Given their tendency to poop ten times a day, babies spend most of their initial years with a diaper strapped on until they are old enough to potty train. However indispensable diapers may be, they can also become a source of suffering, both for the baby and the parents.
Every now and again, your child’s sensitive skin is bound to get irritated within the warm and moist confines of a tightly secured diaper.
In fact, one of the most common skin problems in babies below the age of 3 is the development of an uncomfortable rash on their bottom.
This kind of contact dermatitis is a result of prolonged moisture of the nappy-enclosed skin, constant friction of the skin against the diaper, and contact with chemicals in the baby’s urine and stool.
A diaper rash is characterized by inflamed skin and a rash in the diaper area, which includes the upper thighs, buttocks, and genital area.
Infants between the ages of 9 months and 12 months are particularly prone to this problem given they spend most of their time sitting, allowing minimal air circulation within the diaper. Moreover, it is at this age that babies are administered solid foods for the first time, which ends up making their bowel movements more acidic.
Sleepy-head babies that doze off for long hours tend to remain in wet and soiled diapers for longer and therefore show a greater predisposition to this condition. Although most prevalent among infants and toddlers, a diaper rash can afflict people who wear adult diapers or incontinence briefs as well, regardless of their age.
Distressing as it may be, a diaper rash is generally not considered to be a serious problem, neither is it a sign of parental neglect. All it takes is a few adjustments in your nappy-changing technique along with some tried-and-tested adjunctive home treatments to help manage it.
However, if this relatively harmless condition is not tended to in a timely and appropriate manner, the rash can get secondarily infected by yeast or bacteria, which may require treatment by your health care provider.
What are the Common Causes of a Diaper Rash?
The main cause of a diaper rash is prolonged exposure to a dirty diaper, either moist with urine or soiled with stool. Other common causes are:
- Fungal or yeast infections caused by the Candida species that thrives in the poorly ventilated, warm, and humid genital region, particularly around the skin creases and folds.
- Dietary changes such as a transition from liquid to solid foods or the introduction of new foods can alter the acidic composition of your baby’s stool as well as increase the frequency of his/her bowel movements.
- If the baby is breast-fed, the mother’s diet can also trigger a digestive reaction in the baby.
- Digestive trouble, in the form of diarrhea, often results in the development of rash around the anus, especially because these loose stools contain certain digestive enzymes that can irritate your child’s sensitive skin.
- A rash may even develop as an allergic response to the fragrances, elastic, and dyes used in your baby’s diaper brand, baby wipes, laundry detergent, lotion, and soap.
- Poorly laundered diapers can also aggravate or trigger the development of symptoms.
- Although less common than yeast rashes, a secondary bacterial infection can also take root if your baby’s skin has been irritated to the extent that its integrity and surface barrier have been compromised. This lapse in the skin’s natural defenses gives way to localized staph and strep bacterial infections that are termed as impetigo and leads to the development of sores, yellow scabs, pimples, or draining pus.
- Cellulitis is another serious manifestation of a bacterial infection, which spreads into the deeper layer of the skin and is accompanied by redness, swelling, pain or tenderness, warmth, or a combination of these.
- Antibiotics can also make your baby vulnerable to this problem, by affecting the healthy bacteria that reside in your baby’s gut and that help to prevent the overgrowth of yeast and other bacteria.
How can You Tell if Your Baby is Suffering from a Diaper Rash?
A baby with a diaper rash may show the following signs or symptoms:
- A mild diaper rash develops in the form of pink patches on the diaper-wrapped skin.
- A more aggressive rash has reddish hues and may even develop painful open sores if left untreated.
- The skin enclosed by the diaper may show signs of peeling or scaling and may appear scalded or burnt.
- The rash can also manifest in the form of bumps on the baby’s bottom and thighs, which may or may not be filled with fluid.
- The irritated skin in the diaper region may show signs of extreme dryness.
- If the diaper-enclosed skin tends to be warmer to touch than the rest of the body, it may be taken as a sign of a rash.
