How to manage and prevent a diaper rash?

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Author: Gauri Kshirsagar

WHAT IS A DIAPER RASH OR DIAPER DERMATITIS?

Any rash (redness or inflammation) in the area covered by the diaper is called a diaper rash. It is a ‘general term’ describing any of a number of inflammatory skin conditions that can occur in the diaper area for example candiasis, psoriasis, seborrheic dermatitis etc.  But the rash which is directly or indirectly caused by the wearing of diapers is the most common type. In this article I will be discussing the rash caused by improper use of diapers.

Diaper rash area

Diaper area

WHY DOES A DIAPER RASH OCCUR?

  1. Wetness:
    1. The diaper area is specifically vulnerable because it is a ‘closed environment’ suitable for microorganisms and with frequent wetting, it is more often moist; hence the skin becomes prone to maceration and increases its permeability to other irritants.
    2. The skin here is constantly in contact with strong alkalinizing agents e.g., urine and feces and the pH here is prone to high alkalinity that damages the skin integrity. When the baby’s urine mixes with bacteria from his stool, it breaks down and forms ammonia, which can be very harsh. That’s why children with frequent bowel movements or diarrhea are more prone to diaper rash.
  2. Chemical sensitivity: Your child’s diaper rash may be the result of his diaper rubbing against his skin, especially if he’s particularly sensitive to chemicals like the fragrances in a disposable diaper or the detergents used to wash a cloth diaper. It could also be that a lotion or powder you’re using at diaper time doesn’t agree with your child’s skin.
  3. New food: It’s common for children to get diaper rash when they start eating solid foods or are introduced to a new food. Any new food changes the composition of the stool. (The acids in certain foods, such as strawberries and fruit juices, can be especially troublesome for some kids.) A new food might increase the frequency of your child’s bowel movements as well. If you’re breastfeeding, your child’s skin could even be reacting to something you’re eating.

Causes of Diaper rash

HOW  DOES A DIAPER RASH LOOK LIKE? 

  • The skin in the diaper area looks red and scaly, sometimes with scattered small bumps.
  • You may notice small cracks, rubbed areas, thickening, or raw areas of the skin.
  • The rash can be painful, causing fussiness and crying in your infant.
  • If yeast infection occurs, the rash may become very red with well-outlined borders. Scattered bumps or pimples may appear in the skin near the borders. The rash may spread to cover the entire diaper area or beyond. 
Diaper rash

How does a diaper rash look like?

WHAT ARE SOME POSSIBLE COMPLICATIONS OF DIAPER RASH?

  1. Serious complications are rare. However, diaper rash can be painful for your baby, interfering with sleep and play time.
  2. Yeast infection may occur. Though this causes a red and well-outlined rash, it is usually easy to treat.
  3. Diaper rash may become severe, with very raw sores that may take a couple weeks to heal.
  4. Some babies have repeated problems with diaper rash. Even with treatment, the rash seems to keep coming back.

HOW TO MANAGE A DIAPER RASH?

  1. Try to use a cloth diaper, at least for the first 5 months, I know it’s a tedious task, but also decreases the chances of a diaper rash.
  2. The best treatment for a diaper rash is to keep the diaper area clean and dry. This also helps prevent new diaper rashes.
  3. Lay your baby on a towel without a diaper whenever possible. The more time the baby can be kept out of a diaper, the better.
  4. Most of the diaper give a guarantee of 12 hours dryness, but even than change your baby’s diaper every 4-5 hours and as soon as possible after the baby passes stool. More the skin is in contact with stool or excess urine, more the chances are the chances of developing a diaper rash.
  5. Use water and a soft cloth or cotton ball to gently clean the diaper area with every diaper change. Do not rub or scrub the area. A squirt bottle of water may be used for sensitive areas. AVOID USING BABY WIPES, they invariably contain fragrances and alcohol which irritates the skin and causes a rash (Even if they mention NO ALCOHOL)
  6. Pat the area dry or allow to air-dry. Use baby talcum powder specially in the body folds, after drying the area.
  7. Put diapers on loosely. Diapers that are too tight do not allow enough air flow and may rub and irritate the baby’s waist or thighs. It’s very important to choose the right size.
  8. Using absorbent diapers helps keep the skin dry and reduces the chance of getting an infection, use a trusted brand of diapers.
  9. Always wash your hands before and after changing a diaper.
  10. In case of a rash, a very mild corticosteroid in very less amount (pea size) can be applied over the skin (except the sensitive area) about 2-3 times after diaper change. Steroids should not be used in high quantities and for a longer time.  Ask your doctor which creams, ointments, or powders are best to use in the diaper area.
  11. Apply a diaper rash ointment such as petroleum jelly (Vaseline) or products containing zinc oxide (for example, Desitin). These products can help keep moisture away from the skin. Put on a light layer right after cleaning and drying the diaper area
  12. If the rash takes a long time to heal or is severe, it may be a good idea to visit your doctor. He or she can check to see if the rash has become infected with yeast (Candida) or other germs or if some other type of skin condition is present. If yeast infection occurs, a prescription ointment will be recommended. Apply to the rash with each diaper change (four times per day) for a week or so.
  13. If you decide to use cloth diapers:
    1. Do not put plastic or rubber pants over the diaper. They do not allow enough air to pass through.
    2. Do not use fabric softeners or dryer sheets. They may make the rash worse.
    3. When washing cloth diapers, rinse 2 or 3 times to remove all soap if your child already has a rash or has had one before.

Care of diaper rash

IS THERE ANYTHING SPECIAL IN CASE OF DIAPER CHANGING IN TWINS?

In case of twins, it becomes a bit difficult to manage if you plan to use cloth diapers in the early months, hence I advise to make a diaper changing kit for ease of changing the diapers. Also do refer to my article “How to make a diaper changing station at home” in this blog.

Slide3

Diaper Changing kit

Slide2

Contents of diaper changing cum feeding kit

Diaper Changing Station

Diaper Changing Station


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