The first time you discover a scattering of tiny red bumps on your baby’s sweet bottom, you’re bound to be a little freaked. But diaper rash is pretty much part of the baby package — at least half of the diaper-clad contingent develop it at some point — and some seem to sport one just about all the time.
You can expect diaper rash — a reddish skin irritation on your baby's bottom and inner thighs — to remain a potential problem as long as your little one is in diapers. But these tips and treatment suggestions should help heal that pesky, sometimes painful problem, as well as ward off recurrences.
Types of diaper rash
There are many different types of diaper rash, including:
- Chafing (the most common type): redness often accompanied by small spots or bumps in areas of high friction.
- Yeast infections (aka candidal dermatitis): a bright red, tender rash that usually starts in the creases between the abdomen and thighs and spreads from there.
- Cradle cap (aka seborrheic dermatitis): a deep red rash with yellow scales that appears on babies’ heads — but can also start in (or make its way down to) the diaper area.
- Eczema (aka atopic dermatitis): dry, itchy, red patches, which tend to occur more on the face and scalp than the diaper area.
- Impetigo: a secondary bacterial infection marked by large, puss-filled sores that break open and ooze yellowish fluid, then crust over.
- Intertrigo: a raw rash that can pop up in skin folds and can itch or ooze white or yellowish fluid.
Is diaper rash cream a good idea?
Prevention is the best cure for diaper rash. Spreading a thick, protective layer of ointment or cream on baby's bottom after cleaning it at changing time can help prevent diaper rash or relieve an existing rash and avoid irritating it further.
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There are two types: petroleum-based products (like A&D ointment or plain old petroleum jelly) and those containing zinc-oxide (like Desitin or Balmex). Every baby’s bottom is different, so experiment to see which diaper rash cream works best for treating and preventing diaper rash on your little one.
Before you spread the ointment or cream on baby's bottom, make sure her skin is completely dry. Trapped moisture beneath the barrier cream can make diaper rash more likely — or make a bad case of diaper rash worse.
Be sure to slather it on thickly, like icing, and gently. Don’t worry about removing it completely at each diaper change — rubbing and scrubbing is likely to damage your baby’s skin and make it more rash-prone.
The American Academy of Pediatrics (AAP) recommends skipping over-the-counter ointments that contain an antibiotic, since some ingredients in those products can actually worsen skin irritation.
Other diaper rash treatments
If diaper rash does develop, you may consider also trying alternative treatments to help clear it up, such as:
- Witch hazel ointment
- Breast milk
- Aloe vera or calendula
- Shampoo clay
While some people have found success with these types of alternative treatments, they’re not guaranteed to work. You may want to discuss them with your baby’s doctor before giving them a go.
What causes diaper rash?
A combination of factors often contribute to your baby’s diaper rash, including:
- Dirty diapers. Most rashes are triggered by prolonged exposure to dirty diapers. The enzymes in your baby’s poop can irritate her sensitive skin. Wetness (when is your baby not wet?) can also make those chubby cheeks more susceptible to diaper rash.
- Diaper friction. When your baby’s soft skin folds chafe or rub against each other, or against the diaper itself, it can step up skin irritation and trigger a rash.
- Yeast. Yeast is another common culprit, particularly in persistent rashes, as yeast loves warm, moist environments. What's more, if Mom is breastfeeding and taking antibiotics — or if baby needs these medications — it can increase the risk of yeast infection (and diarrhea), bringing on diaper rash.
- Irritants. The ingredients in disposable diapers, wipes, bath products, baby lotions and laundry detergents can all irritate baby's delicate skin and cause diaper rash.
- Changes in diet. A breastfed baby’s stool can change in consistency and frequency based on what Mom eats. You may notice the same happening when your baby starts eating solids and is exposed to more foods.
Since that pretty much sums up what your baby's bottom is exposed to most of the day and night, it's no wonder she (like many of her compadres-in-diapers) isn't always sitting pretty.
What does diaper rash look like?
