Diaper Rash

New parents may be weary of the idea of diaper rashes, but at times they are inevitable so it is best to understand how to prevent them and then how to treat them.  A diaper rash is a common form of inflamed skin, known as dermatitis, which may appear as a patchwork of bright red skin on a baby’s bottom or genital area.  It usually occurs when a diaper is continuously wet or unchanged; a child has diarrhea or any other condition requiring constant diaper changing. Another cause may be when a child newly begins eating solid foods or if a mother (or nursemaid) who is taking antibiotics is breastfeeding. Sometimes it may be confusing to accurately know if a child has a diaper rash, but common characteristics are skin signs and changes in a baby’s temperament. These rashes are noticeable by red, puffy and tender-looking skin on the buttocks, thighs and/or genitals. The baby may appear more uncomfortable than usual and may cry or fuss when their diaper area is irritated.

Parents or guardians should take the child to see a physician if the rash appears severe, reoccurs even with home remedies and adequate treatment. Symptoms of severe illness will include:

  • Fever
  • Blisters
  • Boils
  • Rash extending beyond buttocks, genitals or thighs
  • Unusual fatigue, weakness or sleepiness.

When a child is taken to the physician, the common causes which will be a part of the differential diagnosis are:

  • Prolonged irritation by fecal matters or urine
  • When a baby starts new foods, i.e. solid
  • A new baby product is presented to the baby
  • Infection caused by bacteria, yeast, or fungus
  • Skin which is hypersensitive – atopic dermatitis, eczema
  • Diapers which fit too tight
  • Maternal antibiotic use.

The best course of treatment for a child is to keep the skin clean and dry, but if management is absolutely necessary, then:

  • Hydrocortisone cream – for itchiness or redness
  • Antifungal cream – for fungal root cause
  • Topical or oral antibiotics – bacterial root cause.

Only utilize these options if they are approved by the pediatrician and prescribed. At home remedies should only be over-the-counter ointment creams:

  • vitamin A,
  • vitamin D,
  • balmex,
  • desitin,
  • triple paste,
  • zinc oxide paste
    • active ingredient in many diaper rash creams.

However, strong steroids should be avoided because improper use of medications may lead to additional problems. All creams should be applied in thick layer. Products which should be avoided in babies are:

  • boric acid
  • camphor
  • phenol
  • benzocaine
  • salicylates,

because each of these may be toxic to a baby.

As a precaution, increasing airflow to the baby’s diaper area is very helpful. Allowing your child to go without a diaper for short periods of time is supportive. Avoiding plastic diapers as well as tightfitting ones, while using loose fitting or large diapers is clever. Furthermore, these are some preventive measures:

  • Regularly change diapers even if the baby does not show any signs or symptoms of needing a diaper change.
  • Rinse baby’s bottom with water as well as a wipe when changing the diaper.
  • Make sure the baby’s bottom, thigh and genital area are completely dry before placing on a new diaper.
  • Do not overtighten.
  • Give baby some air time without a diaper.
  • Pre-soak heavily soiled cloth diapers and wash with hot water.
  • Regularly use ointment.
  • Wash your hands thoroughly after changing a diaper.

In terms of type of diaper, there is no evidence one way or the other in terms of which prevents rashes. Nonetheless, each baby is different and parent’s should try different diaper types if one does not suit their child. If you reside in Denver, then you can visit the Denver Holistic Center for more information.