How best to help baby beat nappy rash

Nappy rash is a common form of inflamed skin (dermatitis) that appears as a patchwork of bright red skin on your baby’s bottom. It is often related to wet or infrequently changed nappies, skin sensitivity, and chafing. It usually affects babies, though anyone who wears a nappy regularly can develop the condition.

As annoying and irritating as it is, it usually clears up with simple at-home treatments, such as air drying, more frequent nappy changes and ointment. If your baby’s skin doesn’t improve after a few days of home treatment, talk with your doctor. Sometimes, you’ll need a prescription medication to treat the rash.

As a parent, you can worry if the rash is severe or unusual, gets worse despite home treatment, bleeds, itches or oozes or causes burning or pain with urination or a bowel movement, and is accompanied by a fever.

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In the time leading up to your appointment, avoid products that seem to trigger your baby’s rash. Wash your baby’s bottom with water after each nappy change.

Avoid soaps and wipes that contain alcohol or fragrance.

Causes

• Irritation from stool and urine. Prolonged exposure to urine or stool can irritate a baby’s sensitive skin. Your baby may be more prone to nappy rash if he or she is experiencing frequent bowel movements or diarrhoea because faeces are more irritating than urine.
• Chafing or rubbing. Tightfitting nappies or clothing that rubs against the skin can lead to a rash. v Irritation from a new product. Your baby’s skin may react to baby wipes, a new brand of dis- posable nappies, or a detergent, bleach or fabric softener used to wash cloth nappies. Other substances that can add to the problem include ingredients found in some baby lotions, powders and oils.
• Bacterial or yeast (fungal) infection. What begins as a simple skin infection may spread to the surrounding region. The area covered by a nappy is especially vulnerable because it’s warm and moist, making a perfect breeding ground for bacteria and yeast. These rashes can be found within the creases of the skin, and there may be red dots scattered around the creases.
• Introduction of new foods. As babies start to eat solid foods, the content of their stool changes. This increases the likelihood of nappy rash. Changes in your baby’s diet can also contribute. If your baby is breastfed, what the mother eats can also lead to nappy rash.
• Sensitive skin. Babies with skin conditions are more at risk
• Use of antibiotics. Antibiotic use also increases the risk of diarrhoea.

Symptoms

Skin signs – Nappy rash is marked by red, tender-looking skin in the buttocks, thighs and genitals. Child irritability – You may notice your baby seems more uncomfortable than usual, especially during nappy changes. The child might cry when the nappy area is washed or touched.

Treatments

The best treatment for nappy rash is to keep your baby’s skin as clean and dry as possible.

However, if the rash persists, the following might be helpful:

• A mild hydrocortisone (steroid) cream;
• An antifungal cream, if your baby has a fungal infection; or
• Topical or oral antibiotics, if your baby has a bacterial infection.

PREVENTION AND HOME REMEDIES

Keeping the nappy area clean and dry. The best way to keep your baby’s nappy area clean and dry is by changing nappies immediately after they are wet or soiled. After you’ve gently cleaned and dried the skin, apply a cream, paste or ointment. Certain products, such as zinc oxide and petroleum jelly, work well to protect the skin from moisture.

Increasing airflow. To aid the healing of nappy rash, do what you can to increase air exposure to the nappy region. These tips may help: Air out your baby’s skin by letting him or her go without a nappy and ointment for short periods of time, perhaps three times a day for 10 minutes each time, such as during naps; avoid airtight plastic pants and nappy covers; use nappies that are larger than usual until the rash goes away.

Zinc oxide is the active ingredient in many nappy rash products. They are usually applied to the rash throughout the day to soothe and protect your baby’s skin. It doesn’t take much – a thin covering will do. The product can be applied over-medicated creams, such as an antifungal or a steroid, when necessary. You could also apply petroleum jelly on top, which helps keep the nappy from sticking to the cream.

As a general rule, stick with products designed for babies. Avoid items containing baking soda, boric acid, camphor, phenol, benzocaine, diphenhydramine, or salicylates. These ingredients can be toxic for babies.

Bathing daily. Until the rash clears up, give your baby a bath each day. Use warm water with mild, fragrance-free soap.

Rinse your baby’s bottom with warm water as part of each nappy change. You can use a sink, tub or water bottle.

Are disposable nappies better than cloth ones? Many parents wonder about what kind of diapers to use. There’s no compelling evidence that cloth nappies are better than disposable nappies or vice versa. If one brand of disposable nappies irritates your baby’s skin, try another. If the laundry soap causes a rash, switch products.

Whichever one you decide to use, always change your baby as soon as possible after he or she wets or soils the nappy to keep the bottom as clean and dry as possible. If you use cloth nappies, careful washing can help prevent nappy rash.

• Pre-soak heavily soiled cloth nappies in cold water.
• Wash nappies in hot water with a mild detergent and bleach.
• Double rinse the nappies in cold water to remove traces of chemicals and soap.
• Do not use fabric softener.