If your child's diaper area looks irritated and red, chances are it's diaper rash. The skin may also be a little puffy and warm when you touch it. Diaper rash can be mild – a few prickly red spots in a small area – or extensive, with tender red bumps that spread to your child's tummy and thighs.
Diaper rash doesn't mark you as a negligent parent. Dealing with diaper rash is part and parcel of childcare, especially in the first year or so of your child's life.
How did my child get diaper rash?
Diaper rash can be caused by anything from a new food to your child's own urine. Here are the most likely culprits:
Wetness. Even the most absorbent diaper leaves some moisture on your child's skin. And when your child's urine mixes with bacteria from his stool, it breaks down and forms ammonia, which can be very harsh. That's why children with frequent bowel movements or diarrhea are more prone to diaper rash.
Although a child left in a dirty diaper for too long is more likely to develop diaper rash, any child with sensitive skin can get a rash, even if his parents are diligent diaper changers.
Chafing or chemical sensitivity. Your child's diaper rash may be the result of his diaper rubbing against his skin, especially if he's particularly sensitive to chemicals like the fragrances in a disposable diaper or the detergents used to wash a cloth diaper. It could also be that a lotion or powder you're using at diaper time doesn't agree with your child's skin.
New foods. It's common for children to get diaper rash when they start eating solid foods or are introduced to a new food. Any new food changes the composition of the stool. (The acids in certain foods, such as strawberries and fruit juices, can be especially troublesome for some kids.) A new food might increase the frequency of your child's bowel movements as well. If you're breastfeeding, your child's skin could even be reacting to something you're eating.
Infection. The diaper area is warm and moist — just the way bacteria and yeast like it. So it's easy for a bacterial or yeast infection to flourish there and cause a rash, especially in the cracks and folds of your child's skin. (Thrush is a type of oral yeast infection. Some children with thrush develop a yeast infection in their diaper area, too.)
Antibiotics. Children on antibiotics (or whose breastfeeding mothers are on antibiotics) sometimes get yeast infections because these drugs reduce the number of healthy bacteria that help keep yeast in check as well as the harmful bacteria they're meant to destroy. Antibiotics can also cause diarrhea, which can contribute to diaper rash.
Should I take my child to the doctor for a diaper rash?
It's probably not necessary. With some diligence, you should be able to clear your child's rash in three or four days without a visit to the doctor.
Do call the doctor if the rash looks as though it may be infected. (Signs of infection include blisters, pus-filled pimples, oozing yellow patches, or open sores.) The doctor may prescribe a topical or oral antibiotic for your child.
For a diaper rash caused by a yeast infection, he may recommend an over-the-counter or prescription anti-fungal cream.
Also call the doctor if your child develops a fever or her rash doesn't go away after several days of home treatment.
What's the best way to treat diaper rash?
Take these steps to heal your child's skin when you see a diaper rash:
- Keep your child clean and dry by changing his diaper frequently. That may mean getting him up at night for a diaper change
- Rinse his diaper area well at each diaper change. Don't use wipes that contain alcohol or fragrance. Some parents keep cotton balls and a squirt bottle or an insulated container of warm water at the changing table for easy, gentle cleanups.
- Pat your child's skin dry — don't rub!
- Use an ointment that forms a protective barrier on the skin after every diaper change to help protect your child's irritated skin from stool and urine. There are several good barrier ointments on the market, including petroleum ointment or petroleum jelly, nonpetroleum jelly, lanolin products, and white zinc oxide.
- Put your child's diaper on loosely or use a diaper that's a little big on him to allow for better air circulation. If you buy disposables, try a different brand to see if that helps.There are varieties for sensitive skin, for example, and extra-absorbent options will pull more moisture away from your child's skin.
- When the weather is warm and your child can play outside or in a room with a floor that's easy to clean, leave his diaper (and ointment) off for as long as possible every day. Exposure to the air will speed healing.
- Consider letting your child sleep with a bare bottom whenever he has a rash. A plastic sheet under the cloth one will help protect the mattress.
How can I prevent diaper rash?
Here are some good preventive measures:
Q) Parents: What are your diaper rash tips?
- The best defense against diaper rash is a dry bottom, so change your child's diaper frequently or as soon as possible after it becomes wet or soiled.
- Clean your child's genital area thoroughly with each diaper change.
- Pat her skin dry — never rub it. You might also try drying the diaper area after a diaper change with a hair dryer set on low.
- If your child seems prone to diaper rash, coat her bottom with a thin layer of protective ointment after each diaper change.
- Skip the talcum powder, as the dust is harmful to your child's lungs. If you want to use powder, choose one that's made from cornstarch. Shake the powder into your hand, away from your child – never directly on or near her — and keep the container well out of her reach at all times. At every diaper change, carefully wash away any powder that accumulates in the folds of your child's skin.
- When your child starts eating solid foods, introduce one item at a time. Waiting a few days between each introduction will make it easier to determine whether sensitivity to the food causes a diaper rash. If it does, you can eliminate that food for the time being.
- Don't secure the diaper so tightly that there's no room for air to circulate. Dress your child in loose clothing.
- Don't wash cloth diapers with detergents that contain fragrances, and skip the fabric softener. Both can irritate your child's skin. Use hot water and double rinse your child's diapers. You might also add half a cup of vinegar to the first rinse to eliminate alkaline irritants.
- Breastfeed your child for as long as you can. Breastfeeding boosts your child's resistance to infections in general and makes her less likely to need antibiotics, which can contribute to diaper rash.
- When your child does need to take an antibiotic, ask the doctor about giving her a probiotic as well. Probiotics encourage the growth of healthy bacteria in the gut, which may reduce your child's chances of getting a diaper rash.
- If your child goes to daycare or preschool, make sure that her caregivers understand the importance of taking these measures to prevent diaper rash.