Diaper rash—gentle preventive care

Diaper rash is a very common problem in babies. It is possible to do small daily actions to prevent or heal it.

What is diaper rash?

Babies have to wear diapers until they are toilet trained. Diaper rash is primarily an irritative reaction of the skin. Children who wear diapers are likely to develop diaper rash, particularly babies between the ages of 8 to 12 months.

Diaper rash is easily recognized because the affected areas are found beneath the diaper (buttocks, groin, lower back and stomach, and genital area). Note that creases are often unaffected. Typical symptoms include redness, itching or a burning sensation that may result in irritability or agitation.

In more serious cases, an infection caused by fungus or bacteria can develop, causing redness and significant pain as well as more serious lesions.

This skin condition has a number of causes. Constantly covered skin promotes moisture, skin contact with urine and feces, and friction of the skin with the diaper contribute to the development of diaper rash. Although this is not a serious health issue initially, special attention should be paid to it, since lack of appropriate care could lead to the situation worsening and to possible complications.

Is my baby likely to develop diaper rash?

The following table shows the factors that protect a child as well as those that contribute to the development of diaper rash.

Protective factors Risk factors
Breastfeeding Use of washable diapers
Use of disposable diapers Premature babies (born before 28 weeks)
Maintaining optimal hygiene Episodes of diarrhea
  Antibiotic treatment
  Use of irritating products

The difference between disposable and washable diapers resides in their capacity to absorb moisture, which is much greater with disposable diapers. That said, using washable diapers can be an adequate choice if they are well maintained. Therefore, it is important to review the cleaning method of washable diapers if your child has several episodes of diaper rash. For instance, you could change detergent or rinse the diapers twice after washing.

The feces of babies who are breastfed has a different consistency and composition which is less irritating to the skin.

How can diaper rash be treated?

Diaper rash must be treated as soon as signs appear to avoid the deterioration of symptoms and a doctor’s visit. The first course of action is to apply a product that contains zinc oxide, which protects the skin and prevents friction. There are many preparations available at the pharmacy. However, parents must choose it carefully, depending on its concentration. In order to treat a reaction, the product must contain 25 to 40% of zinc oxide. A lesser concentration (such as 15%) is sufficient to prevent diaper rash.

Products containing zinc oxide come in various formats, lotion, cream, ointment, or paste. The latter is generally more effective because of its thicker consistency. Paste is rather sticky and it is important not to remove it completely from the skin at every diaper change, as this will cause a significant irritation to the baby’s skin. It is appropriate to leave the residue of paste on the skin and to simply add more as needed.

In more serious cases, when a fungal or bacterial infection occurs, other medications can be used (antibacterial and antifungal creams). However, it is always better to consult a pharmacist or doctor before using them.

When should you see a doctor?

Over-the-counter products are usually suitable to treat diaper rash. However, some situations require medical attention and a more in-depth treatment. This may be the case in the following situations:

  • symptoms do not disappear after at least seven days of constant care
  • symptoms worsen quickly (within 2 to 3 days)
  • the rash and lesions spread to a much wider area than that which is covered by the diaper
  • abnormal lesions on the skin, such as blisters and purulent wounds are observed
  • the child has a fever
  • diaper rash occurs in children whose immune system is weakened

How can diaper rash be prevented?

Prevention is the best strategy to avoid the unpleasantness of diaper rash. The following measures help prevent its onset:

  • Change baby’s diaper often, that is, after each stool or at least every two to three hours.
  • Choose diapers that are the right size (diapers that are too tight increase friction on baby’s skin).
  • Let baby’s bottom aerate for a few moments. You can leave them without a diaper as often as is possible.
  • Dry the area of the skin covered by the diaper well after cleansing and before putting on a clean diaper. Gently pat skin dry with a fresh towel without rubbing.
  • Avoid the use of diaper wipes; instead, use warm water and a clean washcloth. It is not necessary to use a cleanser after each diaper change.
  • When cleansing baby’s bottom or at bath time, choose a gentle soap that is alcohol and fragrance-free to avoid irritation.
  • Apply a protective agent (such as a product containing 15% of zinc oxide) at each diaper change. It is important to note that some formulations contain other ingredients.
  • Do not apply talc powder (it is not currently recommended)
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