Along with one of the certainties in life–taxes–there comes another almost certainty which is taxing and often worrisome to a parent: diaper rash.

The American Academy of Pediatrics reports that more than 50% of all babies will get diaper rash between 4 and 15 months of age. Research from the Journal of Pediatric Dermatology in 2008 reports that there is up to a 95% incidence of diaper rash in infants using cloth diapers.

Diaper rash is caused by the interaction of numerous factors including:

Wet skin/changes in skin pH Fecal material and urine touching the skin
Allergic reactions Friction
Abrasive soaps or chemicals Yeast and bacteria

Preventing diaper rash starts with frequent changing of wet and soiled diapers.

Random party fact: A 1994 study from the journal Dermatitis states that one of the mechanisms for diaper rash is the interaction of enzymes in fecal material when combined with urine is irritating to the proteins in the outer skin layer due to the resulting increase in skin pH.

  • Using non-scented disposable infant wipes during diaper changes help to remove feces and urine from the skin.
  • Do not rub vigorously as this can damage the skin.
  • Use a baby safe soap to remove fecal material which cannot be removed easily with a wipe.  Read more information on bathing your infant here.
  • Avoid the urge to over-wash the area as this can lead to skin chapping and actually worsen the condition.  This is the same premise as worsening chapped lips by licking them more.

The essential point to treating diaper rash is to help create an additional barrier between the skin and potential irritants. Any number of diaper creams, lotions, and ointments are available over the counter, the majority of which use zinc oxide as their main ingredient. Zinc oxide helps to soothe irritated skin and create a barrier of protection. If possible, before applying any cream, lotion, or ointment, allow the diaper area to air dry for 30 minutes which will help to speed up healing.

For more severe diaper rashes, there are pastes available (such as iLex®) which when applied to the skin prevent all moisture from reaching the skin. A layer of petroleum jelly must be applied over the paste to prevent the diaper from sticking to the paste. Avoid using steroid creams on a diaper rash unless instructed by your physician. Steroid creams can cause side effects such as skin discoloration or skin atrophy in the genital area if used incorrectly or for too long.

Have you changed diaper brands or soaps recently?

Diaper rashes which are resistant to standard treatment may be a result of an allergic reaction, known as contact dermatitis.  Have any stubborn diaper rashes evaluated by your pediatrician.

Any severe diaper rash, diaper rash accompanied by a fever, or rash that worsens after a few days of treatment should be evaluated by a physician to ensure that there is no overlying bacterial or fungal infection. Diaper rashes which have small raised red bumps or those which cause pain to the infant are potentially from infectious causes and may require a topical antibiotic or anti-fungal medication.

For more information on diaper rash and treatment strategies, please consult with your pediatrician.

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