Wondering what diaper rash looks like on your little one's tender skin? The telltale sign is a red, inflamed rash on your baby’s genitals, bottom or thighs. It may be mild, or it can cover a large portion of the diaper area. Sometimes, it can spread beyond the diaper region. In worse cases, it can lead to pimples, blisters or sores that may open up and start to ooze fluid or puss.
Your baby may express discomfort by fussing or crying when the area is washed or wiped during diaper changes.
Here are some photos to check your baby's bottom against. But remember: When in doubt, confirm it with your pediatrician and don't try to diagnose your baby at home.
Home remedies to prevent diaper rash
To keep your baby's tender tush in tip-top shape, it's best to take a preventive approach to diaper rash. Try these baby-tested strategies (which should also help heal any existing rash):
- Change your baby's diaper often. Replacing a peed- or pooped-in diaper with a clean, dry one plays a key role in preventing diaper rash. That’s because when skin stays damp for too long, it becomes more susceptible to rash-raising enzymes. So even if your baby isn’t fussing for a change, change her anyway as soon as you know her diaper is wet or soiled. Try to give her a fresh diaper every one to two hours or so. And don’t forget to apply diaper cream!
- Wash your hands before and after. This helps avoid spreading any germs that may cause infections that lead to diaper rash.
- Go bare. Before you replace the diaper, give your baby's bottom some bare air time. Cover the surface you choose to let her enjoy the breeze on with an absorbent pad or towel in case she springs an unexpected leak. Aim to air out the area a few times a day for at least 10 minutes a pop. No time? Blow on her bottom or use a clean diaper to fan her dry.
- Loosen up. Leave a little breathing room in the diaper when it's on. You want your baby's diaper snug enough to prevent leaks but not so tight that it rubs and chafes. You can even go a size up for more space until the rash clears. If she's in cloth diapers, use breathable diaper covers.
- Dodge irritants. Avoid perfumes and alcohols in soaps, scented baby wipes and other products that come in contact with your baby’s nether region. Prevent diaper rash by cleaning her bottom with cotton balls or a washcloth soaked in warm water instead of using wipes — at least during the newborn stage, when that tender skin is the most sensitive. Also opt for a water-only approach or choose alcohol-free, unscented products if your little one seems particularly prone to rashes. Reach for the soap only when necessary.
- Bathe regularly. A bath every day or every other day with warm water and mild, fragrance-free soap can help keep the area free of irritants until the rash clears up. Just be careful you're not bathing your baby too much, which can also irritate the skin. When in doubt, check with your pediatrician about how often to give your baby a bath.
- Change diaper brands or types. Sometimes super absorbent disposables are so efficient at trapping moisture that they help trigger more rashes. Try experimenting with different types of diapers or switch to cloth to see if that helps prevent diaper rash. Cloth diapers are less absorbent, which encourages more frequent changes (a change for the better if it leads to fewer breakouts). But cloth diapers can also mean more diaper rashes (or more severe cases) for some babies, which is complicated by the fact that you can't use many diaper rash creams with them. If that's happening to your little one, changing the detergent you wash the diapers in to one free of dyes and other irritants might help, as could swapping out cloth for disposables, at least temporarily.
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When to call the doctor about baby diaper rash
If you’re concerned about diaper rash, you’re not alone. It’s one of the most common reasons parents reach out to their baby’s pediatrician.
It may be a good time to check in with your baby’s doctor if:
The rash doesn’t clear up or start improving in a few days.
The rash gets worse despite attempting to treat it at home.
Pimples, peeling skin, blisters or pustules appear.
The rash appears to be painful for your baby.
The rash spreads beyond the diaper area.
Your baby also has a fever accompanying the rash.
Your baby's pediatrician may prescribe a topical antifungal cream or ointment, a steroid cream, or (much less likely) an oral antibiotic to help get rid of the diaper rash.
Remember: Few baby bottoms escape diaper rash altogether — it comes with the diaper-wearing territory. But even if you can't prevent diaper rash completely, there's plenty you can do to keep those breakouts to a minimum.
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