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Nappy rash

Nappy rash

Almost all babies get bouts of red, sore skin in the nappy area at some time. It can make your baby uncomfortable and they may even cry more than usual. But don't worry, some simple steps can soon sort out the problem. And you are not alone - it is estimated that about one in three babies suffer from nappy rash at any given time.

What is nappy rash?

Nappy rash is just what it sounds like - a red rash, or sore area, that affects the skin under or around a baby's nappy, particularly where the skin folds. Nappy rash can vary from a mild problem with just a little redness, to a serious rash that is very sore and red, with spots, blisters and even broken skin.

What causes nappy rash?

Nappy rash is due to three main factors:

  • The skin being kept wet under a nappy
  • Chemical irritation due to ammonia in the urine
  • Bacteria in the stools

The combination causes the protective barrier normally formed by the skin to break down. This leads to red and raw skin (inflammation), which allows germs to attack. The longer wet or soiled nappies are left in contact with your baby's skin, the more likely nappy rash is to develop.

In severe cases, nappy rash can become infected with germs - either bacteria or thrush (candida). In thrush infection, the rash tends to have clusters of red spots around the edges of the main red rash area. Nappy rash is more likely in babies with sensitive skin. It may also be more of a problem in babies prone to skin problems. The problem can be caused by the type of nappy you use. Nappy rash is more likely with terry towelling nappies, especially if worn with waterproof pants over the top. Modern disposable nappies are generally better at keeping dampness away from the skin if they are changed regularly.

In rare cases, babies may react to the elastic at the waist and legs of disposable nappies, and also to other components. If this is the case, you will need to change the type of nappy you use.

How can you treat nappy rash?

Nappy rash is caused mainly by contact between your baby's skin and a wet nappy, so the answer is to reduce this contact as much as possible. When you can, leave your baby's nappy off, allowing air to get to their skin. Most babies like being nappy-free, with more freedom to kick their legs. If you are worried about your floor, lie your baby on a large towel or sheet which you can wash in the event of accidents.

Change your baby's nappy frequently and wash and dry the skin in the nappy area carefully. It may help to use a barrier cream (such as zinc and castor oil cream) at nappy changes, but don't use these routinely if your baby does not have nappy rash. Some barrier creams contain antiseptic agents, which can help to deal with any germs. If you are unsure, discuss what to use with your health visitor, pharmacist or doctor.

If your baby's nappy rash does not clear up after a few days, or if it becomes very raw and the skin is broken, see your health visitor or GP. Your baby may need other treatments, which deal more specifically with any infection. Nappy rash with candida infection needs to be treated with antifungal creams.

If nappy rash is an ongoing problem and you use terry nappies, try using one-way nappy liners, which draw moisture away from the skin. Avoid plastic pants where possible. Persistent nappy rash problems can be due to your baby's skin being sensitive to the powder you use when you wash towelling nappies. If so, avoid anything containing biological ingredients and try a double rinse cycle. If these solutions don't help, it may be worth trying disposable nappies (remembering to change them frequently).

How can you prevent nappy rash?

The secret of preventing nappy rash lies in keeping your baby's bottom as dry as possible. This means changing their nappies when they are wet or soiled. This may be a lot more often than you think - as often as every hour in newborn babies. Change the nappy before putting your baby down after a feed, or to sleep.

It is also important to keep your baby's bottom as clean as possible. If the nappy is soiled, use the nappy to remove the worst of it, then wash with warm water and a gentle soap, using cotton wool. Alternatively, use gentle baby wipes. Whenever possible, allow your baby to lie in a warm environment without a nappy for a while before putting on another one.