Bottoms Up! Alleviating Diaper Rash

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nicole-freedman-author-banner-033114 At the Division of Pediatric Urology at Children’s Hospital Los Angeles, I see a lot of diaper rash, because I am always opening up the diaper for exams. Diaper rash is an inevitable part of being a baby. Even though diaper rash is very common, it can cause a whole lot of discomfort for babies and a lot of anxiety for parents. In this article, I will provide some tips, and hopefully make things better, when the inevitable strikes. There are lots of reasons why babies get diaper rash. First things first: both infants who wear cloth diapers and those who wear disposable diapers can get diaper rash. Both disposable and cloth diapers can rub against the skin to cause chafing and irritation. Some babies may even be allergic to the agents used to clean cloth diapers or the components of disposable diapers. Babies have very sensitive skin and it can become easily Bottoms Up! Alleviating Diaper Rashirritated from constant contact with urine and fecal matter. Diapers are also warm, dark and moist inside, which is a perfect breeding ground for bacteria and yeast.

My baby has a diaper rash. What now?

  • One of the best prescriptions for diaper rash is “naked time.” If possible, try to keep the diaper off of your baby to allow their skin to breathe. It may be helpful to remove the diaper when they are sleeping, particularly if you have a baby on the move! The more time with the diaper off, the better.
  • Pat the skin dry, don’t wipe! When your child has a rash, make sure to gently blot the skin rather than rubbing or wiping, because this can worsen skin irritation and cause pain.
  • Use a spray bottle or bulb syringe filledwith plain or soapy (mild, non-fragrant soap) warm water to clean soiled skin. Make sure to rinse the skin well if you used soap! Then, pat the skin dry with a cloth. Sometimes it’s best to avoid baby wipes all together, especially if they contain alcohol or perfumes, as this can cause the skin to burn.
  • Change diapers often. Don’t let your baby sit too long in a wet or soiled diaper. This practice is also a good rule of thumb for preventing diaper rash in the first place. Disposable diapers are very absorbent, which is great for preventing urine leaks, but as a result, parents tend to change diapers much less frequently.
  • Use diaper cream. There are a lot of products on the market, which can be very overwhelming for parents searching in the baby aisle for the perfect cream. One size certainly doesn’t fit all as far as diaper creams go. There are creams that contain lanolin, petrolatum, zinc and other compounds. Ask your baby’s doctor what they recommend for both prevention and treatment of diaper rash. Note that sometimes babies need special prescription creams or antibiotics for bacterial or fungal infections if conventional treatments don’t cut it. So, if you are applying diaper cream and it doesn’t appear to be helping, or the rash looks worse, make sure to take your baby to the doctor.

Gloria Verret, BSN, RN III, CPN, lists the symptoms of diaper rash.

How you can help prevent diaper rash

  • Use a barrier layer. If your baby is prone to getting diaper rash, talk to your child’s doctor about a cream or ointment that would serve as a good barrier layer. Think about what happens when you wash your hands when they are greased with butter or oil: the water beads right off. This same effect will protect the skin in the diaper. When you apply a thick layer of cream to your child’s bottom, it helps to prevent the Bottoms Up! Alleviating Diaper Rashstool or urine from coming directly in contact with their sensitive skin.
  • Change detergents. If you use cloth diapers, it may help to change the type of soap that is being used the wash your child’s diapers. Make sure to rinse the diapers very well before putting them in the dryer. It can also help to wash the diapers with vinegar.
  • Check the size. Diapers that don’t fit properly can make your child more susceptible to diaper rash. If the diaper is too big, it can rub back and forth too much. If it is too small, it may now allow good air exchange, or may put the skin in contact close contact with moisture. It may help to increase or decrease the size of the diaper.
  • Change brands. Some babies may be sensitive to the chemicals, dyes or ingredients used to manufacture diapers. See if changing the brand helps prevent future diaper rash.

When to call the doctor

Most diaper rash can easily be dealt with at home. However, if your child’s diaper rash starts to look worse or is not improving with at-home treatments, or if your baby starts to look sick, make sure to take visit the pediatrician. It is very difficult for doctors and nurses to assess a situation over the phone, especially with rashes. Also make sure to take your child to the doctor if you notice any of the following:

  • Fever over 100.4 degrees with a diaper rash
  • Pustules (small, inflamed bumps filled with fluid) on the skin
  • Severe pain
  • Bleeding
  • Skin that appears to be leaking out clear or honey-color fluid
  • Your baby looks lethargic or won’t eat, drink or play