4 Tips for Preventing Diaper Rash

Diaper rash, also known as diaper dermatitis, contact dermatitis or nappy rash is a generalized term for any skin irritation in the diaper area, and is not usually a serious condition. It is very common and occurs in about 50% of all babies as early as 6 weeks of age and as late as 15 months, but more often at around 8-10 months old. Because it is an inflammation, it may look like a red, sore patch on your baby’s diaper area or groin, if mild. More severe cases may have small bumps on the lower part of the tummy, genitals and skin folds around the upper leg, buttocks or thighs. It is usually painful and may cause a secondary bacterial or yeast infection if not treated.

There are many causes of diaper rash, including irritation from soiled diapers. Urine and feces are acidic and can break down baby’s sensitive skin. Friction or rubbing of the diaper on baby’s diaper area, harsh detergents or soaps, and moisture from wet diapers or from sweat also contribute to the worsening of a diaper rash.  

To prevent diaper rash:
1. Change your baby’s diapers as it becomes soiled. Avoid following a “changing schedule” or waiting until the diaper is fully soaked before changing, as this will expose baby’s buttocks to the moisture of the urine or stool longer than necessary. Bacteria develops quickly in stool and urine, which can turn a simple irritation to a full-blown infection.

2. Wash your baby’s bottom with warm water and mild soap. Avoid rubbing.  

3. Pat the skin dry with a soft clean cloth. Avoid baby wipes or wet wipes as these may have harmful chemicals.

4. Put the diaper on loosely. A tight diaper will lock moisture in and may worsen or cause diaper rash.

If you are not about to travel, go to the mall or eat out, it is a good idea to expose your baby’s buttocks to air dry for a few minutes. Avoid plastic underwear. Plastic panties that are used to cover the diaper must be avoided too, as it may cause chaffing or rubbing of the plastic on baby’s sensitive skin.

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Apply a thick layer of ointment or cream after each diaper change, which will act as a protective barrier between the moisture and your baby’s skin. Choose a cream that contains zinc oxide because it has mild astringent properties, which makes it a good drying agent for minor skin irritations. Not only does it protect, it soothes skin too. The compound may also help promote immune system health, making it helpful in wound healing.

Though not mentioned in the AAP and the Philippine Pediatric Society (PPS) Guidelines, petroleum jelly is another commonly-used moisture-protection barrier, and is cheaper too! Apply liberally to the buttocks to prevent diaper rash. Make sure that your baby’s bottom is completely dry before applying petroleum jelly. If it can lock moisture out, it can also lock moisture in, which defeats the purpose of keeping your baby’s skin dry. If your baby already has diaper rashes, petroleum jelly is not recommended, as it may worsen the condition because it makes the irritated area more moist, worsening the diaper rash.  

Diaper rashes may be treated, but call your pediatrician if:

• The diaper rash occurs in the first 6 weeks of life
• Your baby has a fever along with the rashes
• Your baby loses weight or isn't eating normally
• Large bumps or nodules appear or the rash includes blisters or pus-filled sores.
• The rash spreads to other areas, such as the arms, face or scalp
• The rash does not look like it will go away soon, or gets worse 2 to 3 days after treatment.
• Your baby is taking an antibiotic and has a bright red rash with red spots at its edges. This might be a yeast infection.
• The rash is very painful. Your baby might have a skin condition called cellulitis.

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Photo from greenparenthood.com

This article was first published on July 28, 2011.