What is diaper rash?
Nearly all babies have diaper rash at some time during their infancy. Whether cloth diapers or disposable diapers are used does not affect whether the baby will develop this rash. Prolonged contact with a soiled diaper is the most likely cause of diaper rash.
The incidence of diaper rash typically peaks in babies who are eight to twelve months old. When a baby starts on solids or juices, occasional diaper rash is likely to occur. Sometimes when new foods are fed to the baby, the baby’s body may not be able to digest the food completely; enzymes in the food can cause diaper rash. These enzymes can break down a baby’s skin, causing irritation and even sores known as dermatitis. Acid in foods and juices can also cause irritation; a bright red scald around the urethral opening or on the buttocks can result when the baby cannot digest the acid in such foods as tomatoes or orange juice.
Interaction between the baby’s urine and bacteria on the baby’s skin produces ammonia. Ammonia can be caustic to the diaper area, causing burns. Prolonged wetness can cause the rash to form bumps, which then become white-headed pimples and even weeping areas. These white-headed, weeping pimples are likely to appear if a baby sleeps in a wet diaper for ten to twelve hours or if a baby has a cold, sore throat, or ear infection.
Another cause of diaper rash is yeast infections, such as candidiasis. A rash from a yeast infection is fiery red and bumpy; it may have scaly edges. The rash caused by candidiasis may appear when a baby has been ill, since some antibiotics taken for certain illnesses may destroy the bacteria that control the growth of yeast in the body.
Babies are likely to get diaper rash when they have had diarrhea or an illness. Diarrhea burn is indicated by a bright red burn encircling the baby’s anus after a bout with diarrhea. Streptococcal bacteria may also produce diaper rash; often, diaper rash caused by strep infection will appear after other members of the family have been infected. This rash will be bright red, with swollen areas near the rectum. There may also be slits in the skin.
There are also inorganic causes of diaper rash. A diaper that fits too snugly may cause a rash. Usually, such a rash is shiny and red but not sore. Sensitive skin may also develop a rash when exposed to fabric softeners, detergents, and various toiletries. Such rashes are often tiny red blisters. If the baby wears cloth diapers, a rash can occur if the diaper has been washed in a detergent that contains an enzyme or bleach. The plastic in some disposable diapers can also cause red patches.
The best way to eliminate diaper rash is to keep a baby clean and dry. Caregivers should remove wet or soiled diapers as soon as they are aware of them. The baby should be washed with warm water and dried off at each diaper change. If there is a rash, the baby should be allowed, whenever possible, to lie with the diaper area uncovered. If air is allowed to move around the diaper area, it is less likely that a rash will form, and if one does occur, it is more likely that the rash will heal. Therefore, the baby’s diapers should not be fastened too tightly to the skin. Topical agents that form a barrier to the skin's surface can also prevent diaper rash.
If the baby’s diaper rash is caused by a yeast infection, then antifungal medication will be needed to clear up the problem. Severe diaper rash caused by prolonged wetness can sometimes be controlled by using extra-absorbency disposable diapers. Topical corticosteroids can be useful if the diaper rash is due to allergic contact dermatitis.
If the diaper rash appears to be a result of irritation from detergents used in washing cloth diapers, then the diapers should be washed in milder detergents. Drying diapers in a very hot dryer or in the sunshine will kill organisms that can cause rashes. If all else fails, boiling diapers for a half hour or more will destroy most bacteria.
Diaper rash can be prevented by coating the diaper area with a protective ointment such as petroleum jelly. If a diaper rash does develop, the ointment can prevent further spread of the rash. Care must be taken, however, because medicated ointments can prevent the stay-dry liner of disposable diapers from drawing moisture away from the body, making the rash worse.
A physician should be consulted for a diaper rash that resembles a chemical burn, develops blisters, or becomes infected. A secondary infection, which must be treated by a doctor, is a fairly common complication of diaper rash. A urinary tract infection may develop from uncontrolled diaper rash.
Undoubtedly, diaper rash has been around since babies began to wear diapers. It can be largely prevented through vigilant caregivers who make sure that diapers are changed as soon as they become soiled or wet. Nevertheless, when a baby is sick or sensitive skin comes in contact with irritants such as detergents, it is likely that diaper rash will occur.
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