Most babies wear diapers for their first few years of life. Diapers are super convenient! But, when pee and poop stay close to a baby’s skin for too long, it can result in a rash. This is true for both disposable diapers and cloth diapers. The good news is, diaper rashes are rarely severe and most of the time they can be treated at home with over the counter products.
“Diaper rashes are among the most common skin disorders of infancy. In one survey of 1089 infants, diaper dermatitis occurred in 50%; however, only 5% had severe rash. The peak incidence of diaper dermatitis is between 9 and 12 months of age.”
There are three main causes of diaper rash. Let’s take a look at what they are:
- Irritation: certain substances can cause the skin to become red and inflamed when they touch the skin for too long. This is usually how a diaper rash starts. Pee or poop are on the skin for too long and the skin gets angry! Also, having loose, frequent poop from, stomach bug or from antibiotics, can cause an irritation rash.
- Yeast: yeast likes to grow in warm, moist places. If irritation is not treated, yeast can start to grow. Usually you will notice this type of rash in the folds of the skin.
- Allergy: sometimes skin is just sensitive to things that it shouldn’t be sensitive to! Babies can have skin allergies to certain products or intolerances to certain foods.
There is good news! Since most diaper rashes are not severe, that means they can usually be treated at home and, for the most part, should go away in a few days. If a diaper rash does not go away with home treatment in a few days, it’s time for a call to the pediatrician.
I really like this little trick from UpToDate for remembering what to do for diaper rash:
A = Air out the skin
B = Barrier / Breastmilk
C = Clean
D = Disposable diapers
E = Educate
Air out the skin
Since diaper rash can often be caused by irritation from having wet pee or poop on it, letting that little bottom air dry can make a huge difference! I know this is easier said than done, especially if your little one is having diarrhea from a stomach bug or from antibiotics, but even a little bit of diaper free time can really do wonders! If it’s nice outside, let your little one run around (or crawl, or just chill out on a blanket!) sans-diaper in the fresh air. If it’s a little cooler, try taking off the diaper a few extra minutes before or after bath time.
Barrier / Breastmilk
A barrier is any type of cream that is used to protect the skin from contact with pee or poop. My favorite, and what we used most often for kiddos in the hospital, is Boudreaux’s Butt Paste. Here is the thing though, you want to put it on THICK like cake frosting! Too little barrier cream = pee and poop can get through to your sweet babe’s skin.
Get this! Breastmilk can actually be used to treat diaper rash too! A study in 2017 found that when breastmilk was applied to an irritated bum, the rash went away faster than when breastmilk was not used!
There have been limited studies about natural herbs and pastes that can be helpful for diaper rash too. If you are interested in making your own barrier ointment, Dr. Kathi Kemper, holistic pediatrician, lists the following ingredients as safe to use on your little one: calendula (marigold), chamomile, chickweed, comfrey, elder flowers, goldenseal, lavender, marsh mallow root, rosemary, witch hazel.
She also urges parents to avoid using:
- Talcum powder
- Garlic (too potent for baby skin)
- Egg white (can cause allergy)
This one can be obvious, but it can also be tricky!! We want to make sure that all of the pee and poop is off our little one’s skin, but we also don’t want to be too rough and irritate their skin more. So what’s a mama to do?! Well, if your little one only wet their diaper but didn’t poop, there is no need to scrub their skin. Even if there is still barrier cream visible, it’s okay to leave that on there and just add some more.
If there is poop on their skin, you want to make sure you get it all off. One way to do this is to plop your little one in the tub….although this can get annoying if every diaper is a poopie one! You can also use a little squirt bottle, or even just a wet washcloth to gently wipe their little bottom. It’s a good idea to only use water because the solutions in baby wipes can be irritating to an already red bum! The goal is to clean the skin without being too rough and irritating angry skin.
If you use cloth diapers and notice your little one getting a diaper rash, it could be a few different things: sensitivity to a detergent, diapers that haven’t been washed properly, or just too much moisture.
Also, there are limited types of barrier creams that you can use with cloth diapers because most diaper creams will interfere with the absorbency of the diaper. If you REALLY want to keep trying cloth diapers and your little one is just a teeny bit red, my favorite cloth diaper safe barrier cream is Earth Mama Bottom Balm.
If you are noticing a rash with cloth diapers, it may be a good idea to temporarily switch over to disposable diapers. This gives you time to get the rash under control and troubleshoot what might have been going on with your cloth diapers. Don’t be discouraged! You can still switch back to cloth diapers after the rash is gone. If diarrhea was involved, make sure you wash your cloth diapers properly so the same problem doesn’t come back again!
Guess what? You are doing this RIGHT NOW!! Educate is about learning what can cause diaper rashes and preventing them from happening in the first place! Now you know to make sure your little one’s bootie is clean and dry. Pee or poop on the skin for too long can cause a rash.
Also, certain foods can cause irritation. My little baby bear, for example, gets a red bum when he eats too much citrus fruit, so we have to limit clementine’s, pineapple, and even kiwi. Others may be sensitive to dairy products, as another example.
What if you have been doing the ABCDEs of diaper rash care and your little one STILL isn’t getting better??
These tricks only really address the first cause of diaper rash, irritation. But if your little one is suffering from another cause of diaper rash, you may need to look into other treatments.
If the diaper rash is related to yeast, you will most likely need a prescription from your child’s pediatrician to treat it. Usually mama’s figure this out by using the ABCDEs for a few days and not seeing any improvement. At that point, it’s best to give your child’s pediatrician a call, and they will probably ask you to come in, A yeast infection can only be diagnosed by someone specially trained, so I do not recommend trying over the counter treatments for yeast until you talk to your child’s healthcare provider. Using the wrong product can actually make your little one’s rash worse!
Allergy or sensitivity
If all else fails and you have tried everything, it may be that your child has a sensitivity to a certain product. This could be a brand of diaper, wipes, or barrier cream. It could also be a food sensitivity that your little one has eaten themselves, or something they are sensitive to from mama’s breast milk. Although it can be an incredible frustrating process, finding the offending thing and getting rid of it is the best course of action. Try changing just one thing at a time and give it a few days. It can take time but be patient! If you change too many things at once, you won’t know what worked and what didn’t.
Putting it all Together
We have covered soooo much about what causes diaper rashes and what us mamas an do about them. So lets wrap it up really quickly so you can get back to your sweet babe!
The 7 things you need to know about diaper rash:
- Air it out.
- Use a barrier cream or breastmilk. Apply the barrier cream thick like cake frosting.
- Keep it clean. Wash gently with just water.
- Temporarily switch to disposable diapers if you have been using cloth.
- Keep in mind the causes of diaper rash: irritation, yeast, and allergies or sensitivities.
- Reach out to your child’s healthcare provider if the rash doesn’t get better in a few days. It’s possible that you may need a prescription medication.
- If nothing else is working, try changing out brands of diapers, wipes, and creams to see if your little one is sensitive to a specific product. Only change one at a time so you know what was causing the problem.
- Integrative approaches to acne and diaper rash by Dr. Kathi Kemper, holistic pediatrician
- Diaper Rash from Boston Children’s Hospital
- Diaper Rash from Seattle Children’s Hospital
- Patient education from UpToDate: Diaper rash in infants and children (Beyond the Basics)