Diaper rash: Preventative tactics and treatments |
I will never forget the day I saw what a really bad diaper rash can do. It was on a beautiful little three-month-old girl in my mother-baby group, and it was truly horrible: Her skin looked raw. Rebecca started crying as soon as her mom started changing her diaper, screamed as the poor woman washed the area as gently as she possibly could, and reacted almost as strongly to having medicated cream applied afterwards. We were all left shaken by the ordeal.
Rebecca had a yeast infection, just recently diagnosed, and medication soon cleared up her sore bum. But even plain old diaper rash can be plenty troublesome, especially for those babies who have extra sensitive skin. There was another baby in that same group who spent much of his first two months with no diaper on at all, lying on layers and layers of flannelette because, as his mom said, “Everything gives him a rash - disposable diapers, rubber pants, laundry soap, you name it.”
Fortunately, most babies are not that tender. A combination of preventive tactics and prompt treatment of any irritation should keep diaper rash in check.
Dry skin is happy skin. “Moisture is the enemy,” says public health nurse Deanna Stirling, of London, Ontario. “Dryness is really number one,” both to prevent diaper rash and to help the skin heal once it sets in. Paul Munk, a community paediatrician and assistant professor of paediatrics at the University of Toronto, agrees. “The drier it is, the less diaper rash.” In addition to frequent diaper changes, it’s important to make sure the skin is really dry before rediapering or putting on any kind of cream. Munk says you might even use a hair dryer on a very low setting, of course being careful not to burn your baby!
“Airing the bottom,” while it causes laundry, gives your baby a break from the hot, moist confines of the diaper and can be quite helpful when a rash is threatening. “Set your baby on a moisture-proof pad, cover her with a blanket, and let her air,” says Stirling. “Again, it’s to prevent moisture from breaking down the skin.”
Clean it gently. Urine, and especially stool, against the skin will irritate it, so your baby needs to be kept really clean. Be careful, though, because aggressive soaping of his bum can strip the protective oils from his skin and make things worse. A common rule of thumb is to rinse with water for pee and a mild soap and water (rinsing well) after every bowel movement. If you use commercial wipes, Munk advises against the type that’s alcohol-based. For really gentle cleansing, he suggests cleaning off stool with mineral oil on a tissue - this will also feel a lot nicer if your baby already has a rash.
Use a barrier cream. You don’t have to put anything on your baby’s bum if there’s no sign of a rash, says Munk, unless she has sensitive skin. If she does, petroleum jelly or a zinc-oxide-based cream provides some protection against moisture. If a rash does develop, it should improve after two or three days of treatment with a zinc oxide cream, says Stirling. You may have to experiment a bit - everyone seems to discover a favourite product that seems to work best on their baby. Munk doesn’t advise powder of any kind because your baby might inhale it.
Know when to see the doctor. If your baby has a yeast infection, he will need specific medication prescribed by the doctor. A baby’s bottom with a yeast infection is usually described as bright red, even purply, and angry-looking, with a sunburned or scalded look. There are often “satellite spots” - little spotted areas spreading out from the main rash.
Babies can also get an eczema-type rash in the folds of the skin, explains Munk, or a bacterial skin infection, which often comes up in tiny pimples. Both of these need specialized treatment. Finally, an apparently normal rash that doesn’t respond to home treatment, or gets worse, should also be seen. In severe cases, your doctor may suggest a cream containing a small amount of hydrocortisone.
Be sensitive to babies with sensitive skin. If your baby is very rashy even with careful diaper hygiene, suspect a reaction to whatever comes in contact with her skin. Some babies react to fragrances or other ingredients in soaps, lotions, wipes or laundry detergents. A few react to disposable diapers, or a certain brand of disposables. A buildup of ammonia in cloth diapers can also irritate (try adding vinegar to the rinse), as can plastic diaper covers (which raise the temperature inside the diaper). You may need to try a few different brands before you find the best products for your baby’s skin.
Finally, be aware that even “buns of steel” babies can have periods when they are more susceptible to rash. Loose stools, whether from an illness, a food reaction or teething drool, can be more acidic and “burn” on contact. Yeast - in the diaper area, or in the mouth where it is called thrush - may be more likely to set in after an illness or after treatment with antibiotics. By being extra watchful during these times, you have a better chance of getting control of the rash before it makes your baby miserable.
