Health Tips / Nappy Rash

Diagnosis and Symptoms

All babies experience nappy rash although some are likely to suffer more severely than others. The condition can range from a mild redness of the baby's bottom to a more severe condition which results in soreness and blistering. This can result in the breakdown of the top layer of the skin (epidermis) to leave areas of broken moist skin. As a result the skin may be prone to bacterial, fungal and yeast infections such as thrush, resulting in sore, red and raw skin. Consequently nappy rash, when it occurs should be treated early to avoid infection.

Nappy rash is caused by repeated exposure of sensitive skin to moist conditions caused by the presence of urine and faeces in the nappy. The worst areas are often creases or folds in the skin which trap moisture and provide a warm moist environment in which fungal infections thrive. Friction of the skin against nappies may also be a factor. Other causes can be irritation of the skin by soaps or traces of detergents in washing powders used to wash terry-towel nappies.

Preventative Measures 

It is important to keep the area clean and dry with regular and frequent nappy changes. The skin should be allowed to breathe and if possible, the baby should be left for short periods during the day without a nappy. When changing nappies a soft flannel cloth and warm water should be used to wash the area. A baby wipe may be more convenient especially when travelling. Particular attention should be paid to creases or folds in the skin.

A protective or barrier cream or ointment (eg CALDEASE, BEPANTHEN, MORHULIN, SUDOCREM, VASOGEN, ) some of which contain additional antiseptic may be applied before fitting a new nappy. This creates a protective barrier to prevent sensitive skin coming into contact with urine, faeces and sources of infection.

All traces of detergents should be thoroughly rinsed from terry-towel nappies.

Avoid the use of plastic pants as they trap moisture and lead to the moist, warm conditions in which bacteria, fungal and yeast infections thrive.

Nappies which have a one-way layer next to the baby s skin are preferable as they allow aeration of the skin. Night-time nappies are recommended to allow a sleeping baby go 8 to 12 hours between changes.

Non-prescription Treatments 

When nappy rash occurs, extra care and attention should be paid to follow the steps outlined above in order to prevent further irritation or infection. Nappies should be changed as soon as possible after wetting to limit the contact of urine with irritated skin.

Furthermore, the skin should be allowed to breathe by leaving the baby lying on, rather than in, the nappy, as much as possible. Protective creams should be avoided during nappy-free periods as they will prevent aeration of the skin.

Cleaning with water and soap may irritate the skin. VASELINE or other oily products are often used as an alternative.

If a fungal infection is present your pharmacist may be able to recommend a suitable antifungal cream such as CANESTEN or DAKTARIN.

If the skin is very raw and sore or if yellow spots appear, you may be advised to consult your doctor.

Further Information on medicines including dosage is available at www.medicines.ie

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