At some time, almost all babies develop diaper rash, which is confined to the skin covered by a diaper. The affected area is dotted with small, pimple-like bumps that may become scaly or crusty. Sometimes the sores ooze and have an unpleasant odor. Most diaper rash is caused by a yeast or bacterial infection. These organisms thrive in a moist, warm environment, which is enhanced by infrequent changing and/or wearing rubber pants or plastic coated diapers. Diaper rash is most common between the ages of six and nine months. Some babies seem to be more vulnerable than others, but those who are breast-fed are less prone to the condition. Diarrhea and the administering of antibiotics increase susceptibility. Other contributing factors include friction, introduction of new foods, and skin contact with stale urine, detergent residue in cloth diapers, and chemicals used in some disposable products.
Diagnostic Studies And Procedures
Most parents can readily recognize a diaper rash by its characteristic appearance and its confinement to the but tocks and genital area; there is usually little or none in the skin creases. In some cases, however, the rash may develop into a more severe infection; the baby should be taken to a doctor if the area is unusually red and inflamed, if pus filled sores develop, or if there are other symptoms, such as a fever, diarrhea, and listlessness.
Ordinary diaper rash does not require medical treatment. If it does not clear up in two or three days of home care, however, a doctor may prescribe a medicated ointment.
Aloe gel applied to the diaper area is said to speed healing, especially if crusty sores develop. Herbalists also suggest comforter ointment. In stubborn cases, applying a poultice made of powdered comfrey root might help. Using arrowroot powder instead of ordinary baby powder may promote healing of skin sores.
Frequent changing is the first step in treating diaper rash and preventing recurrences. However, there is no clear agreement on whether cloth or disposable diapers are better when it comes to preventing the condition. At least two medical studies have found that super absorbent disposable diapers, which contain a gelling material, keep the skin drier and afford greater protection against rash than cloth and regular disposable diapers. On the other hand, between cloth and conventional disposable diapers, cloth keeps the baby drier, especially if it contains an inner layer of nonwoven fabric. If your baby often develops diaper rash, despite frequent changing, experiment with different types of diapers. If you do use cloth diapers, make sure that they are properly washed and sterilized. Commercial diaper services can usually be trusted to do this adequately. If you wash your own, use hot water and a mild laundry soap. Rinse the diapers, then put them through another wash cycle with a half cup of chlorine bleach to sterilize them. Add an ounce of white vinegar per gallon of water to the final rinse cycle. This rinse will help later to neutralize the ammonia in the baby’s urine.
Home care clears up most diaper rash in two or three days. Here are tactics that usually help.
- Leave off the diaper as much as possible. Exposing the skin to the air and preventing contact with urine and feces speeds healing. To minimize mess, place the baby on a rubber mat that is covered with a sheet or towel.
- Change the baby as soon as possible after bowel movements any prolonged skin contact with feces worsens diaper rash, and can cause blistering and infection.
- When changing the baby, wash the area with plain water and a mild soap. Don’t use commercial diaper wipes; these contain alcohol and other chemicals that may irritate the baby’s skin. After washing, pat the skin dry before diapering. Alternatively, use a hair drier set on low.
- Before putting on a fresh diaper, you may, as some dermatologists suggest, apply a mild vinegar solution to the baby’s bottom. Use one part vinegar to eight parts water, and gently wipe it on the skin after washing. To avoid moisture buildup, allow the skin to dry thoroughly before diapering.
- To make the baby more comfortable, apply corn starch or a commercial baby powder containing corn starch. Pour a little into your hand and then spread it on the baby’s bottom; you and your baby will inhale less of the powder when it is applied this way, than if it is sprinkled directly onto the skin. Avoid talcum powders; they can cause lung damage if inhaled.
- To speed healing, try applying vitamin E oil directly to the skin. Skin creams or ointments should not be used until the rash clears up, however, because these can slow healing. When the rash is gone, products that contain zinc oxide or petroleum jelly can be used to protect the skin from a recurrence. These ointments tend to adhere to the skin; to remove them, use a cotton ball dipped in baby oil.
- Don’t use plastic pants, which keep moisture in. Also avoid the use of thick, bulky diapers or wrapping the material too tightly. The diaper should be loose enough to let in some air.
Other Causes of Infant Rashes
In unusual cases, a rash in the diaper area may be a manifestation of a more general skin disease, such as infantile psoriasis or seborrheic eczema. In such cases, the baby is likely to have rashes on other parts of the body.