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  • Sara Silvestri, MD FAAP

Diaper Rash – A True Pain in the Butt


At one time or another almost every baby will have a diaper rash. Their poor sensitive diaper areas can become red and, in bad situations, raw and bleeding. Here’s some tips to

try to keep the rashes away.


Keep it Dry


The most effective way to prevent diapers rashes is to keep the area as dry as possible. This means frequent diaper changes and trying not to let your baby sit in a wet or dirty diaper for too long. Yes, it’s a lot of diapers. Yes, you will do nothing in those early days but feed the baby and change diapers. Trust me, it’s better than having them be fussy and associating diaper changes with pain.


Keep it Clean


Anytime urine or stool touches the skin, irritation will begin. Be careful to do a thorough cleaning in all of the folds, nooks and crannies. You may be surprised how far a poopie diaper can spread!


Keep it Gentle


Be gentle with your cleaning. While we want to be thorough, we don’t want to scrub. Rubbing too hard will also cause irritation itself and can cause the skin to be more easily irritated by other factors.


Keep it Natural


I’m not here to comment on cloth vs. disposable diapers and I’m not going to tell you to throw away all of your wipes. However, it’s important to know that some babies will have reactions to diapers and wipes. The diapers with blue dye in the middle are particularly bothersome for some kids. Many wipes have chemical additives including fragrances that can be harsh on tiny bums. When possible, let them have some time to “air out” and use damp paper towel instead of wipes. If using cloth diapers, try to be mindful to use gentle detergents with less additives and make sure they are well sanitized so that you don’t introduce new bacteria or other irritants to the skin.


Keep the Powder on the Shelf


I frequently hear how grandma advised mom to use some powder in the diaper. Unfortunately, this can backfire and lead to rashes. Instead of allowing the moisture in that region to absorb into the diaper, the powder can absorb it and hold it against the skin.


Keep it Protected


While dry is best, if you know you are going to be in a situation that may prevent you from changing a wet or dirty diaper right away, you can use a thin layer of diaper cream to prevent the more noxious urine or stool from directly touching the skin. Remember to use something gentle and preferably without colors or fragrances.


Keep it Snug, but not Tight


No one wants to be cleaning up accidents from a leaky diaper. Sometimes in our attempt to prevent messes though, we tighten those diapers up too tight. A diaper that’s too tight will not only trap moisture in more, but can lead to chronic rubbing around the hips and groin which can lead to irritation and rash.


Keep Changes in Mind


Sometimes factors outside of the diaper region can lead to rashes and it’s good to be mindful of those triggers. Different foods can lead to changes in urine or stool which can irritate skin. Sometimes babies with thrush will also get a yeast rash in their diaper region. Lastly medicines, especially antibiotics, are notorious for triggering more severe diaper rashes that sometimes need special prescription creams to treat.

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