An essential part of every baby's care is diapering. Until a child is toilet-trained, usually by 3 years of age, diapers are used to collect urine and bowel movements. It is estimated that a baby uses six to 10 diapers each day - this translates to about 2, to 3, diapers each year. With so many diaper changes, parents want to know how to make this task quicker and easier. Generally, there are two choices—cloth or disposable—and each type has advantages and disadvantages.
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Dermatitis of the buttocks, genitals, lower abdomen, or thigh folds of an infant or toddler is called diaper rash.
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Dermatitis of the buttocks, genitals, lower abdomen, or thigh folds of an infant or toddler is called diaper rash. The outside layer of skin normally forms a protective barrier that prevents infection; when the barrier fails, the child may develop a rash in the area covered by the diaper.
Diaper rashes occur equally with cloth diapers and disposable diapers. Diaper dermatitis results from prolonged contact with irritants such as moisture, chemical substances, and friction. Urine ammonia, formed from the breakdown of urea by fecal bacteria, is irritating to sensitive infant skin. Ammonia by itself does not cause skin breakdown. Only skin damaged by infrequent diaper changes and constant urine and feces contact is prone to damage from ammonia in urine.
Inadequate fluid intake, heat, and detergents in diapers aggravate the condition. Bouts of diarrhea can quickly cause rashes in most children. Diaper rash begins with erythema in the perianal region. Left untreated, the area can quickly excoriate and progress to macules and papules, which form erosions and crust.
Under certain circumstances in infants under the age of six months, toddlers who have been on antibiotics , and immune compromised children diaper dermatitis may become secondarily infected with Candida ablicans. Sometimes severe diaper dermatitis becomes super-infected with bacteria streptococci or staphylococci. Diaper rashes occur in the diaper-wearing age group birth to three years of age.
Diaper rash occurs in about 10 percent of infants and is most common between the ages of seven and nine months. Some infants seem predisposed to diaper dermatitis.
These infants have such sensitive skin that diaper dermatitis is a problem from the first few days of life. Baby with severe diaper rash. When parents and caretakers do not change the children's diapers often, feces is in contact with skin and irritation develops in the perianal area. Urine left in diapers too long breaks down into ammonia, a chemical that is irritating to infant skin.
Ammonia dermatitis of this type is a problem in the second half of the first year of life when the infant is producing a larger quantity of urine. When the diaper area has prolonged skin contact with wetness the natural oils are stripped away, the outer layer of skin is damaged, and there is increased susceptibility to infection by bacteria or yeast. Frequently a flat, red rash resulting from chafing of the diaper against tender skin causes friction rash.
This rash is not in the skin folds. It may be more definite around the edges of the diaper, at the waist and leg bands. The baby does not seem to experience much discomfort. Sometimes chemicals in detergents contribute to contact dermatitis. These rashes should clear up as soon as the chemicals are removed. Ignoring the condition may lead to a secondary infection that is more difficult to resolve. Another infectious cause of diaper rash is impetigo.
This bacterial infection is characterized by blisters that ooze and crust. Parents should call the child's healthcare provider for the following reason:. Diagnosis is made by examining the diaper area and taking the history of the onset and duration of the lesions.
The presence of skin lesions means the baby has diaper rash. However, there are several types of rash that may need specific treatment to heal. It is useful to be able to distinguish them by their appearance and causes.
A baby with a rash that does not clear up within two to three days or a rash with blisters or bleeding should receive an evaluation and care from a healthcare professional. Antibiotics are prescribed for rashes caused by bacteria and impetigo. This may be a topical or oral formula, depending on the size of the area involved and the severity of the infection.
Over-the-counter antifungal creams are often used to treat a rash resulting from yeast. If topical treatment is not effective, an oral antifungal is prescribed.
Treatment of diaper candida in young infants should include oral drops to treat any candida in the mouth and gut to avoid re-infection. Mild steroid creams, such as 0. Prescription strength creams are needed for short-term treatment of stubborn cases. Intertrigo can be treated with a combination of hydrocortisone and anti-fungal creams. Good diaper hygiene prevents or clears up many simple cases of diaper rash.
Many rashes can be treated as follows:. What the baby eats can make a difference in stool frequency and acidity. Typically, breast-fed babies have fewer problems with rashes.
When adding a new food to the diet, the baby should be watched closely to see whether rashes appear around the baby's mouth or anus. If they do, the new food should be avoided temporarily. Babies who are taking antibiotics are more likely to get rashes because of yeast. To help bring the good bacterial counts back to normal, Lactobacillus bifidus can be added to the diet. It is available in powder form from most health food stores. Some herbal preparations can be useful for diaper rash.