- A severe diaper rash may begin to bleed if not tended to properly in time.
- If your baby appears to be unusually fussy or tends to cry a lot during diaper change, he/she may be having a diaper rash.
How Do You Prevent a Diaper Rash?
You can save yourself and your baby a lot of pain and trouble by proactively adopting certain preventative measures to avoid the development of a diaper rash. To that end, certain oft-recommended steps to include in your daily routine are:
- Be mindful about the state of your baby’s diaper condition by checking it frequently and preferably changing it every 2 hours.
- Change your baby’s wet or soiled nappies as soon as possible, to minimize contact with stool or urine that causes the rash in the first place.
- When changing your child’s nappy, wash his/her bottom with mild soap and warm water in the case of visible soil and simply with water otherwise. Alternatively, you can even use unscented baby wipes to clean the diaper region. Often, a damp and soft washcloth does the job better than most prepackaged wet wipes.
- Because it’s paramount to keep your baby’s diaper area completely moisture-free, allow your baby’s bottom to dry completely before putting on another diaper. It’s best to rid your baby’s bottom area of moisture by fanning it or patting it rather than rubbing the skin. You can even let your baby go diaper-free for a while to allow the skin to dry on its own.
- Secure your baby’s diaper in such a way that allows optimum air passage in the enclosed area, that is, neither too tight nor too loose that it comes undone.
- Strap the diaper in a way that does not allow its adhesive tabs to stick to your baby’s skin.
- Always wash your hands before and after changing diapers to prevent the transmission of infectious germs.
- For babies who are prone to getting rashes, it may be useful to apply a generous layer of a suitable barrier ointment to your baby’s bottom region after a rinse, but only after pat drying it. It helps lubricate the diaper-enclosed region and thereby stave off any potential skin irritation. Do not share these ointments and creams with other children.
- Limit the use of talc, cornstarch, or baby powder on your baby’s bottom because their inhalation can cause respiratory irritation.
When Should You See a Doctor?
Despite being an obvious inconvenience, most diaper rashes pose no real threat to your baby’s health. However, a visit to the pediatrician becomes indispensable if the following symptoms occur:
- Your baby gets a diaper rash in the first 6 weeks of his/her life.
- The rash fails to subside or show any signs of improvement despite preliminary treatment. The symptoms become progressively worse, and the rash spreads to other areas such as the face, arms, and scalp.
- If the raised red bumps on your baby’s bum do not respond to initial treatment, it’s possible that he/she is suffering from a fungal/yeast diaper rash, which can only be treated with doctor-prescribed antifungal creams.
- You notice the development of pimples or small ulcers.
- The rash shows signs of bleeding or begins to ooze discharge.
- If your baby looks sick, lethargic (extremely tired), and runs a high temperature, he/she might be suffering from a more severe infection.
Why are Some Babies More Prone to Diaper Rash than Others?
Babies, in general, tend to have far more sensitive skin than adults. However, some babies are vulnerable than others as their skin gets aggravated and develop a rash at the slightest sign of irritation. The diaper area is a particularly weak spot for babies with extrasensitive skin and, thus, needs to be tended with adequate care.
Moreover, a diaper rash is also a frequent occurrence in the case of children that sleep for long hours or are not as expressive about having a diaper that needs changing.
What are the Treatment Options for a Diaper Rash?
- Frequently changing your baby’s diaper remains the foundational step for minimizing exposure to stool and urine, which is primarily responsible for diaper dermatitis. By avoiding these precipitating agents, you can effectively protect your baby’s diaper-enclosed skin from developing a rash or becoming secondarily infected by skin bacteria or yeast.
- In the event that a rash develops, it is recommended to opt for simple cleansing methods using water and soft cloths rather than disposable wipes, which might contain irritants that can aggravate your baby’s distressed skin.
- Slathering your baby’s diaper region with copious amounts of skin protective and lubricating ointments that contain either petroleum jelly or zinc oxide provides an effective barrier against skin irritants and reduces friction of the affected skin against the diaper.
