Irritant diaper dermatitis also called “Diaper rash” is very common in babies, the prevalence can reach up to 35 % in the first 2 years. The peak incidence occurs between 9 and 12 months of age. As a mother, it is important to diagnose and treat it early to prevent secondary infection and worsening of symptoms.
How to diagnose it?
It appears on convex surfaces of the skin, mainly red patches and scaling. Usually the skin folds are spared unless there is a secondary fungal or bacterial infection. In other words, your baby’s skin is red, irritated around the area covered by the diaper (usually the buttocks and the perianal area).
Although it is called diaper rash, it is not caused by the diaper but occurs as a result of diaper use. Wetness is the main culprit; prolonged exposure to wetness causes the outer protective layer of the skin to breakdown. Urine and stools are skin irritants and their combination increases the skin pH resulting in worsening of the skin permeability to irritants.
Tightfitting diapers that rub on the skin can also lead to a rash. Diaper size is based on weight, if you notice that the diaper is tight on the belly or if there is significant leakage, you might want to use a bigger size diaper.
If the diaper rash is not treated, fungal of bacterial infection can develop which not only affect the convex surfaces but also the skin folds, genitalia and thighs.
When babies start to eat solid food, the content of the stools change which increases the risk of diaper rash.
Antibiotics whether they are taken by the mother of breast-fed babies or babies themselves can also increase the risk of diaper rash secondary to yeast infection (similar to vaginal yeast infection in women). Some antibiotics can also cause diarrhea which could lead to diaper rash.
How to treat diaper rash?
Air out the skin as much as possible Allow the baby to go diaper-free for a short period of time.
I usually let my baby go diaper-free after a bath, I swap the wet bath towel for a dry one and let him play on the changing table (under supervision) wearing only a onesie bodysuit to cover his tummy and back.
Apply a protective ointment or paste. My favorite paste is Triple Paste ointment. The paste is thick, hypoallergenic, fragrance-free and recommended by pediatricians. It’s simply the best but it comes with a heavy price tag. For those who live in Canada, its equivalent is Zincofax extra-strength. After I let the baby skin air dry, I apply triple paste on the genitalia, buttocks and perianal area.
It’s the most important step. This is one of those things your mom told you about that you probably ignored (like I did initially). Using wipes is great, don’t get me wrong, however they do not CLEAN as well. It’s like using a hand gel sanitizer, it doesn’t substitute for washing your hands!
Clean the skin with soap and lukewarm water after every stool. When the baby is small, it’s easy to wash her in the sink. When they get older (and heavier), either use the sink (if your biceps are strong) or use a bath. Wash the skin with a gentle soap and make sure to remove all the residual paste especially in the skin folds. After cleaning, pat dry the skin and do not wipe if there is diaper rash.
D: Diaper and Disposable.
Change the diaper after each stool and use disposable diaper for the time being rather than cloth diaper. Do not wait for the diaper to be “full”, change it as soon as there is a stool.
Educate yourself or follow my blog ;) about how to prevent a diaper rash.
If your baby’s skin doesn’t get better after 3-5 days, you should see the pediatrician. Usually the doctor would prescribe a hydrocortisone (steroid) and antifungal creams.
There are other causes of skin irritation not caused by diapers. If the problem persists, you need to see a dermatologist.
I hope this article was helpful for all the moms and moms-to-be.