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  • Diaper Rash

    Definition

    A diaper rash is a skin irritation under your baby’s diaper. The rash can be on the abdomen, genitals, and in the folds of the buttocks and thighs. Most babies develop a diaper rash at some time during infancy.
    Thigh Folds on Baby
    Baby
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    Causes

    A diaper rash develops when your baby’s skin is irritated. Irritation can be caused by:
    • Leaving dirty diapers on for too long
    • Too much moisture next to the skin
    • Diapers or plastic pants that are too tight
    • Allergic reaction to diaper material or detergent
    • Yeast or bacterial infection
    • Rubbing or chafing of the skin
    • Diarrhea

    Risk Factors

    Factors that may increase your baby's risk of diaper rash include:
    • Frequent stools
    • Infrequent changing of baby’s diaper
    • Treatment of babies or nursing mothers with antibiotics
    • Starting on solid foods
    • Age: 8 to 10 months old
    • Sensitive skin

    Symptoms

    The main symptoms of diaper rash are bumps, redness, and scaly patches on the skin under the diaper. There may also be blister-like spots on the skin. Your baby may also be more fussy and irritable when the diaper is changed.
    If the rash is not cared for, it can become infected. It can become a very bright red with red bumps and blisters.
    Symptoms of a more severe rash may include:
    • Open sores, boils, or pus develop
    • Your baby is not sleeping or eating normally
    • Your baby develops a fever
    • The rash becomes worse or does not improve in 2 or 3 days
    Contact your doctor if your child has signs of a severe rash.

    Diagnosis

    Most parents can recognize a diaper rash when they see it. A diaper rash doesn’t normally require a visit to the pediatrician.

    Treatment

    Diaper rashes usually clear up in three or four days with the following treatment:
    • Change diapers frequently.
    • Use plain water instead of baby wipes to rinse your baby’s skin.
    • Pat dry gently. Rubbing can irritate the rash.
    • Apply a protective ointment to the diaper area. The ointment should contain zinc oxide.
    • Expose your baby’s skin to the air as much as possible.
    • Do not use creams that have boric acid, camphor, phenol, methyl salicylate, or a compound of benzoin tincture.
    • Do not use talcum or cornstarch powders.
    If the rash is severe, see your child's pediatrician. Your pediatrician may suggest use of a mild hydrocortisone cream to calm the skin. If the rash is very red, your doctor may recommend a cream like miconazole. This type of cream is effective for treating yeast infection. These creams are available without prescription but your pediatrician may want to discuss these options before starting treatment.

    Prevention

    To help prevent diaper rash:
    • Change your baby’s diaper frequently.
    • Use plain water to rinse your baby’s diaper area after changing.
    • Dry the diaper area well after changing. Let the area air out.
    • Allow your baby to go without a diaper when possible.
    • Avoid using fabric softeners on cloth diapers.
    • Use cloth diapers or super-absorbent disposable diapers to prevent irritation.

    RESOURCES

    American Academy of Family Physicians http://www.familydoctor.org/

    American Academy of Pediatrics http://www.healthychildren.org/

    CANADIAN RESOURCES

    About Kids Health http://www.aboutkidshealth.ca

    Sick Kids http://www.sickkids.ca/

    References

    Diaper rash. American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/diaper-rash.html . Accessed August 15, 2012.

    Diaper rash. American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/ages-stages/baby/diapers-clothing/Pages/Diaper-Rash.aspx . Accessed August 15, 2012.

    Diaper rash. Nemours foundation Kidshealth website. Available at: http://kidshealth.org/parent/infections/fungal/diaper%5Frash.html . Accessed August 15, 2012.

    Diaper rash. Children's Physicians Network website. Available at: http://www.cpnonline.org/CRS/CRS/pa%5Fdiaperra%5Fhhg.htm . Updated June 2011. Accessed August 15, 2012.

    Kleigman RM, Jensen HB, Behrman RE, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2007.

    Revision Information

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