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Diaper rash

Diaper rash is a common form of inflamed skin (dermatitis) that appears as a patchwork of bright red skin on your baby's bottom.

Diaper rash is commonly linked to continuously wet or infrequently changed diapers, diarrhea, and using plastic pants to cover diapers. Diaper rash also may develop after solid foods are added to your baby's diet, when breast-feeding mothers eat certain foods or when your baby is taking antibiotics.

Diaper rash can alarm parents and annoy babies, but most diaper rash cases can be resolved with simple at-home treatments.

Symptoms Causes Prevention

Diaper rash is characterized by the following:

  • Skin signs. Diaper rash is marked by red, puffy and tender-looking skin in the diaper region — buttocks, thighs and genitals.
  • Changes in your baby's disposition. You may notice your baby seems more uncomfortable than usual, especially during diaper changes. A baby with a diaper rash often fusses or cries when the diaper area is washed or touched.

Diaper rashes can occur intermittently, anytime your child wears diapers, but they're more common in babies during their first 15 months, especially between 9 and 12 months of age.

When to see a doctor

Diaper rash is usually easily treated and improves within a few days after starting home treatment. If your baby's skin doesn't improve after a few days of home treatment with over-the-counter ointment and more frequent diaper changes, talk to your doctor. Sometimes, diaper rash leads to secondary infections that may require prescription medications.

Have your child examined if:

  • The rash is severe
  • The rash worsens despite home treatment

Also see your child's doctor if the rash occurs along with any of the following:

  • Fever
  • Blisters or boils
  • A rash that extends beyond the diaper area
  • Pus or weeping discharge
  • Unusual sleepiness

Causes of diaper rash can be traced to a number of sources, including:

  • Irritation from stool and urine. Prolonged exposure to urine or feces can irritate a baby's sensitive skin. Your baby may be more prone to diaper rash if he or she is experiencing frequent bowel movements because feces are more irritating than urine.
  • Introduction of new foods. As babies start to eat solid foods, the content of their stool changes, increasing the likelihood of diaper rash. Changes in your baby's diet can also increase the frequency of stools, which can lead to diaper rash. If your baby is breast-feeding, your baby may develop diaper rash in response to something the mother has eaten.
  • Irritation from a new product. Disposable wipes, a new brand of disposable diapers, or a detergent, bleach or fabric softener used to launder cloth diapers can all irritate your baby's delicate bottom. Other substances that can add to the problem include ingredients found in some baby lotions, powders and oils.
  • Bacterial or yeast (fungal) infection. What begins as a simple skin infection may spread to the surrounding region. The area covered by a diaper — buttocks, thighs and genitals — is especially vulnerable because it's warm and moist, making a perfect breeding ground for bacteria and yeast. These rashes can be found within the creases of the skin, and there may be red dots scattered around the creases.
  • Sensitive skin. Babies with skin conditions, such as atopic dermatitis or eczema, may be more likely to develop diaper rashes. However, the irritated skin of atopic dermatitis and eczema primarily affects areas other than the diaper area.
  • Chafing or rubbing. Tightfitting diapers or clothing that rubs against the skin can lead to a rash.
  • Use of antibiotics. Antibiotics kill bacteria — the good kinds as well as the bad. When a baby takes antibiotics, bacteria that keep yeast growth in check may be depleted, resulting in diaper rash due to yeast infection. Babies whose breast-feeding mothers are on antibiotics are also vulnerable.

A few simple strategies can help decrease the likelihood of diaper rash developing on your baby's skin:

  • Change diapers often. Remove dirty diapers promptly. If your child is in child care, ask staff members to do the same.
  • Rinse your baby's bottom with water as part of each diaper change. You can use a sink, tub or water bottle for this purpose. Moist washcloths and cotton balls also can aid in cleaning the skin. Don't use wipes that contain alcohol or fragrance.
  • Pat your baby dry with a clean towel. Don't scrub your baby's bottom. Scrubbing can further irritate the skin.
  • Don't overtighten diapers. Diapers that are too tight prevent airflow into the diaper region, setting up a moist environment favorable to diaper rashes. Tightfitting diapers can also cause chafing at the waist or thighs.
  • Give your baby's bottom more time without a diaper. When possible, let your baby go without a diaper. Exposing skin to air is a natural and gentle way to let it dry. To avoid messy accidents, try laying your baby on a large towel and engage in some playtime while he or she is bare-bottomed.
  • Wash cloth diapers carefully. Pre-soak heavily soiled cloth diapers and use hot water to wash them. Use a mild detergent and skip the fabric softeners and dryer sheets because they can contain fragrances that may irritate your baby's skin. Double rinse your baby's diapers if your child already has a diaper rash or is prone to developing diaper rash. If you use a diaper service to clean your baby's diapers, make sure the diaper service takes these steps as well.
  • Consider using ointment regularly. If your baby gets rashes often, apply a barrier ointment during each diaper change to prevent skin irritation. Petroleum jelly and zinc oxide are the time-proven ingredients included in many prepared diaper ointments. Using these products on clear skin helps keep it in good condition.
  • After changing diapers, wash your hands well. Hand washing can prevent the spread of bacteria or yeast to other parts of your baby's body, to you or to other children.

Cloth or disposable diapers?

Many parents wonder about what kind of diapers to use. When it comes to preventing diaper rash, there's no compelling evidence that cloth diapers are better than disposable diapers or vice versa, though disposables may keep baby's skin slightly drier. Because there's no one best diaper — use whatever works best for you and your baby. If one brand of disposable diaper irritates your baby's skin, try another.

Whether you use cloth diapers, disposables or both kinds, always change your baby as soon as possible after he or she soils the diaper to keep the bottom as clean and dry as possible.

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