Diaper Rash

Diaper rash is the term used to describe a rash or irritation in the area covered by the diaper. The first sign of diaper rash is usually redness or small bumps on the lower abdomen, buttocks, genitals, and thigh folds—surfaces that have been in direct contact with the wet or soiled diaper. This type of diaper rash is rarely serious and usually clears in three or four days with appropriate care. The most common causes of diaper rash include:

1. Leaving a wet diaper on too long. The moisture makes the skin more susceptible to chafing. Over time, the urine in the diaper decomposes, forming chemicals that can further irritate the skin.
2. Leaving a stool-soiled diaper on too long. Digestive agents in the stool then attack the skin, making it more susceptible to a rash.

Regardless of how the rash begins, once the surface of the skin is damaged, it becomes even more vulnerable to further irritation by contact with urine and stool and to subsequent infection with bacteria or yeast. Yeast infections are common in this area and often appear as a rash on the thighs, genitals, and lower abdomen, but they almost never appear on the buttocks.

Although most babies develop diaper rash at some point during infancy, it happens less often in babies who are breastfed (for reasons we still do not know). Diaper rash occurs more often at particular ages and under certain conditions:

• Among babies eight to ten months old
• If babies are not kept clean and dry
• When babies have diarrhea
• When a baby starts to eat solid food (probably due to changes in the digestive process caused by the new variety of foods)
• When a baby is taking antibiotics (because these drugs encourage the growth of yeast organisms that can infect the skin)

To reduce your baby’s risk of diaper rash, make these steps part of your diapering routine:

1. Change the diaper as soon as possible after a bowel movement. Cleanse the diaper area with a soft cloth and water after each bowel movement. Avoid using diaper wipes which may irritate the skin further.
2. Change wet diapers frequently to reduce skin exposure to moisture.
3. Expose the baby’s bottom to air whenever feasible. When using plastic pants or disposable diapers with tight gathers around the abdomen and legs, make sure air can circulate inside the diaper.

If a diaper rash develops in spite of your efforts, begin using an oil-based barrier (ointment) to prevent further irritation from the urine or stool. The rash should improve noticeably within forty-eight to seventy-two hours. If it doesn’t, consult your pediatrician.