- Antifungal creams or medicines, which can only be prescribed by your child’s pediatrician, are warranted to treat a candida infection.
- Similarly, the doctor may recommend a course of antibiotics, in the case of a bacterial infection.
- Your doctor may also recommend a mild topical steroid cream or ointment.
If your child gets a diaper rash, there also are many natural home treatments that you can try to comfort your child and speed up the healing process.
Simple Ways to Avoid Diaper Rash
Here are some home remedies for treating a diaper rash.
1. Give Your Child Diaper-Free Time
When an infant has a diaper rash, ensuring that they spend some time during the day with no diaper or bottoms on can help the area to dry out and heal.
People should also avoid putting infants in tight, synthetic, or rubber bottoms while they have a diaper rash.
Dressing them in loose bottoms made of 100 percent cotton can help to keep the rash dry and allow the skin to breathe.
The best way to cleanse your baby’s bottom before every diaper change is to rinse the skin with ample amounts of warm water. If your baby has had a bowel movement, you might want to couple the water with a gentle soap for added cleansing.
However, using soap often can delay the healing of the rash and is therefore advised only in the case of soiled diapers. Make sure to use a gentle, unscented, or fragrance-free soap. After rinsing your child’s bottom, make sure that the skin is completely dry before strapping on a new diaper.
When opting for baby wipes, make sure you choose a brand that does not contain any added fragrance or alcohol. Some parents even prefer to use dampened washcloths made from soft fabric to wipe their baby’s diaper region clean.
Another time-saving tip is to keep your diaper changing table equipped with a squirt bottle or an insulated container of warm water along with cotton balls that come in handy for easy, gentle cleanups.
3. Vinegar Works as a Gentle Disinfectant
Stale urine is extremely alkaline in nature and can burn a baby’s soft skin, much like an acid. In this regard, vinegar is one of the best ingredients to offset the high pH.
- If you are using reusable diapers or cloth diapers, rinse them in a vinegar solution. Add 1/2 cup of vinegar to 1/2 a bucket of water and use this solution to rinse your baby’s diapers. This will help get rid of any soap buildup in the diapers as well as any urine smell.
- Make a very weak vinegar solution by adding 1 teaspoon of white vinegar to 1 cup of water. Use this solution to wipe your baby’s bottom when changing the diaper. This simple step will help to make your baby’s bottom resistant to yeast.
4. Apply Petroleum Jelly
Many pediatricians recommend applying a thin layer of protective coating on the baby’s soft skin every time you change a diaper. Petroleum jelly is perfect for this purpose. It will help protect the diaper area from the irritating effects of urine and feces.
- After removing a soiled diaper, clean your baby’s bottom with warm water.
- Dry it well with a cotton towel, and then apply petroleum jelly.
- Do this every time your baby needs a diaper changed, and the diaper rash will heal quickly.
5. Give Your Baby’s Skin a Gentle Scrub with an Oatmeal Bath
The high amount of protein in oatmeal soothes a baby’s soft skin and helps preserve the skin’s natural protective barrier. It also contains the chemical compound saponin, which helps remove unwanted oils and dirt from the skin pores.
- Add 1 tablespoon of dried oatmeal to the bath water.
- Let your baby soak in the water for 10 to 15 minutes.
- Then, bathe your baby in the solution. It will have a soothing effect on the baby’s skin.
- Do this twice daily to heal the diaper rash.
6. Use Coconut Oil as a Skin Salve
- Coconut oil works as a great moisturizer. Gently apply some coconut oil on the diaper area several times a day.
- You can even add several tablespoons of coconut oil to the bath water for added moisturizing. It will help kill yeast, such as Candida, which causes diaper rashes as well.
7. Trust the Moisturizing Goodness of Shea Butter
Shea butter has antifungal, anti-inflammatory, and yeast-killing properties that can help prevent and get rid of a diaper rash. It also has beneficial vegetable fats that can improve the circulation, promote cell regeneration, and helps the skin to heal.
