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Annoys Babies, Concerns Parents

        It’s nearly universal. It’s persistent. Despite your best efforts it still occurs. Fortunately, you can overcome the majority of your child’s diaper rash incidents by following some basic steps and using a medicated cream.

        Almost every baby gets diaper rash at least once before he or she outgrows diapers. The first case can come as soon as the first month of life. While all babies are susceptible, those four to twelve months old, teething, starting solid food or taking antibiotics are especially vulnerable.

        When a diaper is left on too long, trapped moisture and friction from movement can irritate the skin, causing redness and inflammation in the diaper area. Once the skin is compromised, chemicals in your child’s urine and feces can cause further irritation.

        In reality, diaper rash is a complex of symptoms – redness, sores, dry or weeping areas – that can signal many different conditions from psoriasis to intertrigo.

        However, the most common type, a friction diaper rash, is an irritation caused by prolonged contact with urine and feces. In some cases it is accompanied by a secondary yeast infection called candida.

        Babies are born with soft, sensitive skin. This tender skin is dryer than adult skin because it has fewer glands to secrete oil.

        Unfortunately, many of the things parents do with good intentions – daily bathing, using lots of suds and wiping with moist towelettes – actually dry out the natural protection their babies’ skin needs.

        The result: The baby can’t produce enough oils to protect its skin, making it susceptible to diaper rash.

        Skin – including your baby’s tender skin – is quite strong. But here’s how a diaper rash, technically diaper dermatitis, breaks it down.

        Urinary wetness increases skin friction, raises the skin pH, makes the skin less cohesive, and makes it more permeable. These effects combine to intensify the action of stool enzymes or other irritants that then inflame the skin.

        When the outermost layer of skin has been damaged, it is easy for microorganisms such as yeast or bacteria to invade the inflamed skin.

        In addition to enhancing the activity of other irritants, urine acts as a direct irritant. When the skin is moist it is also more conducive to bacterial growth.

        Yeast is by far the most common type of organism found in a diaper rash. Yeast involvement should be suspected in any diaper rash that has not improved dramatically with 72 hours of appropriate therapy.

        Current or recent antibiotic use makes a yeast infection even more likely, since this reduces the amount of the skin's 'good' bacteria that fight infection.

Healthy skin is clean, dry skin. As long as your baby is in a diaper, maintaining clean, dry skin is a challenge.

Following these steps can help:

• Change diapers as soon as they are soiled. If your child is in daycare, remind the staff to do the same.
• Always wipe from front to back. Water is all you need to wash the area.
• Pay special attention to skin folds and creases, make sure they are thoroughly rinsed and dried.
• Pat your baby dry with a clean towel.
• Whenever possible, let your baby go bare-bottomed. Exposing skin to air is a natural and gentle way to let it dry.
• Give your baby’s bottom a little breathing room. Consider using a larger-sized diaper until the rash goes away.
• At the first sign of redness apply a diaper rash cream. Continue to apply at each diaper change until the rash is cleared.
• After changing diapers, wash your hands well.

    Just as important as the actions you take are the actions and products you avoid.

Here are some useful tips:

• Use plain water instead of diaper wipes.
• Use a mild soap only when necessary (e.g., diarrhea that won’t come clean with water). Even mild soaps remove natural oils that protect your baby’s skin.
• Don’t scrub your baby’s bottom. Scrubbing can lead to further skin breakdown.
• Don’t dry your baby with a blow dryer. Hot air from a blow dryer can cause skin to shrink and crack.
• Avoid diapers with elastic bands. Also avoid using plastic pants when a rash is present.
• Skip the powder. Once it becomes wet, powder is useless for reducing the friction between your baby’s skin and the diaper. (And it’s possible your baby will inhale large amounts of powder, which could be dangerous.)

        If you follow the above guidelines and the rash persists or worsens, call your doctor. Your healthcare provider is the best source for the continuing health of your baby. Also contact them whenever these situations occur:

• A mild diaper rash turns the baby’s skin slightly red and spotty. As it becomes worse, the redness becomes brighter and tiny blisters might develop. The blisters can grow, blending together, to eventually form a crust on your baby’s skin. A weeping, crusty rash might indicate a bacterial or yeast infection and should be treated by your doctor.
• If your baby’s diaper rash does not improve after three days of treatment, see your doctor – the problem may be caused by another skin disorder. In some cases, a very short course of topical corticosteroids is prescribed.
• Have your child examined if the diaper rash occurs along with a fever, blisters, boils or draining pus.

These might signal a secondary infection that requires further treatment.

        Some parents worry about what kind of diapers to use. Neither cloth nor disposable diapers are more likely to cause diaper rash in most cases. Both cloth and disposable diapers inhibit evaporation of moisture from the surface of the skin, creating the environment for a rash.

        When using cloth diapers, make sure any detergent residues are rinsed away. Otherwise, these chemicals or fragrances can irritate your baby’s skin either causing a rash or making an existing rash or infection worse.

        As always, the best medicine is prevention. By following the proven guidelines presented in this brochure you will practice good skin care for your baby. This will help you avoid many cases of diaper rash.

        Despite your efforts, there may still be times when a diaper rash occurs. Using a medicated diaper rash cream can soothe your child during these occurrences.

        You don’t have to wait until a diaper rash develops to use a diaper rash cream. Some products can prevent a rash by creating a protective barrier on the skin to help seal out wetness and irritants.

        These creams have proven so effective in treating diaper rash that studies show 92% of babies experience noticeable relief within twenty-four hours, and 68% experienced relief within ten hours.

        For best results apply with each diaper change, especially at bedtime and anytime when exposure to wet diapers is prolonged.

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