Diaper Rash

Causes

A diaper rash forms when a baby’s skin is irritated. It can be caused by:

• Leaving dirty diapers on for too long
• Too much moisture next to the skin
• Diapers or plastic pants that are too tight
• Allergic reaction to diaper or detergent
• Yeast or bacterial infection
• Rubbing or chafing the skin
• Diarrhea

Risk Factors

Things that may raise a baby's chance of diaper rash include:

• Frequent stools
• Not changing the baby’s diaper often enough
• Taking antibiotics—could be the baby or a nursing mother
• Sensitive skin
• Poorly fitting diapers or plastic pants

Symptoms

The main symptoms of diaper rash are:

• Skin changes under the diaper:
  • Bumps
  • Redness
  • Scaly patches
  • Blister-like spots or sores
• Baby is more upset or fussy when their diaper is changed

If the rash is not treated, it can get infected. It can become bright red with red bumps and blisters.

Symptoms of an infected rash may include:

• Open sores, boils, or pus
• The baby is not sleeping or eating normally
• The baby has a fever
• The rash gets worse or does not get better in two or three days

Call the baby's doctor if there are signs of an infected rash.

Diagnosis

Most parents know a diaper rash when they see it. The baby does not need to see their doctor for a mild diaper rash.

Treatment

Diaper rashes often clear up in three to four days with these steps:

• Change diapers often.
• Use water and a clean washcloth or baby wipes to rinse the baby’s skin. Do not rub.
• Pat dry gently. Rubbing can bother the rash.
• Apply a thick layer of protective ointment to the diaper area. Examples include petroleum jelly, bag balm, or zinc oxide ointment.
• Expose the baby’s skin to the air as much as possible. Keep the baby diaper free when possible.
• Do not use talcum or cornstarch powders.
• Do no use creams that have:
  • Boric acid
  • Camphor
  • Phenol
  • Methyl salicylate
  • A compound of benzoin tincture

If the rash is severe, take the baby to their doctor. The doctor may suggest using a mild hydrocortisone cream to calm the skin.

If the rash is yeast-related, then the doctor may advise a medicine to put on it.

Antibiotic ointments may be used for mild bacterial infections. These creams are found in drug stores, but the baby's doctor may want to discuss these options before starting treatment.

Severe infections may need oral antibiotics.

Prevention

To help reduce a baby's chance of diaper rash:

• Change the baby’s diaper often.
• Use water and a clean washcloth or baby wipes to rinse the baby’s skin.
• Dry the diaper area well after changing. Let the area air out.
• Let the baby go without a diaper when possible.
• Avoid using fabric softeners when washing cloth diapers.
• Use cloth diapers or very absorbent disposable diapers to prevent irritation.
• If the baby is taking antibiotics, ask their doctor about giving the baby probiotics at the same time.