Calendula reduces inflammation, tightens tissues, and disinfects. It is recommended for seborrheic dermatitis as well as for general inflammation of the skin. The ointment should be applied at each diaper change. Chickweed ointment can also sooth irritated skin when it is applied once or twice daily. With proper treatment these rashes are usually better in three days if there is no underlying health problem or skin disease.
If the rash does not improve with treatment then the child probably has a yeast infection. In that case, the rash becomes bright red and raw, covers a large area, and is surrounded by red dots. For yeast infection, the child needs a special cream. Changing the diaper immediately and good cleaning are the best action a parent can take to prevent diaper rash. Some children will get a rash from certain brands of disposable diapers or from sensitivity to some soaps used in cloth diapers.
If cloth diapers are used, always wash them separate from other clothing and add bleach to the soap. After washing, the diapers should be rinsed thoroughly. There are two choices, cloth or disposable. Parents need to decide what works best for their baby and lifestyle. In the event of suspected yeast, a tablespoon of cider vinegar in a cup of warm water can serve as a diaper area wash. This is diluted enough that it should not burn, but acidifies the skin pH enough to hamper the yeast growth.
Barrier ointments can be valuable to treat rashes. Those that contain zinc oxide are especially effective. These creams and ointments protect already irritated skin. Cornstarch powder is soothing to rashes that are moist, such as impetigo.
Diaper dermatitis diaper rash —An inflammatory reaction to irritants in the diaper area. Impetigo —A bacterial infection of the skin characterized by skin blistering. Lactobacillus bifidus —A property of breast milk that interferes with the growth of pathogenic bacteria in the gastrointestinal tracts of babies, reducing the incidence of diarrhea.
Lactobacillus bifidus can be added to infant formulas to help control diarrhea. Middlemiss, Prisca. What's That Rash?
London: Hamlyn, Kazzi, Amin, and Khoa Nguyen. Toggle navigation. Description Diaper dermatitis results from prolonged contact with irritants such as moisture, chemical substances, and friction. Demographics Diaper rashes occur in the diaper-wearing age group birth to three years of age.
Causes and symptoms When parents and caretakers do not change the children's diapers often, feces is in contact with skin and irritation develops in the perianal area. When to call the doctor Parents should call the child's healthcare provider for the following reason: newborn with rash looks or acts sick or has a fever rash looks infected pimples, blisters, boils, weeping sores, yellow crusts, red streaks rash is not better in three days after treatment for yeast rash bright red then peeling off in sheets or raw and bleeding rash beyond the diaper area rash painful and not responding to home care.
Diagnosis Diagnosis is made by examining the diaper area and taking the history of the onset and duration of the lesions. Treatment Antibiotics are prescribed for rashes caused by bacteria and impetigo.
Complication The main complication is secondary infection by yeast or bacteria. Home care Good diaper hygiene prevents or clears up many simple cases of diaper rash. Many rashes can be treated as follows: Change diapers frequently.
Keep the area dry and clean. Check the diaper often, every hour if the baby has a rash and change the diaper as soon as it is wet or soiled. Check at least once during the night. Good air circulation is also important for healthy skin. Babies should have some time without wearing a diaper. A cotton pad can protect the bed while the baby is diaper free.
Any stool left on the vulva is very irritating. Browse local questions Questions Helpful? Identify the offending products and avoid them. It can nourish and treat the irritated skin. These include secondary syphilis, herpes, genital warts, and pubic lice.
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It may also help treat or prevent diaper rash. Using coconut oil topically may help relieve inflamed diaper rash and any accompanying redness, irritation, or itching.
It also helps moisturize skin and heal wounds. However, coconut oil may reduce skin inflammation, itching, and irritation. It may also help provide a skin barrier , which might further protect the skin as it recovers from diaper rash. Researchers have also found evidence that suggests coconut oil can help promote wound healing.
More research is needed on the effects of coconut oil on diaper rash. You can use it for however long as needed, but stop using coconut oil if your baby shows any sign of sensitivity to it. Apply about 1 teaspoon of coconut oil to the affected area. If your coconut oil is solid, you may need to warm it up between your hands or place the jar in warm water to apply.
After applying the coconut oil, allow the skin to completely dry before putting on a fresh diaper. You can do apply the coconut oil a few times throughout the day.
Choose a product with no added fragrance. If your baby is at least 6 months old, you can use coconut oil in combination with essential oils such as tea tree , lavender , or chamomile. Diaper rash usually clears up within a few days. You should start to see improvements in the severity of the rash after a few applications of coconut oil.
If your baby has diaper rash, managing the rash and taking steps to prevent it from getting worse can help speed up the healing process and make your baby as comfortable as possible. They can help you find a treatment that works. Diaper rash is a common condition. It can often be easily treated at home. When using coconut oil to treat diaper rash, always carefully monitor the effect of the oil on your baby. Discontinue use if any irritations or adverse reactions occur. Diaper rashes are a common problem for babies.
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