Rebecca had a yeast infection, just recently diagnosed, and medication soon cleared up her sore bum. But even plain old diaper rash can be plenty troublesome, especially for those babies who have extra sensitive skin. There was another baby in that same group who spent much of his first two months with no diaper on at all, lying on layers and layers of flannelette because, as his mom said, “Everything gives him a rash - disposable diapers, rubber pants, laundry soap, you name it.”
Fortunately, most babies are not that tender. A combination of preventive tactics and prompt treatment of any irritation should keep diaper rash in check.
Dry skin is happy skin. “Moisture is the enemy,” says public health nurse Deanna Stirling, of London, Ontario. “Dryness is really number one,” both to prevent diaper rash and to help the skin heal once it sets in. Paul Munk, a community paediatrician and assistant professor of paediatrics at the University of Toronto, agrees. “The drier it is, the less diaper rash.” In addition to frequent diaper changes, it’s important to make sure the skin is really dry before rediapering or putting on any kind of cream. Munk says you might even use a hair dryer on a very low setting, of course being careful not to burn your baby!
“Airing the bottom,” while it causes laundry, gives your baby a break from the hot, moist confines of the diaper and can be quite helpful when a rash is threatening. “Set your baby on a moisture-proof pad, cover her with a blanket, and let her air,” says Stirling. “Again, it’s to prevent moisture from breaking down the skin.”
Clean it gently. Urine, and especially stool, against the skin will irritate it, so your baby needs to be kept really clean. Be careful, though, because aggressive soaping of his bum can strip the protective oils from his skin and make things worse. A common rule of thumb is to rinse with water for pee and a mild soap and water (rinsing well) after every bowel movement. If you use commercial wipes, Munk advises against the type that’s alcohol-based. For really gentle cleansing, he suggests cleaning off stool with mineral oil on a tissue - this will also feel a lot nicer if your baby already has a rash.
Use a barrier cream. You don’t have to put anything on your baby’s bum if there’s no sign of a rash, says Munk, unless she has sensitive skin. If she does, petroleum jelly or a zinc-oxide-based cream provides some protection against moisture. If a rash does develop, it should improve after two or three days of treatment with a zinc oxide cream, says Stirling. You may have to experiment a bit - everyone seems to discover a favourite product that seems to work best on their baby. Munk doesn’t advise powder of any kind because your baby might inhale it.
Know when to see the doctor. If your baby has a yeast infection, he will need specific medication prescribed by the doctor. A baby’s bottom with a yeast infection is usually described as bright red, even purply, and angry-looking, with a sunburned or scalded look. There are often “satellite spots” - little spotted areas spreading out from the main rash.
Babies can also get an eczema-type rash in the folds of the skin, explains Munk, or a bacterial skin infection, which often comes up in tiny pimples. Both of these need specialized treatment. Finally, an apparently normal rash that doesn’t respond to home treatment, or gets worse, should also be seen. In severe cases, your doctor may suggest a cream containing a small amount of hydrocortisone.
Be sensitive to babies with sensitive skin. If your baby is very rashy even with careful diaper hygiene, suspect a reaction to whatever comes in contact with her skin. Some babies react to fragrances or other ingredients in soaps, lotions, wipes or laundry detergents. A few react to disposable diapers, or a certain brand of disposables. A buildup of ammonia in cloth diapers can also irritate (try adding vinegar to the rinse), as can plastic diaper covers (which raise the temperature inside the diaper). You may need to try a few different brands before you find the best products for your baby’s skin.
Finally, be aware that even “buns of steel” babies can have periods when they are more susceptible to rash. Loose stools, whether from an illness, a food reaction or teething drool, can be more acidic and “burn” on contact. Yeast - in the diaper area, or in the mouth where it is called thrush - may be more likely to set in after an illness or after treatment with antibiotics. By being extra watchful during these times, you have a better chance of getting control of the rash before it makes your baby miserable.
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cynthia | June 19, 2010 at 7:58 am - §
i love this site. it helps me to know more about my baby
Rita | June 30, 2010 at 9:12 pm - §
I used Baby Silk By MD moms Diaper rash cream, and never looked at another rash again, I totally recommend it, they are all natural.