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Is your baby’s bum looking beyond angry these days? If they’re between 4 and 15 months old, chances are that she might have a diaper rash. And —take a deep breath — it’s nothing you did wrong. At least half of babies this age have had a diaper rash at least once in the last two months.
Diaper rashes can come on quite suddenly and make you and your little one miserable. They can also be pesky and difficult to heal, leaving you feeling pretty powerless.
The key to effective treatment is understanding what type of rash your baby has. That’s right — there are several of these monsters you may encounter. Don’t worry, though, we’ve got you covered — from A+ identification to zinc oxide diaper creams.
Your baby’s skin deals with a lot under a diaper. You’re busy changing all the pee and poop, but your baby’s bottom is literally stewing in it all day. Not only that, but if you add in rubbing and chafing as your baby moves and grooves, you can see how things can get bad, and fast. Poor thing!
Rashes caused by irritants — urine and feces — are the most common type doctors see on the exam table. They may look red and shiny. The area may even feel warm to the touch.
This type of rash is focused on the genitals, buttocks, thighs, and stomach, but it’s not usually found in the creases or folds of the skin between these areas.
And watch out for the acidic poop
Yeah, acidic poop. Diaper rashes may increase when your baby starts eating solid foods. When certain foods are eliminated from the body, they may make poop particularly irritating. Eating foods may also make your baby poop more often, leading to even more rashes.
And if you’re breastfeeding, keep an eye on your diet as well. Some people feel that certain foods they eat bother their baby’s bottom.
You can treat most rashes caused by irritation with over-the-counter (OTC) creams and ointments. Look for creams with zinc oxide or thick petrolatum-based ointments that can protect the skin while it heals. If the rash is particularly severe, you may need prescription cream to help clear it up.
Preventing this type of rash is all about keeping baby’s skin happy.
- Change baby frequently throughout the day — every 2 to 3 hours, and more often if your baby has diarrhea. Also change at night. We know, not ideal. But you really should do it, especially if you suspect there may be poop in their diaper.
- Apply a barrier before the rash starts. Creams and ointments help shield the skin from moisture and irritants. Consider adding this to your normal routine.
- Size up or loosen the diaper a bit to give the skin more space. Again, this is particularly important overnight when your little one is in their diaper the longest.
- Give your sweet babe some diaper-free time to let the skin breathe. Worried about accidents? Place a towel down first — just in case.
- Watch what baby is eating. What causes a rash in one baby may not in another. And steer clear of juices, which are acidic and may cause diarrhea.
Related: 7 tips for diaper rash treatment
Candida — more commonly referred to as yeast — rashes have a deep red color. They show up as patches or plaques inside the diaper area, in the folds and creases of the thighs, and even outside the diaper area. There may be red dots just outside the main area of redness.
Baby girls may also have a white or yellow discharge from the vagina and itching. Baby boys may have scaling or redness on the penis.
If you suspect yeast, take a look if your baby’s mouth as well. They may have thrush, which is a yeast infection in the mouth. This type of rash can happen when baby is taking antibiotics for an illness. Breastfeeding moms may even pass along yeast infections after taking medications.
Some people have had good luck with OTC antifungal creams. But you’ll probably need to make an appointment with your pediatrician, who will likely prescribe some type of antifungal ointment or cream for yeast infections.
Oral antifungal medicines are sometimes needed, but your topical creams or ointments usually do the trick.
Yeast diaper rashes are common. They aren’t always related to antibiotic use, so they’re hard to prevent, so it’s best just to keep following healthy diapering practices.
Research on probiotics use in infants is slim, but you might consider asking your pediatrician about giving your baby probiotics while they’re on antibiotics. Probiotics may encourage good gut bacteria to help keep yeast at bay.
Though not common, your baby could be allergic to something in their diaper or wipes. With repeated exposure, they may end up with a nasty rash.
Can’t pinpoint anything new in your routine? Keep in mind that allergic reactions may take between 1 and 3 weeks to show up after the first exposure.
Diaper rashes caused by allergic reaction are red, shiny, and can show up on large areas — on the genitals, buttocks, abdomen, thighs, and in the creases. Basically, you’ll see it anywhere and everywhere diapers and wipes touch or where other products are applied.
Your baby’s rash won’t clear up until you figure out what they’re allergic to. Even then, it may take between 2 and 4 weeks after you eliminate the allergen for the rash to clear.
OTC diaper creams can help with symptoms. Try formulas for that are fragrance free and hypoallergenic. You may want to speak with your doctor about prescription medications if the rash is particularly severe.
You’ll need to figure out what’s causing the reaction. Try looking at each step in your diapering routine individually.
- If you have changed diaper brands, try changing back or look for a brand of diapers that doesn’t include chemicals or dyes.
