By Elizabeth Pantley
Diaper Rash 101
Diaper rash, as the name implies, is a rash that appears in the area covered by your baby’s diaper. Since a baby’s skin is very soft and sensitive, almost every baby has at least one diaper rash during the padded-bottom years. For some babies, it's a rare occurrence, but others seem to have especially sensitive skin that frequently erupts in that telltale shade of painful-looking red.
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The causes of diaper rash
The most common reason for a rash in the diaper area is simply that a baby’s delicate skin is surrounded 24 hours a day by a diaper — one that is often wet or messy. This creates a warm, moist area that's perfect for irritating that soft-as-butter skin.
Diaper rashes occur regardless of diaper type. All kinds of diapers — whether disposable or cloth — trap moisture. Other factors can contribute to a rashy bottom, such as friction, heat and bacteria.
Preventing diaper rash
To reduce the likelihood and frequency of diaper rash, here are the most important preventive measures.
• Change your baby’s diaper as soon as it becomes wet or messy.
• With each change, wash your baby’s bottom and dry it thoroughly, paying special attention to skin folds and creases.
• Don’t scrub your baby’s bottom. Using too much pressure when cleaning can lead to skin breakdown. Instead, wipe or pat gently.
• Always wipe from front to back, so you don't transfer rectal bacteria to the genital area.
• Don’t secure a diaper too tightly. Allow for some air to flow inside.
• Avoid using harsh or perfumed soaps when washing your baby’s skin or laundering cloth diapers.
• Rinse cloth diapers thoroughly with very hot water.
• If using diaper covers, avoid plastic and use only breathable fabric types.
• If your baby sleeps through the night and wakes up in the morning with a soaked diaper, apply diaper ointment before putting on your baby’s sleep-time diaper each evening.
Treating diaper rash
If your baby has a rash now, try the following ideas to clear it up. Follow up by using the prevention strategies in the previous section to help keep your baby rash-free.
• Change your baby frequently.
• After cleaning and drying his bottom, coat it with petroleum jelly or a diaper ointment.
• If your child is in daycare, talk to your caregiver about your treatment plan.
• When possible, let your baby go bare-bottomed for a while. Exposing your baby’s skin to air is a gentle, natural way to help it to heal.
• Don’t use powder that contains talc. Once wet, powder can increase the friction between your baby’s skin and the diaper. Also, your baby might inhale some powder, which can be dangerous to his health.
• Experiment with different types of diapers, wipes and diaper ointments.
When to call the doctor
A mild diaper rash isn’t cause for alarm. There are times, however, when you should call your doctor.
• When the rash persists without improvement for longer than three or four days.
• If the rash spreads beyond the diaper area.
• If the rash is bright red or if there are sores or blisters.
• If there is a discharge from your baby boy’s penis.
• If your baby is taking antibiotics.
• If your baby has a fever or is acting sick.
More than just diaper rash
Various other rashes sometimes are misdiagnosed as “diaper rash.” Become familiar with the other types of baby rashes so that you’ll know if the one on your baby's bottom requires more extensive remedies.
© Elizabeth Pantley. Excerpted from Gentle Baby Care.
Parenting educator Elizabeth Pantley is the author of numerous parenting books, including the widely cited The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night. Buy her books at Powells.com. She is a regular radio show guest and is quoted frequently on the web and in national family and women’s publications. Elizabeth lives in Washington state with her husband, their four children and her mother. Visit her at www.pantley.com/elizabeth.