How to Prevent and Treat Diaper Rashes
Understanding Diaper Rashes:
It is a common misconception that most diaper rashes are precipitated by leaving a baby in wet diapers. Diaper rashes are usually not caused
by urine, or leaving a baby in wet diapers. They are caused by contact with stool.
Our digestive tract generates enzymes designed to breakdown protein. Baby stool can contain significant concentrations of these
enzymes. These enzymes can quickly breakdown the proteins in skin, starting a rash. Stool also contains other irritants. This is why it is
so important to change a diaper dirtied by stool AS SOON AS POSSIBLE.
Once a diaper rash has taken hold and skin has broken down, it is difficult to heal. Wet diapers WILL prolong the rash. The wet environment inside a
diaper is conducive to the growth of yeast and bacteria which can quickly infect the skin – delaying healing and making the rash worsen.
Frequent stools can continue to breakdown the skin around the diaper area. Healing an existing rash requires that you keep the baby’s bottom
as dry as possible, minimize further contact with stool, and treat infection.
The most common skin infection in diaper rashes is a yeast infection. Our skin is colonized with yeast called candida albicans. This
organism usually lives on the surface of our skin without causing any problems. However, if skin breaks down, candida can gain entry and start
an infection. Yeast will thrive in a wet environment with a basic pH (the usual environment of a wet bottom). 80% of all diaper rashes have a
fungal or yeast component.
Diaper Rash Prevention:
1. Change diapers as soon as possible after every bowel movement. Remember, stool is the number one culprit for diaper rash.
2. Use a barrier cream with zinc oxide – I have personally found Balmex to be the most effective. It contains aloe, which is very soothing and helps to
heal skin. Original A & D ointment is another lighter alternative. Herbal balms with chickweed, calendula, comfrey and plantain may also help skin
heal and protect itself.
If baby’s bottom is just starting to get irritated, you can use an over-the-counter 1% Hydrocortisone cream twice a day to lessen the irritation. It should
NOT be used for more than a few days. If your baby already has a yeast infection, do NOT use Hydrocortisone cream because it will make it worse!
3. Avoid foods that cause your baby to have loose stools or the telltale red circle around the anus, which often signals an allergy. Look for
common allergens such as: dairy cow products, citrus fruits and juices, wheat, nuts, tomato products, etc. and keep them out of baby’s diet for several
days. Slowly introduce one allergen back into baby’s regular diet for a few days and observe the effect of the food on baby’s bottom.
4. Breastfeed your baby. Stool from breastfed babies is less irritating to the skin, and nutrients in breastmilk keep baby’s skin in the best state of
health. However, you may want to experiment with removing common allergens from mother’s diet, in case baby is reacting to an allergen coming from
the mother’s milk.
Steps to Effectively Treating Diaper Rashes
Keep Baby as Dry as Possible:
1. When possible, allow baby to walk around, or nap, without diapers (even 15-20 minutes a day should help). Let baby nap while lying on a few cloth
diapers so baby’s bottom has time to air out. One of my friends had a baby with a severe diaper rash that persisted for months. The only thing that
cured it was several hours of “naked buttocks” time while baby slept outside in the shade during the summer.
2. Use super-absorbent disposable diapers or cloth diapers with fleece liners. These help keep baby’s skin drier.
3. Change diapers every 1-2 hours, and immediately after a bowel movement.
Minimize Further Irritation:
4. Change diapers immediately after each stool.
5. Avoid allergens that may cause diarrhea.
6. Use soft baby wipes and water (I recommend washable flannel baby wipes with plain water – they are much gentler than disposable wipes with
chemicals). If you use cloth diapers and wipes, be sure to add 1/2 cup of white vinegar to the rinse cycle to help remove possible irritants.
Treat Yeast Infection:
A yeast infection will often occur if a diaper rash goes untreated for several days, or if the child has been on antibiotic medicine. It is characterized by
red, raised patches over the diaper area.
7. Use Nystatin cream mixed half & half with a barrier cream (Balmex). There are other antifungal creams available, but Nystatin is the
most effective, and is the least likely to cause burning.
Some sites recommend the use of Clotrimazole anti-fungal cream, but my daughter screamed until I washed it off because it burned her tender skin so
much. I never used it again.
8. Contact you physician if the rash has not improved significantly after 7 days. There may be a bacterial component to the infection, which
would require a prescription antibiotic cream.
9. Yes, diaper rashes can be very painful. If baby is showing signs of pain, administer infant ibuprofen per the package instructions. Do not
underestimate how painful a diaper rash can be. Imagine have a 2nd degree burn on your bottom!
Disclaimer: This information is provided for educational purposes only and is not intended to replace advice from your pediatrician or other health care
provider. If you are concerned about your child’s health, please consult with your health care provider regarding the advisability of any opinions or
recommendations stated herein with respect to your individual situation.
About the Author
Andrew Wolf was the main photographer for the Thriving Babies guide to babywearing. He, and his wife, Rebecca, have one child and are expecting
another in May 2007. He is currently researching and writing about successful dieting principles at: http://TheDietingSecret.com/blog