically the same manner as any diaper rash. In addition you will want to do the following:

• Add one capful of distilled white vinegar per gallon of water to the baby’s bath water.
• Apply one of the many over-the-counter yeast creams (Gyne-Lotrimin, Lotrimin AF, Monistat) to the diaper area 4 times a day after cleansing well with mild soap and warm water and patting dry.

When to Call the Doctor

Call your child’s doctor if:

• The baby develops a fever.
• The rash does not clear in 5 days.
• The rash appears to be getting worse instead of better.
• Blisters or pimples develop in the diaper rash.
• You have concerns.