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Unfortunately, a diaper rash is a normal part of being a baby and although you can limit the amount of rash, it will flare up from time to time. There is usually mild redness and scaling where the diaper touches your baby’s skin. In bad cases, the rash can cause pimples, blisters and other sores. If the rash becomes infected, it may be bright red and the skin may be swollen. Small red patches or spots may spread beyond the main area of the rash. Most diaper rashes are caused when diapers rub against the skin, fit too tightly or are left on for too long. Heat, moisture and an irritated skin cause the rash to start and for germs to grow.
Here are a few points to remember to prevent and treat diaper rash in your baby:
The best defense against diaper rash is a dry bottom.
Change the diaper when it is wet or soiled – this may be as often as hourly in a newborn baby.
If using disposables, try different brands as some will fit your baby better than others.
Change the diaper before putting your baby down to sleep or after a feed.
If the diaper is soiled, use the diaper to remove the worst of it, and then wash with warm water with or without a mild soap, using cotton wool. Alternatively, you can use unscented baby wipes although these may leave a film of bacteria on the skin. Be sure to wipe all the stool and urine away. If your baby has diaper rash, avoid wiping the sore areas and use a bulb syringe to gently wash the affected area. After cleaning, blot your baby’s bottom dry. Make sure it is 100% dry before putting on another diaper.
Avoid using plastic pants.
Do not use talcum powder – it can get into your baby’s lungs. If you need to use a barrier try petroleum jelly.
Whenever possible, allow your baby to lie in a warm environment without a diaper for a while with no cream and the bottom up. This lets the air help dry out the rash which is important for the healing process.
If your baby seems to have a sensitive skin, be wary of anything that might cause problems e.g. detergents and softeners, soaps, and more rarely certain elastics and fabrics or if there is a history of eczema in the family. When using cloth diapers, detergents and softeners may still remain (the test is to smell and wring them when still damp – if bubbles appear then you need to wash again). Add half a cup of vinegar to the rinse cycle to remove alkaline irritants.
If using cloth diapers, use liners to keep the skin dry.
If you baby sleeps through the night but has diaper rash, it may be a good idea to change the diaper once during the night until the rash is better.
The diaper rash could worsen if your baby has diarrhea.
If the bottom is very raw, soak in a baby bath or a basin of warm water to which has been added 2 tablespoons of baking soda for 10 minutes, 3 times per day.
When your baby starts solid foods, introduce only one new item at a time and allow a few days between introductions. You will then be able to pinpoint if diaper rash is caused by a food allergy.
With good care, diaper rashes are usually better within 3 days. But contact your doctor if you are concerned, if your baby looks or acts as if he or she is very sick, if there is a large red area with a fever or if the skin is bright red and peels off in sheets.