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Diaper Rash

                  DIAPER RASH

 

     Diaper rash is any rash that develops inside the diaper area. In mild cases, the skin might be red. In more severe cases, there may be painful open sores. It is usually seen around the groin and inside the folds of the upper thighs and buttocks. Mild cases clear up within 3 to 4 days with treatment.

 

Most babies get diaper rash, but it is usually not serious. More than half of babies between 4 and 15 months of age develop diaper rash at least once in any 2-month period. There are many ways to limit the frequency and severity of diaper rashes, but from time to time it may flare up anyway.

 


WHY BABIES GET DIAPER RASH

 

Babies have very sensitive skin that is easily irritated by the chemicals and moisture of urine and stools and by the friction of a diaper.  Skin that is irritated then becomes more susceptible to the infection with bacteria and yeast, which can make the rash worse.

 

Diaper rash occurs more often when babies get older and more mobile, and are eating more solid foods. Increased diaper rashes are also associated with frequent stoolings, such as diarrhea, especially when in a soiled diaper overnight. Fungal diaper rashes, in particular, may be associated with antibiotics or nursing babies whose mothers are on antibiotics.

 

PREVENTING OR MINIMIZING A RASH

 

Many babies do not have any problems with rash, and don’t need  much in the way of prevention. However, these tips may be helpful for those that always seems to be battling it:


Change diapers, especially poopy diapers, frequently and right away - at least every two hours in newborns. You can space this out as baby starts to urinate less often.


GENTLY wipe all stool or urine away- use unscented AND alcohol free wipes or just plain water and cotton pads.


Experiment with different brands of diapers- some babies are sensitive to specific fragrances or additives in the disposable diapers.


If using cloth diapers  add a ½ cup vinegar to the rinse cycle, and rinse cloth diapers well.


Use ointment with each diaper change- A&D Ointment is an excellent preventive ointment, but others can also be used, including those containing zinc oxide. In babies less than 2 months old, A&D or plain Vaseline is best.


TREATING DIAPER RASH

   
      Rinse bottom with water-  avoid wiping the sore areas. Instead, use a bulb syringe or squirt bottle to gently wash baby's diaper area, and GENTLY pat away remaining stool, and BLOT the bottom dry. You do not need to completely remove any layers of diaper rash cream as long as the stool and urine are removed.

    Air it out- lay baby on a towel (with a waterproof pad underneath to catch accidents) with bottom up and no diaper cream on. This will help dry out the rash and allow it to heal.

    Use diaper rash cream- when you put the diaper back on, use GENEROUS amounts of cream, such as:


 Zinc oxide- for moderate irritant rashes. Brand names Desitin and Balmex contain fragrances that may make rashes worse in babies with sensitive skin.

   
Acid mantle- sold in stores, good for moderate irritant rashes, and may be used with zinc oxide over it.


Triple paste - a nice mixture containing zinc oxide, petrolatum, lanolin, beeswax and cornstarch. Good for severe diaper rashes and especially good for those kids with sensitive skin since it contains no fragrances. However, triple paste should NOT be used when a yeast rash is present, as the cornstarch can feed the yeast.


Lanolin Ointment
- good for sore bottoms, all natural. Babies who are allergic to wool may react.


Bag Balm
- excellent healing ointment for sore and raw bottoms.


Or mix your own diaper rash cream- for VERY severe or stubborn rashes, try mixing the following “recipe” and applying with diaper changes.

o       3 ounces A&D or Aquaphor

o       3 ounces zinc oxide cream (CVS brand is nice- no fragrance)

o       3 teaspoons original Maalox liquid. The Maalox cuts the acidity of the urine and stool and also feels cool on application.

 

 
SOME SPECIFIC DIAPER RASHES

There are some diaper rashes that are more than irritation from stool, urine and diaper. They may require different treatment. To be sure, see the doctor, especially if diaper rash is not improving after 2-3 days, if the baby has fever, seems ill, if the rash contains pus filled sores or blisters, or if the rash seems very painful.


Yeast Rash
- especially with antibiotic use or with a prolonged rash.  This is a raised, red, patchy rash with sharp borders and little “satellite” spots sprinkled around the diaper area. Yeast rash should be treated with anti-fungal cream, applied under the other creams 2-3 times per day. Common Anti-fungal creams:



Clotrimazole (Lotrimin) - over the counter. Apply 2-3 times per day beneath other diaper creams for up to 2 weeks.


Nystatin- a prescription, slightly different cream for yeast.


Acidophilus powder- a natural alternative of bacteria that fight yeast.


Impetigo- This rash occurs when bacteria invade damaged skin from diaper rash. It generally has blisters, sometimes filled with pus or red raised patches with honey colored crusting and oozing. It requires a  prescription antibiotic ointment.


Seborrhea- a skin condition that can affect different parts of the body (on the head it causes cradle cap), but can be severe in the diaper. Is usually a big, red, patch with distinct edges sometimes with grease and scale.  It is treated with 1% hydrocortisone cream 2-3 times per day, not to be used for more than a week unless directed by a doctor. It can also be treated with selenium sulfide dandruff shampoo applied at bathtime.


“Allergy” ring- a variety of foods can irritate baby’s bottom, especially acidic foods such as citrus and tomato sauce. It looks like a red ring around the anus. Treatment is discontinuing the culprit foods.


As you can see diaper rashes are quite common, and can be very irritating to both mother and baby. Even to the trained eye these rashes can look alike and it may take an extra visit and different prescriptions or treatments to finally help resolve the rash.

 

Helpful links for this topic:


American Academy of Pediatrics

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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