Understanding Nappy Rash and How to Prevent It

Nappy rash (or diaper rash) is a common condition that affects both babies and infants. It typically appears as red, inflamed patches or rashes on the skin in areas where a nappy is worn (e.g., the buttocks, thighs, and genitals). Nappy rash can range from mild cases to severe irritation and inflammation of the baby’s skin. This condition is usually treatable at home; however, it’s essential to understand its causes, recognise the symptoms in your baby or infant, and learn about effective treatments and prevention strategies to maintain their comfort and health. In this article, we will break all of this down.

What Causes Nappy Rash?

As mentioned above, nappy rash occurs in the area where a nappy is usually worn—an area where the skin is typically most sensitive. Some of the most common causes of nappy rash include:

• Wet nappies worn for extended periods: Prolonged dampness can lead to irritation.
• Friction: The rubbing of the nappy against the skin can aggravate irritation.
• Urine and stool contact for extended periods: Ammonia from urine and enzymes from stool can break down the skin barrier’s function.
• Allergies: Certain baby wipes, nappies, or laundry detergents used to clean clothing can cause allergic reactions, leading to irritation and rashes.
• New foods being introduced into your baby’s diet: When solid foods are introduced, changes in stool composition can sometimes increase the chances of irritation.
• Antibiotics: Antibiotics can potentially upset the natural balance of bacteria, making fungal infections more likely.

Signs & Symptoms

So, we know that irritation, inflammation, and redness in the nappy area are some of the main signs and symptoms of nappy rash. However, there are several other indicators. So, what are these?

• Raised, sore, or scaly patches of skin.
• Baby or toddler showing signs of discomfort, such as greater fussiness during nappy changes.
• Severe cases of nappy rash may include blisters, pimples, or broken skin.

Prevention

Nappy rash is common; nevertheless, there are some effective strategies to help prevent it. Some strategies to prevent nappy rash include:

• Frequent Nappy Changes: Change nappies as soon as possible after they are wet or soiled. This minimises skin contact with irritants and reduces the risk of moisture buildup.
• Products for Sensitive Skin:
  • Opt for gentle, fragrance-free baby wipes or warm water and cotton wool to clean the nappy area.
  • Avoid harsh soaps or alcohol-based products that can dry out the skin.
  • Use Barrier Creams: Apply a thin layer of barrier cream to create a protective shield between the skin and irritants. This can be done after every nappy change. There are a variety of barrier creams that can help with nappy rash.

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• Ensure Nappies Are Properly Fitted: Make sure to choose nappies that fit snugly but are not too tight, as excessive friction can worsen irritation.
• Allow for Air Time: Let your baby go nappy-free for short periods to let their skin breathe. Fresh air can help reduce moisture and irritation.
• Weaning & Changes to Diet: If introducing new foods, particularly when first introducing solids, do so gradually to observe any allergic reactions in your baby.
• Infections: Keep your baby’s skin clean and dry to prevent fungal or bacterial infections. If your baby is on antibiotics, monitor for signs of fungal overgrowth, such as a bright red rash with a defined edge.

Treating Nappy Rash

If your baby develops nappy rash, the following steps can help:

• Clean gently: Use lukewarm water and a soft cloth or fragrance-free wipes to clean the area. Pat dry gently instead of rubbing.
• Use medicated creams: For mild cases, barrier creams are usually sufficient. For fungal infections, consult your pediatrician for antifungal creams.
• Change nappies often: Increase the frequency of nappy changes to reduce moisture and exposure to irritants.
• Let the skin heal: Allow your baby’s skin to breathe by providing nappy-free time.

When to See Your Paediatrician

In most cases, nappy rash resolves with home care, but consult with your paediatrician if you notice any of the following signs or symptoms:

• The rash persists or worsens/spreads after a few days of treatment.
• Blisters, oozing, or pus develop.
• Your baby has a fever or seems unwell.
• The rash appears to be caused by an allergic reaction

Dr Sara Watkin is our Consultant Paediatrician and Neonatologist (Newborn Specialist) here at Optimal Healthcare in Grand Cayman. Dr Watkin treats a range of newborn and paediatric conditions and illnesses.

Learn more about Dr Watkin’s services  here.