Just about every baby will get a nappy rash (or several) at some time in their nappy-wearing life, and a nappy rash can get worse very quickly if not treated. Many new parents don't know how to effectively treat a nappy rash as they have never had to do so before, so here is some information to help.
What causes a nappy rash?
Sensitive skin and something that triggers a rash are the 2 main causes of nappy rash.
Sensitive Skin
All babies have soft, delicate, sensitive skin but some skin is more sensitive than others. Babies with rashes on other parts of their bodies due to things like cradle cap or eczema, are more prone to nappy rash due to their sensitive nature, and this tendency is often inherited.
Chemicals in urine
A baby's skin doesn't like having urine (or faeces) in contact with it for too long. Urine can vary in pH due to stress such as teething or illnesses, and the chemicals in urine can change into ammonia which can burn skin.
Thrush (Candida Albacans)
Candida is a type of fungus naturally found in and on our body (such as the mouth, throat, bowel, vagina and skin), and thrush is Candida that grows out of control. In babies, thrush results because babies immune systems are not yet strong enough to control the growth of yeast. Sometimes the level of this yeast rises due to health problems like viral infections or taking certain medicines like antibiotics.
Chemical Exposure
Chemicals in nappy-soaking solutions, laundry detergents and fabric softeners can irritate skin. Some baby wipes can cause irritation if they contain alcohol or fragrances. Scented soaps or baby lotions can also irritate. Reynard make a great range of Reynard Dry Baby Wipes, made from cloth that when moistened with just water. make a great chemical free, scent free wipe
Plastic pants
Pants that prevent airflow to a baby's bottom keep baby's skin wet, and a humid environment is a perfect condition for starting a nappy rash.
Friction or rubbing
Rough or tight nappies can rub and chafe. Drying cloth nappies in the clothes dryer make them softer against baby's skin, and it's always good to size-up any nappy where feasible.
Symptoms
Red rash (inflamed skin around the genital area and anus looks red and moist)
Blistering (skin may blister and then peel, leaving raw patches called ulcers
Ulcers (raw patches of skin that are open to infection - these can sometimes form on healthy skin near the area of the rash
Prevention
The old saying "prevention is better than cure" rings true.
1. Be aware of the type of skin that your baby has, and choose products accordingly - experiment with different types of products to find the ones that are right for your baby
2. Change nappies often, don't leave them in a dirty nappy for longer than necessary. When changing, clean skin and dry properly before putting on a fresh nappy - don't rush and don't drag a wipe over the skin too harshly. If faeces is sticking to skin after using a wipe, use good old fashioned unscented soap and water (where possible) to loosen and remove. Dry, and if using a powder afterwards, use a talc-free powder, like Burt's Bees or Gaia.
3. Keep a nappy off for as long as possible to dry skin naturally. Try keeping bubs on a mat on the floor, or extend tummy time without a nappy
4. Watch for nappy rash at change time, especially if a baby is sick or stressed
Treatment
A tried and tested home treatment for nappy rash - at every nappy change where possible:
1. Bathe affected area in warm water with bicarbonate of soda (which creates an alkaline water bath, to neutralise skin)
2. Pat dry (don't rub)
3. If area is still moist, gently blow dry area with a hair dryer on cool or very low heat at a distance. Make sure skin is thoroughly dry.
4. Apply a barrier cream (zinc-based is good) to dry skin to stop future wetness sinking into affected area. Try Sudocrem, Bepanthen, Burt's Bees Baby Bee Diaper Ointment.
Note: Zinc based cream tends to leave stains on cloth nappies (and clothes), so users of cloth nappies often use disposable nappies while treating nappy rash.
5. If necessary, give pain relief, as nappy rash can be very painful for a baby.
If the rash doesn't go away, ulcers develop, or redness starts to spread, don't hesitate seeking the advice of a health care professional. There are many topical creams on the market that work very well for thrush and other skin infections, as well as steroid creams (anti-inflammatory). These would be applied on clean dry skin a few minutes before a barrier cream.
