Caring for Diaper Rash

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Lucile Salter Packard Children's Health Services
Parent Information and Referral Center

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Most babies will get a diaper rash at some time. Their bottoms are in frequent contact with moisture, bacteria and ammonia, and there is rubbing from the diaper. Babies and toddlers are at risk as long as they are wearing diapers. Rashes are much easier to prevent than to cure.

Preventing diaper rash

Changing the diaper immediately and good cleaning are the best things you can do. Diaper rashes occur equally with cloth diapers and disposable diapers. Some children will get a rash from certain brands of disposable diapers, or from sensitivity to some soaps used in cloth diapers. If you use-cloth diapers bleach them by adding Clorox, Borax or Purex to the wash. Be sure to rinse thoroughly.

Change diapers frequently

The most important thing is to keep the area dry and clean. Check the diapers often, every hour if your baby has a rash, and change them as needed. Check at least once during the night.

Gentle cleaning

Frequent and vigorous washing with soap can strip the baby's tender skin of the natural protective barrier. Wash gently but thoroughly, including in the skin folds. Do not use diaper wipes if your child has a rash, as they can burn and increase the irritation. You can sit the baby in a basin or tub of lukewarm water for several minutes with each diaper change. This helps clean and may also be comforting. You can also pour warm water from a pitcher or use a squirt bottle. Do not use any soap unless there is very sticky stool, then a very mild soap is okay; wash gently and rinse well. Baby oil on a cotton ball can also be used.

Pat dry or leave diapers off for a while

Let the skin air dry, or pat very gently with a very soft cloth or paper towel. A hairdryer set on cool can also be used. Leave the skin open to the air as much as possible. Fasten diapers loosely and don't use airtight rubber pants. If you use disposable diapers it can help to punch holes in them to let air in.

Skin protection

Petroleum jelly (Vaseline) provides a good protective coating, even on sore, reddened skin, and is easily cleaned. A number of other ointments are available commercially; see what works for your baby and what your doctor recommends.

Be very careful with all powders; be sure the baby does not breathe them in. Do not use talcum powder because of the risk of pneumonia. Cornstarch reduces friction and may prevent future rashes.

Yeast diaper rash

Some diaper rashes are caused by a yeast called Candida Albicans, which often causes problems when a baby already has a diaper rash, is on antibiotics, or has thrush. This rash appear bright red and raw, covers large areas, and is surrounded by red spots. Call your pediatrician for a special cream to treat this rash, and follow the guidelines above. With proper treatment these rashes are usually better in 2-3 days.

Call your doctor if

• any big blisters or sores (more than one inch across) develop
• the rash isn't much better in three days
• the rash becomes solid, bright red, raw or bleeds
• pimples, blisters, boils, sores or crusts develop
• the rash interferes with sleep
• the rash spreads beyond the diaper area
• your child starts acting very sick or has an unexplained fever

Resources

• Your Child's Health by Barton D. Schmitt. Bantam Books,
• Caring for Your Baby and Young Child by Steven P. Shelov, Ed. Bantam, 1991.
• What To Expect the First Year by Arlene Eisenberg, H. Murkoff & S. Hathaway. Workman Publishing, 1989.

Credits

Preparation of this handout supported by a contribution from the Stanford Nurse Alumnae

Lucile Salter Packard Children's Health Services
Parent Information and Referral Center:
1-650-498-KIDS or 1-800-690-2282