Noticed a diaper rash in your newborn? Here are some tips for parents to deal with it

Diaper rash, also known as diaper dermatitis, is a common condition in which a baby’s skin in the diaper area becomes red, scaly, moist and tender. It can vary from mild to very severe. Although diaper dermatitis can be seen in any patient wearing diapers, it typically peaks between 9 and 12 months

What causes it?

Usually it is the result of irritation, infection or allergy. When a diaper is left too long or poop remains in contact with skin for long periods, a rash happens because of irritation. Prolonged contact of skin with urine and poop can lead to diaper rash. Urine changes the skin’s pH levels, which allows bacteria and fungus to grow easily leading to skin excoriation and rash. Babies with sensitive skin also may develop rashes. 

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Sometimes, babies with diarrhea may have severe rashes due to the presence of a reducing substance in poop. Starting new food sometimes may lead to diarrhea, resulting in rash. 

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Here’s how to treat it

The goal of treating a diaper rash is to create conditions that allow diapered skin to maintain its physiologic pH and limit exposure to irritants that promote skin breakdown. 

Remember the mnemonic of ABCDE (air, barrier, cleansing, diaper, and education)

A: Air time, or being diaper-free can be challenging for families to incorporate into their daily routine for extended periods. However, open air time is one of the most economical, safe, and efficacious treatments for diaper dermatitis. It increases air circulation and drying of the area while decreasing friction from the diaper.

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B: Barrier. Apply rash creams (containing zinc oxide and petroleum jelly). Apply a thick smear of it (like icing over cake) at every diaper change. These creams soothe the skin, and also prevent urine and stool mixture from coming in contact with the skin directly. Creams with higher zinc oxide content are usually considered better. 

C: Cleansing. Use clear water to cleanse the diaper area with each diaper change. Using water in a squirt bottle lets you clean and rinse without rubbing. Pat dry; do not rub. Allow the area to air dry fully.

D: Diaper. Often parents are confused whether to use cloth nappies or disposable diapers. Cloth nappies can be washed again and used. Disposable diapers are for a one-time use. Research suggests that diaper rash is less common with the use of disposable diapers. Because disposable diapers absorb urine, there is less chance that urine and stool mixture will come in contact with your skin. Regardless of which type of diaper you use, diaper rash occurs less often and is less severe when you change diapers often. If you use a cloth diaper, you can use a stay-dry liner inside it to keep your baby drier.

E: Education. It’s important for the paediatrician to educate parents about a diaper rash. The importance of changing diapers frequently and keeping the area clean and dry must be understood.

What can you do to prevent diaper rash?

Mothers need to be aware of diaper rash; they need to start taking steps to prevent diaper rash from the first week only. The most important thing to do is to keep your baby’s skin dry and clean as possible, plus changing the diaper frequently so that poop and pee don’t irritate the skin.

These are few tips to prevent diaper rash: 

• Change your baby’s soiled or wet diapers as soon as possible and clean the area well. 
• Occasionally soak your baby’s bottom between diaper changes with warm water. You can gently scoop the water over your baby’s bottom with your hand or squeeze it from a plastic bottle.
• Let your baby’s skin dry completely before you put on another diaper.
• Pat the skin gently with a soft cloth when drying it — rubbing can irritate skin.
• Put the diaper on loosely to prevent chafing.
• Change diapers often — ideally every 2 hours or so — and after every poop.

Applying diaper cream or ointment with each diaper change can help some babies with sensitive skin, but not all babies need this.

If you use cloth diapers, check the manufacturer’s directions on how to best clean them. Only use detergents in the amount recommended, and run an extra rinse cycle after washing to remove traces of soap or detergent that can irritate your baby’s skin. Avoid using fabric softeners and dryer sheets — even these can irritate skin.

What should be avoided?

When it comes to preventing and treating diaper rash, less is more.

• Avoid using highly fragranced products, including fabric softeners and dryer sheets. Hypoallergenic and fragrance-free are much less irritating for many babies. 
• Put your baby in clothes that are breathable. Rubber pants or tight plastic covers over a diaper can promote a moist, hot environment.
• You should also refrain from using baby powder on your baby. It’s a no-no for babies because they can inhale it, which can harm their lungs.

When should you consult your doctor?

With all the measures described above, the majority of rashes heal in 3 to 5 days. However, if a rash becomes infected, that is there is the appearance of blisters or pus-filled sores or it’s not healing and increasing in severity, one should consult a pediatrician. Use steroid or antifungal cream on his/ her recommendation.