Nappy rash

Nappy rash

What is nappy rash?

Nappy rash can mean anything from slight redness on your baby's bottom to a full-scale outbreak of very sore and infected blisters. The blisters can break to leave areas of moist skin, which may become infected. The most common infection is a yeast infection called thrush, which causes the skin to become red and raw.

Blisters and pimples may form on other parts of the baby’s body when they have nappy rash. If the nappy rash lasts for more than a few days the skin is likely to be infected. The rash may be worse where the baby's skin creases.

What causes nappy rash?

Even the best cared-for babies can develop nappy rash at some stage or other, so don't feel that you are a totally inadequate parent if your baby happens to fall victim! The root cause of the problem is the exposure of your baby's bottom to damp conditions such as urine and faeces, where bacteria can set in and cause an infection.

Sometimes the constant friction of the nappy against baby's sensitive skin can be enough to cause nappy rash and, for parents who use terry towelling nappies, traces of detergent left in these nappies can lead to nappy rash. Some children may suffer from eczema or psoriasis, which may be irritated further by wearing a nappy.

Given that babies' bottoms spend an average of two, or more years, encased in nappies it is no wonder that nappy rash is such a common problem. Since newborn skin is very sensitive, great care should be taken to keep baby as clean, dry and comfortable as possible at all times, but especially in the first six months of life.

Can nappy rash be prevented?

Almost every baby suffers from a mild form of nappy rash at some stage, but to prevent more severe outbreaks, it is of the utmost importance to observe a strict code of hygiene when changing baby.

For parents who use terry towelling nappies, great care should be taken in sterilising and rinsing them, making sure that all traces of detergent are removed from the nappies in the rinsing process. Discretion in the use of plastic pants is also advised as they tend to trap moisture and can set up the warm, moist conditions in which bacteria thrive.

During the first six months of life, your baby's bottom should be kept as dry as possible, with frequent nappy changing. If possible, baby should be left for short periods throughout the day to kick and play around without a nappy. Babies just relish the freedom of this, but do make sure to leave the nappy just under your baby and to ensure that the room is warm and draught-free.

At every nappy change (even when the nappy is just wet), make sure to wash baby's bottom with a soft flannel and warm water, or with a baby wipe and coat the entire area with a silicone-based barrier cream before putting on a clean nappy. It goes without saying that baby should never be left in a soiled nappy.

If nappy rash does develop, what then?

If your baby does develop nappy rash, despite your best efforts to prevent it, leave them lying on, rather than in, the nappy for as much of the day as possible. If there are actual sores or little yellow spots present, it might be a good idea to consult your GP and let them have a look at your baby in order to prevent a more severe infection.

Make sure to change your baby the moment they are wet or soiled and clean the infected area with Vaseline or oil, rather than water or soap. Do not use any protective creams on the bottom until the rash has disappeared. While silicone-based creams are excellent for preventing nappy rash, they will not cure it once it is present. In fact, the only purpose these creams serve during an outbreak of nappy rash is to keep air off the skin. A baby with nappy rash is bound to be cranky and irritable, so patience is called for!

How do I protect my baby's bottom?

Babies should be allowed to play and kick around at some stage every day with no nappy. This advice would be much more practical if we lived in a Mediterranean climate, as sadly there are far too few opportunities in Ireland for babies to get some sunlight on their bottoms!

Having said that, it must be remembered that your baby's bottom is not accustomed to sunlight, so if you do take them outdoors on a sunny day without a nappy, remember to put on an old pair of cotton underpants to protect that delicate skin from the sun.

For older babies, it is a good idea to get into the habit of using a silicone-based cream at every nappy change. This will prevent urine from coming into contact with the delicate skin on the bottom and acts as a barrier against other forms of bacteria as well.

By the time your baby reaches six to seven months, they will probably be sleeping for eight to 12 hours every night without a nappy change, so it is important to protect their bottom from nappy rash.

There are many good-quality disposable nappies on the Irish market which are especially designed for night-time wear. While they may be a bit more expensive, they are certainly well worth the investment, as a sore bottom can end up being much more expensive in the long-run, especially if it warrants a visit to your GP.

Try to buy nappies which have a one-way layer next to the baby's skin and a built-in plastic backing. Try not to buy nappies which have elasticated legs as these can prevent air from circulating around your baby's bottom at night, allowing it to get sore.

For parents who use a combination of terry towelling nappies and plastic pants, the best type of plastic pants to use at night are tie-on pants. While these will not keep your baby and their cot perfectly dry, they will greatly lessen the risk of the baby developing a bad case of nappy rash.

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