As a parent, you’ve probably seen it all when it comes to changing your little one’s diaper. From gassy false alarms to blowouts, your baby can keep you on your toes when it comes to bowel movements. But one thing that can be a bit of a surprise is a red rash on their bottom.
Diaper rash is common, but it can be painful and uncomfortable for your baby. There are many remedies out there (and some old wives’ tales you should avoid), so how do you best tackle the rash?
Here we share the causes for diaper rash, do’s and don’ts for treatment and some prevention tips to get your baby’s bum as smooth as, well, a baby’s bottom.
What causes diaper rashes?
The two biggest causes for diaper rashes come down to moisture and friction.
“Commonly, urine and stool left in the diaper can irritate your baby’s skin over time,” said Vidya Surapaneni, MD, a pediatrician with Banner Children's. “Diapers can also chafe or rub against your baby’s bottom causing friction.”
Other things that can contribute to a diaper rash are:
- Fragrances in detergents, lotions and oils
- Diarrhea caused by a specific food, such as a milk protein intolerance, or as the result of antibiotics
- Excessive heat
- Skin conditions like atopic dermatitis or eczema
- Fungal and bacterial infections
- Changes in your baby’s diet, such as starting solids
Do’s and don’ts for treating a diaper rash
The key to treating your baby’s diaper rash is to keep your baby’s bottom as clean, cool and dry as possible. Dr. Surapaneni gave us some do’s and don’ts to follow:
DO: Use a barrier cream
You’ve heard a little bit goes a long way with certain products, but when your baby has a diaper rash slather, lather and apply a thick layer of barrier cream to their bottom. “A zinc oxide containing cream or a mineral or petroleum jelly ointment is a good option,” Dr. Surapaneni said.
DON’T: Use a higher concentration or very thick paste or ointment
Unless your child’s health care provider recommends, avoid products that say “maximum strength” as these can be difficult to remove from your baby’s skin due to their thick and sticky nature.
DO: Ditch the diaper from time to time
Allow for diaper-free time during the day to help speed up the healing process. If you’re concerned about accidents, place them on a disposable absorbent mattress pad and let them play.
DO: Avoid sunbathing
Back in the day, your parents may have laid you out in the sun for a diaper rash, but we know now that this is a big no-no. The UV rays in the sunlight can cause further irritation and babies under 6 months of age should be kept out of direct sunlight altogether.
DO: Avoid wipes, if possible
You read that right. Baby wipes, even the ones marketed for use on sensitive skin, can still be irritating—especially when your baby has a diaper rash.
Believe it or not, warm water with mild non-fragrant soap and a cloth is often enough to clean up their pee and poop. If you do use baby wipes, choose water-based ones that are free of dyes, scents and alcohol.
DON’T: Use these over-the-counter and household products
Unless your child’s health care provider has directed you to do so, avoid using steroids, salicylic acid-containing products, antibacterial or antifungal creams.
In addition, cornstarch/talc baby powders should be avoided due to the risk of inhalation and lung injury, Dr. Surapaneni said. “Unless your doctor prescribes it in a compounded medication for a certain type of rash, avoid using these products."
How can I prevent a diaper rash?
You may not always be able to protect your baby’s bum from a diaper rash, but there are steps you can take to keep it from happening.
- Check on your baby’s diaper before and after each feeding and at bath time, when they are less than 3 months old. Change the diaper when wet or soiled as soon as noticed. In older children, change when wet or soiled and at least three additional times during the day or between play.
- Allow diaper area to dry before putting on a diaper.
- Use high absorbent nighttime diapers or pullups for bedtime.
- If you notice redness, use a thin layer of petroleum or mineral oil as a barrier from further irritation.
- If using cloth diapers, ensure you properly wash for a thorough clean. Avoid using barriers like swim diapers beneath the cloth diaper as it will hold onto more moisture in the region until changed.
- Use fragrance-free products, such as soap, lotions, laundry detergent and fabric softener, as much as possible.
- Use appropriately sized diapers to avoid friction. You may find certain brands are a better fit than others.
When to call the doctor
Most diaper rashes can be treated at home. Sometimes a diaper rash can take some time to go away completely, but it should start to improve after just a few days of following the above tips.
However, call your child’s health care provider if your baby’s diaper rash doesn’t improve or/and they experience the following:
- A fever of 100.4 or higher
- Significant diarrhea
- Rash spreads to other areas of the body
- There are breaks in the skin with blisters, boils, pus or discharge
- Baby isn’t gaining weight as expected