- Look for wipes that are similarly stripped of alcohol, fragrances, and other chemical additives. Or just use a soft cloth with warm water.
- If you’re using cloth diapers, examine the detergent you’re using. Your best bet is a free and clear formula.
Maybe baby has a skin infection down there. What starts as a tiny area of infection may quickly spread in the moist, warm conditions under the diaper. The most common culprits are group A Streptococcus and Staphylococcus aureus bacteria.
- With strep, the rash may be bright red and focused around the anus, though it can spread to the genitals. You may even notice blood in your baby’s poop.
- With staph, you might see pus-filled bumps with a red base. These blisters may rupture with a yellow-brown fluid and leave behind scales.
Bacterial infections can get serious if they aren’t treated promptly. So, you’ll need your pediatrician’s help. Look out for other worrisome symptoms, including fever of 100.4°F (38°C) or higher, bleeding, weeping or pustules, or lethargy.
This type of rash can’t be treated with OTC creams. Instead, make an appointment with your doctor to get prescription antibiotics, like amoxicillin and penicillin. Infections, like strep, tend to recur, so it’s a good idea to make a follow-up appointment as well.
Infections can’t always be prevented, but you can keep an eye out for early signs so the infection doesn’t become severe. Infections may also be more likely if there is persistent irritation, like small cuts or scratches, in and around the diaper area.
Wash the area gently and pat dry so you don’t accidentally scratch or cut your baby’s delicate skin. Be sure to treat other types of diaper rashes, as they have the potential to turn bacterial the longer the skin is damaged.
There are a number of other issues that can affect your child’s skin and cause a rash. If your child’s condition seems long-lasting, your best bet may be getting a referral from your pediatrician to a dermatologist who specializes in children’s skin.
This may look like a normal diaper rash at first, but it can become purple and crusty. Sometimes you may even see blisters or weeping.
Eczema is usually dry and itchy. Though it occasionally causes diaper rash, it is more common on other parts of the body. It can often be managed by bathing and moisturizing with mild soaps and creams or ointments.
Avoiding irritation is important, which means you’ll want to use fragrance-free products, diapers, and wipes. Keeping the skin breathing and cool is also helpful.
Your doctor may prescribe medicated ointments or bleach baths. Many babies and young children outgrow their eczema by the time they’re 3 to 5 years old.
This can very closely resemble a diaper rash or yeast infection. Doctors often misdiagnose the condition at first. And even if you do see a pediatric dermatologist, it can be hard to distinguish between eczema and psoriasis in babies.
The good news is that the treatment course is similar for both conditions. You’ll want to keep the skin happy by using gentle products and consider using prescription ointments.
This can cause diaper rashes and impact skin on other parts of the body, like the scalp, face, and neck. While this type of rash is red, you also may see yellow or oily patches under the diaper and in the skin folds.
Treatment involves topical medications. While doctors don’t totally know what causes it, there’s good news. Seborrheic dermatitis tends to go away on its own by the time your baby reaches 6 months to 1 year in age.
Impetigo is a contagious skin infection caused by the same bacteria (group A Streptococcus and Staphylococcus aureus) that causes general bacterial dermatitis.
Impetigo, however, looks like sores instead of a rash. These lesions may rupture and ooze on different parts of the body. They typically focus around the nose, mouth, hands, and feet, but you can also find them in the diaper area or anywhere else that has been exposed.
Treatment requires topical or oral antibiotics to heal. Until your little one has treatment for 24 hours, they may pass the infection on to others.
This type of rash is made up of tiny bumps. In fact, it’s sometimes called “prickly heat” for this reason. It happens when the skin — anywhere on the body — is hot and can’t breathe. In the diaper area, you may see it particularly in the creases. The sweat ends up blocking the pores and creates the redness, bumps, and itching.
Thick creams and ointments may make matters worse. So, if you suspect heat rash, don’t slather on diaper creams. Treatment involves cooling the area and promoting good air flow.
Your best friend may swear that switching to cloth diapers helped her kids with rashes. Or maybe you’ve read the opposite is true when browsing around baby forums. (All the advice you get in the first year can surely be confusing!)
What do the experts say? Well, there’s no real evidence to suggest that either type is better. Instead, you need to choose what works best for your family and your budget. This simply means finding a brand of diaper that doesn’t irritate (if you do disposables) and finding a laundry soap that doesn’t irritate (if you use cloth).
Either way, change your baby frequently to keep their bottom clean and dry.
If you feel like you’ve tried every diaper cream under the sun, and your child’s rash is still raging, pick up the phone. You don’t need to do all this detective work alone. Rashes that don’t respond to home treatment after 2 to 3 days are a reason to visit your doctor.
And make an appointment sooner if you see pus-filled sores, blisters, or any other worsening symptoms, like fever. Once you get the right treatment for your baby’s rash, you’ll both feel a whole lot better.