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Nappy rash: types, causes, treatment & prevention

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We all the know the saying “as soft like a baby’s bottom” but we also know that these sensitive little bottoms can be irritated, causing nappy rash. Fortunately, if you know what type of diaper rash you are dealing with it makes it a lot easier to treat. Yes, you read right. There are various types of diaper rash and each one is treated differently.

Types of nappy rash

  • Contact nappy rash is the most common. It is caused when wet skin comes into contact with the nappy. You may see redness and swelling of the skin along the top of the diaper, over the bum area and around the legs.
  • Yeast rashes are often caused by a yeast infection. This baby fungal rash lives on your baby’s skin and in the intestines. It can grow rapidly in moist environments, making a diaper the ideal place to thrive. This rash in infants appears as tiny dots or pimples usually found in creases and folds in the diaper area. If left untreated you may see swelling, blisters, ulcers, large bumps or sores filled with pus. Baby fungal rashes need to be treated with topical antifungal medication in the form of a cream, ointment or powder. Your doctor would be able to prescribe the right one for your baby.
  • Allergy-related rashes arise as a result of an allergic reaction to something such as shampoos, detergents, diapers, wipes, creams, lotions, soaps and even foods that a baby may have eaten. It is harder to identify because it looks like a contact rash, but it doesn’t clear up with traditional treatment. Try to identify and remove the allergen. If the rash still continues contact your doctor.

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  • Bacterial rashes such as staph and strep are usually caused when bacteria enter already open skin. Staph infections look like pus-filled blisters that rupture and form a crust. Strep infections are a bright red rash found in the area around the anus and genitals. Bacterial rashes need to be treated with antibiotic ointment or oral antibiotics.
  • Eczema is a skin condition that can be heredity or may be triggered by a food allergy. It appears as red, dry, scaly patches. Certain foods, soap and fragranced wipes/creams can aggravate these rashes on babies’ bodies. Try and identify and remove the cause. Eczema creams can also be purchased from your local pharmacy.

Nappy-related rashes are caused by skin irritation, yeast infections or allergic reactions.

How to treat nappy rash

  • Wash your hands with soap and water before nappy changes.
  • Do not leave baby in a wet diaper for long periods of time. You do not need to change baby after every pee but the diaper should be changed every two to three hours. Poo nappies should be changed immediately!
  • Clean baby’s bottom thoroughly, but gently, and then let the area dry before putting on a fresh diaper.
  • Make sure the diaper is not closed too tightly.
  • Use only alcohol- and fragrance-free baby wipes and creams.
  • Use cotton wool dipped in warm water to remove dried poo.
  • Once the area is clean follow with a layer of barrier cream to protect your little one’s bottom.
  • Air out the skin by letting baby go without a diaper for a little while each day.
  • Use disposable diapers (not cloth) while baby has a nappy rash, as they are more absorbent and minimise the skin’s exposure to wetness.

Distressed baby showing how to treat nappy rash

10 home remedies for treating nappy rash

  • Powders such as baby powder and maizena (corn starch) can reduce friction and moisture but should not be used on baby’s bottom because your baby could inhale it, causing damage to the lungs. Also, maizena can actually make a yeast infection worse.
  • Vaseline (petroleum jelly), nipple cream and shortening can all be used as barrier creams to protect the skin from urine and stool, but not for treatment of a rash in infants.
  • Coconut oil has antifungal and moisturising properties and can be used to treat baby’s fungal rash by applying a thin layer onto their bottom.
  • Tea tree oil also has antiseptic and antibacterial properties. Mix three drops with coconut oil and apply as a barrier cream.

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  • Soothing sitz baths (with baking soda, coconut oil or oatmeal) balances pH levels and removes unwanted bacteria and fungi from baby’s skin.
  • As breast milk is packed with antibodies, it will heal skin and soothe irritation. Apply it on a cotton ball and dab it onto the affected area.
  • Clean baby’s bottom with cotton wool dipped in a mixture of one teaspoon white vinegar in a cup of water.
  • Aloe vera gel is natural and soothing, and can be used to treat inflammation.
  • Make a mixture of almond, tea tree and lavender essential oils and water. Put in spray bottle and spray onto the affected area. Pat dry.
  • A layer of sugar-free yoghurt can also be reapplied at each diaper change.

Please note: The above home remedies are not medical advice and should be used at your own discretion.

10 Nappy rash facts and myths

  1. Nappy-related rashes are caused by skin irritation, yeast infections or allergic reactions. Non-nappy-related rashes are caused by bacteria and skin conditions such as eczema and psoriasis. #FACT
  2. Breastfed babies have fewer diaper rashes than formula-fed babies #FACT
    This is probably because formula-fed babies are more likely to get diarrhoea and gastrointestinal illness than babies who are breastfed.
  3. A nappy rash is less likely to be caused by pee alone. #FACT
    The enzymes in poo may irritate baby’s skin. Poo also contains organisms that can cause skin infection. As urine breaks down, it releases ammonia which causes the pH of the skin to rise and also makes the enzymes from baby’s stool more active. This can lead to damage of tissue and skin resulting in nappy rash.
  4. Baby wipes can aggravate nappy rash. #FACT
    While most baby wipes are safe to use, some contain alcohol and additives like antiseptics or are fragranced, which can irritate the skin. Some brands are also rougher than others.
  5. Teething causes nappy rash. #MYTH
    Teething does not directly cause nappy rash. Nappy rash is a result of wet skin coming into contact with the diaper. If your baby is suffering from teething-induced diarrhoea, this increases the chances of suffering from nappy rash.
  6. Antibiotics indirectly cause nappy rash. #FACT
    Antibiotics can cause diarrhoea which increases the risk of developing nappy rash.
  7. Diaper rash doesn’t just appear on the bum. #FACT
    It can appear on any part of the skin that the diaper touches such as the lower abdomen, top of the legs, lower back and folds and creases of the skin.
  8. There are two different types of nappy cream. #FACT
    One is a barrier cream that is used before the rash occurs and the other is a treatment cream to be used after the rash develops.
  9. Using too much bum cream is a bad thing. #FACT
    Applying too thickly can decrease absorbency of the nappy creating a moist environment, increasing the risk of developing a rash.
  10. Changes in your baby’s stool from trying fresh foods could cause nappy rash. #FACT

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