Many diaper rashes are normal. This is not a statement of infant heresy, but a simple fact. Many babies develop angry red areas of skin under their nappies, which usually cause more concern to the mother than the child. There are other rashes that should not be present and require medical treatment. It is far better to prevent these rashes than to later find it necessary to take aggressive treatment measures.
Prevention involves changing wet nappies as soon as possible, and avoiding, when practical, the use of pilchers or plastic overpants. Many mothers and babycuddling friends will know how impractical the latter can be at times.
Diaper liners can protect the skin and should be used routinely with cloth nappies. When nappies are washed, rinse them thoroughly afterwards to remove chemicals and detergents. When bathing the infant, use a small amount of the mildest soap possible (as soap can remove the protective oils that coat an infant’s skin), and apply zinc cream, lanolin or petroleum jelly to the bottom afterwards.
Despite all these precautions, many mothers still present to a doctor’s surgery with a happy baby who has a diaper rash. This does NOT mean that these women are poor mothers – in most cases it is merely the excess sensitivity of their child’s skin. Diaper rashes are generally due to wetness.
Sweat can play a part as well as urine, so it is important not to overdress the child, particularly in summer. It is not unusual to see a baby with a diaper liner, diaper, pilchers, pants and jumpsuit covering its overheated lower half. Rough textured nappies are also a problem, and diaper liners or disposable nappies can overcome this, as can the correct selection of material when making nappies.
Diaper rashes that require medical treatment are usually due to infection or oversensitive skin. The most common infection is fungal, and may be called tinea, thrush or monilia. This may appear first in the mouth, before migration through the gut to cause problems around the anus. This type of rash often avoids the deep creases of the bottom, has a bright red edge with a paler center, and there may be small spots beyond the edge of the main rash. It is treated by anti-fungal creams for the bottom, and anti-fungal drops or paint for the mouth.
Babies who may develop eczema later in life, have more sensitive skin than normal, and this may cause angry red rashes in the fold lines. These may require a mild steroid cream to clear them. Other nasty types of diaper rash, such as bacterial infections, are uncommon. Most can be treated, controlled and prevented by the mother with some advice from her general practitioner.
All diaper rashes are aggravated by urine, and it is often worth while to allow the baby to lie without a diaper on, but with a diaper or two underneath it in the cot to catch any accidents. Overbathing may also aggravate diaper rashes, and it may help to bathe only every second day, wiping dirty areas with a damp cloth (without soap) at other times.
Creams and ointments from chemists can be used on mild rashes, but ensure that the preparation is designed for this purpose, as some treatments not specifically designed for babies’ bottoms may aggravate the rash.
A diaper rash is not a reflection on the mother or a sign of neglect. If the rash does not settle after simple remedies, it is sensible to be reassured by your doctor that it is not one of the more serious forms that requires specific treatment.
