When Diaper Rash Strikes

Take a few sensible steps to keep baby’s bottom in good health.

A red bottom is the last thing you want to find when you open your baby’s diaper. But it’s not unusual for infants and toddlers to develop diaper rash, a skin condition that occurs from wearing diapers. “Diaper rash is very common,” says Daniel Krowchuk, M.D., FAAP, chief of general pediatrics and adolescent medicine at Wake Forest University School of Medicine in Winston-Salem, N.C. “A study we published in 2000 indicated that approximately 25 percent of children make a visit to a provider for this condition.” The first and most obvious symptom is redness of the skin on areas in direct contact with the diaper. “Parents may notice redness, bumps or breaks in the skin in or around the diaper area,” says Tanya Remer Altmann, M.D., FAAP, associate medical editor of Caring for Your Baby and Young Child, Birth to Age 5 (American Academy of Pediatrics, 2009) and a pediatrician in Westlake Village, Calif. “Sometimes the skin can be uncomfortable or tender to touch. Some babies will fuss or cry when changed if the rash is bothering them.”

Most rashes are the result of leaving your baby in a wet or soiled diaper for too long. Moisture from a soiled diaper can harm your baby’s skin and make it more prone to chafing. In more severe cases there may be painful open sores. Once the skin is irritated and damaged, your baby will become vulnerable to yeast or bacterial infections.

According to the American Academy of Pediatrics, more than half of babies between 4 months and 15 months of age will develop diaper rash at least once in a two-month period. Diaper rash is most common between 8 to 10 months of age. It’s also common when babies have frequent bowel movements or diarrhea.

Diaper rash is more likely when babies start to eat solid food, which causes changes in the digestive process. Babies are more vulnerable too, if they — or their nursing mothers — are taking antibiotics, which makes them prone to yeast infections.

Get the Red Out

Healing the rash involves being more vigilant about changing your baby’s diapers. While your baby is battling a bout of diaper rash, here’s what you can do:

• Rinse the affected area with warm water. Repeat the process with each diaper change until the rash subsides. Wash with a mild soap only after a bowel movement since overusing soap can disrupt the healing process.
• Choose the right kind of wipes. Avoid wipes that contain alcohol or fragrances. “If wipes seem to bother your infant, try plain water with a soft paper towel or wash cloth until the rash heals,” Dr. Altmann says.
• Expose your baby’s bottom to air. Let your baby wear a loose diaper so air can circulate. While she’s napping, take the diaper off and lay her on a towel. Drying out the area will reduce the risk of developing a yeast infection.
• Consider a good soak. Soaking in an oatmeal bath can help soothe a sore bottom, Dr. Altmann says.

Keeping Rash at Bay

Fortunately, you can take steps to prevent diaper rash, especially if you know your child is vulnerable. Apply a thick layer of diaper ointment that contains zinc oxide on to your baby’s bottom at every diaper change. Avoid putting the diaper on too tightly, which will trap the moisture and discourage air circulation. A petroleum jelly type product also works well.

Consider using extra absorbent diapers, too. “With the advent of super-absorbent diapers, which wick moisture away from the skin and keep the skin dry, the frequency of irritant diaper dermatitis has declined greatly,” says Dr. Krowchuk, who is also former chair of the AAP Section on Dermatology.

And make sure to change your child’s diaper frequently. “Changing the diaper promptly after it becomes wet or soiled is the best way to prevent diaper rash,” Dr. Krowchuk says.

When to Call the Doctor

If you’re using an over-the-counter diaper ointment, and your baby’s diaper rash still doesn’t improve after a few days, or is even getting worse, call your pediatrician. The rash may have developed a yeast infection.

“Depending on the type of rash, your doctor may recommend a yeast cream, especially if the rash is bright reddish pink and raised with bumps surrounding it, which are signs of a candida or yeast diaper rash,” Dr. Altmann says.

The good news is, diaper rash can be prevented and is easily treated. “Once children are toilet trained and out of diapers, the problem goes away,” Dr. Krowchuk says.