I have been thinking about doing this post for a while now. With a daughter who has extremely sensitive skin, we struggle with diaper rash. Dealing with this and being a nurse who frequently deals with diaper rash at work, I have come up with some great ways to help both prevent and treat diaper rash. How fitting then when my Nursing for Women’s Health magazine came in the mail this month with information and CEUs for preventing and treating diaper rash!
What is diaper rash and how does it happen?
Most babies have diaper rash at some time, but it is most prevalent between 9 and 12 months. Diaper rash is a red blotchy bottom that can have many causes. Thankfully diaper rash is rarely serious and when treated early can clear up in 3-4 days, but if it is left untreated, it can become more and more painful, leading to skin breakdown, skin infections, and very fussy babies.
There are 3 different kinds of diaper rash.
- Chafing Dermatitis: This is caused by the diaper irritating the baby’s skin, usually around the legs or bottom. This is the most common and the easiest to treat.
- Irritant Contact Dermatitis: This is a reaction to something that the baby’s skin is in contact with. It can be the diapers, wipes, stool, urine or anything else you may be using on her skin. Even products that are made for babies can cause this reaction.
- Diaper candidiasis (yeast infection): This is a bright red rash with pinpoint bumps that may eventually develop yellow blister-like bumps. If you think your baby has this type of rash, she needs treatment, you should see your baby’s pediatrician.
Preventing Diaper Rash
The best thing you can do is to prevent diaper rash before it happens. Thankfully, there are a lot of things you can do.
- Wash your hands. You should wash your hands before and after every diaper change.
- Change the diaper. As soon as the diaper is wet or soiled, change it (about every 1-3 hours during the day). I completely understand that this is not always possible if you are traveling or if your baby is sleeping, but when you are at home and able to, change the diaper as often as needed. If your baby is still waking up in the night, make sure you change her diaper every time.
- Clean gently. Cleaning with warm water and a soft cloth is sufficient enough, but using wipes is fine as well. Try not to rub the skin too much, again I know this can’t always be the case.
- Clean from front to back, especially for little girls.
- Allow to air dry. Giving her bottom a chance to air dry is the best thing you can do to keep from holding moisture against her skin.
- Use barrier cream. If you know you will not be able to change her diaper, you can use barrier creams such as A&D or Aquaphor, which will keep any stool or urine off her sensitive skin. I do this every night right before bed with a clean diaper.
- Coconut oil. For all you crunchy moms out there (and even the not so crunchy moms) you can use coconut oil. There are so many uses and benefits to using coconut oil, but it is one of my favorite go-tos for preventing and treating diaper rash. (The benefits and uses of coconut oil is a whole other post on its own, one day.)
- Breastfeeding. Breast milk lowers the pH of stool so it is less irritating to the skin.
It doesn’t matter if you use cloth diapers or disposable, whatever your choice, look for these features to help prevent diaper rash:
- Soft and breathable cover or outer shell.
- Absorbent to pull moisture away from baby’s skin.
- For newborns, a way to keep the diaper away from the umbilical cord, such as a notched or foldable top.
- Stretchy fabric that gathers at the waist, sides and legs as a leakguard.
- Made for sensitive skin, so it should be fragrance-free and chlorine-free.
- Fasteners that are easily adjustable.
Treating diaper rash
Even if you do everything you can to prevent diaper rash, your little one may still end up with an irritated bottom, but you can easily treat it, if you start at the first sign of a rash.
- For slightly red skin, you can use A&D or Aquaphor. Personally I love aquaphor! You can also use a zinc oxide cream such as Desitin or Butt Paste, but I personally do not like these as well because you have to wipe more to get them off. You want to do this with every diaper change until the rash is gone.
- Leave her diaper off. Air is the best treatment for diaper rash, so if you can, leave her diaper off as long as you can. For little ones who are not moving yet this is easier, you can just place a cloth diaper or towel under her and lay her down. For older ones who are moving it is a little trickier. For my daughter, I set her on her potty chair, this way her bottom is exposed to the air, and if she pees it is in the potty, it’s a win-win!
- Try changing the diapers, wipes or cream you are using. It took a lot of trial and error with us to find diapers and wipes that worked for my daughter (remember I said she had sensitive skin?). After some time we discovered that we have to use either Pampers Swaddlers or Cruisers and Pampers sensitive wipes. We also learned that my daughters rashes strangely worsened when using desitin.
- For really stubborn diaper rash, you can mix up Aquaphor and Milk of Magnesia. I warm up the aquaphor a little bit, just enough to soften it, not to melt it, and mix in the Milk of Magnesia. I don’t have a specific ratio, but this just makes it easier to get the MoM on, if you want you can try taking a cotton ball and just patting it on baby’s bottom. Again, you want to do this with every diaper change until the rash is gone.
- I would give a couple of days to see if each of these works, unless the rash is getting visibly worse. If the rash is staying the same, you may want to change approaches. If after trying all of this the rash doesn’t get better, or the rash continues to get worse, your baby may need more intense treatment and you should make an appointment with your pediatrician.
Has your little one every had diaper rash? What did you do to treat it? How do you prevent diaper rash?
As always, feel free to ask questions if you have any!
Resource: Nursing for Women’s Health Volume 19, Issue 4 “Parent Pages Diaper Rash”