Diaper Rash: How to Keep Your Baby's Bottom Irritation Free
  Contributed by: Corey McLain, Pharm.D. Candidate
                        KU School of Pharmacy

What is Diaper Dermatitis?
Diaper Dermatitis, or diaper rash, is an inflammatory process that affects the skin around the diaper area.  When infants experience diaper rash, their skin becomes red, irritated, and inflamed.  In severe cases, diaper rash may lead to skin infections.  While diaper rash mainly affects infants and children, it can also affect adults. 

What causes diaper rash?
Diaper rash is caused by a combination of factors.  After birth, a baby's skin is exposed to may chemicals and irritants.  The following list of factors can contribute to diaper rash.

  • Covered skin
  • Moisture
  • Irritating chemical exposure to urine and stool
  • Friction and chafing
  • Bacteria and yeast

How can it be avoided?
Unfortunately, diaper rash is common.  Children can start to experience signs and symptoms of diaper rash within the first week of life.  Almost every child will experience a diaper rash at some point, and most will get diaper rash multiple times. 

Although diaper rash is normal, you can take steps to minimize and possibly avoid diaper rash in your child. 
  • Change diapers frequently.  The diaper needs be changed shortly after it is soiled.  Newborns soil their diaper every 2 hours.  Unfortunately, that means the diaper needs to be changed every 2 hours.  As your baby grows, they are able to hold urine and stool longer.
  • Clean your baby's bottom and groin during each diaper change to reduce the skin's exposure to moisture and irritating chemicals.  Be sure to allow the skin to dry before applying ointment or putting on a new diaper.

  • Use diaper rash ointments to protect the skin.  A list of products is found later in this article.
  • Avoid plastic diaper coverings and plastic pants.  These coverings can increase the temperature of the skin around the diaper area and prevent moisture escape.

If your child has frequent diaper rash, there are additional factors to consider:
  • Try a new brand of diaper and check the size.  Some diapers may chafe or may be too small for your baby.  Each brand of diaper fits a little different.  Changing the brand or size of the diaper may alleviate the friction and chafing that could cause diaper rash. 
  • Try different diaper wipes.  Some babies have skin that is sensitive to certain brands of wipes.  Unscented, plain, and sensitive wipes tend to be less irritating to the skin.  Alternatively, you could try to clean your baby using warm water with a little mild soap.
  • Keep a log book to record the type of food that your baby eats and when they develop diaper rash.  Sometimes diaper rash can be caused by stools after eating specific foods.
  • Consider increasing the amount of time that your baby is diaper-free.  Allowing your baby to have exposed skin will permit the skin to dry.  One possibility is to allow your baby to sleep on an open diaper cloth during naps.  The diaper cloth will protect the mattress and the skin will be exposed to air.

What types of products are available for diaper rash?
There are many products that can be used to help ease the discomfort of diaper rash. 
  • Products that contain zinc oxide: Desitin Ointment

  • Products that contain petroleum: Vaseline Ointment or Aquaphor Baby Healing Ointment
  • Combination products: Triple Paste Medicated Ointment or Boudreaux's Butt Paste
  • There are many additional products, such as Calmoseptine.  Talk to your pharmacist for additional options.

When should I talk to my Physician?
In most circumstances, diaper rash does not cause serious illness to children.  However, the following circumstances are instances when you should consult your doctor.
  • Occurs in the first 1-2 months of life
  • The skin looks infected (warm, painful, inflamed, pus, etc)
  • The skin has pimples or ulcers
  • The skin creases look worse than the rest of the area
  • Fever
  • Baby is not eating well and losing weight
  • Large bumps appear
  • Rash spreads to other areas or includes the head or arms
  • No improvement after treating for 3 to 5 days

The treatment of diaper rash is very similar to the methods of avoiding diaper rash.  For more information, check out this website: http://familydoctor.org/051.xml.

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