- Wash your baby’s bottom with mild soap and lukewarm water. Allow the area to dry naturally.
- Rub pure shea butter gently in your hands until it melts. Then, press your hands on the affected area, rubbing the shea butter on the irritated skin.
- Leave it on for a few minutes, and then put on a fresh diaper.
8. Ribwort Plantain Oil Has a Skin-Healing Effect
Many health experts recommend the use of plantain oil to relieve the pain of a diaper rash. This oil is highly effective for the treatment of a diaper rash resulting from an allergic reaction.
The oil has anti-allergic properties that can help soothe and relieve inflammation associated with a diaper rash. To treat a diaper rash, you can use plantain oil or the herb.
- Crush clean, fresh plantain leaves with your hands and put them next to your baby’s skin with each diaper change.
- Alternatively, you can apply plantain oil directly on your baby’s skin before putting on a fresh diaper.
If the diaper rash does not get better even after trying these remedies, consult a doctor immediately.
Expert Answers (Q&A)
Answered by Dr. Kathleen Berchelmann, MD (Pediatrician)
How long does it take for a diaper rash to heal completely?
It depends on how severe the rash is. The best approach is to get on top of the diaper rash as soon as you notice it. Most diaper rashes will resolve within 2 to 7 days.
Is toothpaste an effective remedy to treat diaper rash in children?
I don’t recommend toothpaste; I feel there are many better options.
Can adults get a diaper rash without wearing a diaper?
Yes, very much so. This is especially common among athletes, or people who generally wear tight-fitting, poorly breathable athletic clothing and remain sweaty for several hours after exercise.
Can a baking soda bath help comfort a baby suffering from a diaper rash?
Putting baking soda in the bath may provide a little bit of symptomatic relief, and I don’t think it hurts anything, but it’s also not very effective for making a rash go away.
Can a cold compress be used on a diaper rash to soothe the itching?
Yes, of course, but this is only a temporary solution. The cooling effect will dissipate as soon as the compress is removed, and thus the relief will be rather short-lived.
What are the various types of rashes?
General skin breakdown: This type of rash is most common if a baby is left in a dirty or wet diaper too long, or requires frequent diaper changing, especially with diarrhea. This type of diaper rash is best treated with a good barrier diaper cream or ointment.
Yeast diaper rash: Yeast can grow in the diaper area, especially if it is warm, wet, or sweaty. This causes a red rash which can subsequently develop white bumps, as it progresses. Yeast diaper rash needs to be treated with an antifungal cream, usually prescribed by your physician. If the rash is bad enough, or if the baby also has a yeast infection in his or her mouth, your doctor may recommend an oral antifungal medication.
Bacterial infections: Everyone’s poop is full of bacteria, and so bacterial diaper rashes are common. They are treated with topical antibiotic ointment, or, if necessary, an oral antibiotic. It is important to understand the difference between a yeast or fungal diaper rash and a bacterial diaper rash. They are treated with different medications.
Rarely, a bacterial diaper rash can develop into a puss filled pocket, or abscess, that may need to be drained.
Can a diaper rash in babies exhibit white bumps along with the rash?
Yes, especially if it is a yeast rash.
What is the major difference between a normal diaper rash and a yeast-induced rash?
Yeast rashes are itchy and often have white bumps.
Please provide some additional tips or inputs regarding diaper rash for the benefit of our readers.
The best way to prevent diaper rash is to keep your baby clean and dry. The hardest part is really waiting for your baby’s bottom to be dry before you apply the new diaper. Try singing the ABC song with your baby while you wait for his or her bottom to dry. This will help you bond with your baby and teach him/her a thing or two, while making the waiting period more fun and easier to pass.
About Dr. Kathleen Berchelmann, MD: She is a board-certified pediatrician, wife, and mother of seven children. She is frequently consulted regarding general pediatric issues and pediatric behavioral health issues. You can schedule a secure, live video consultation with her. She offers a free initial 10 minute consultation as well as insurance billed visits.
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