Nappy rash

Nappy rash is common in babies in New Zealand – find out about nappy rash, the causes, signs and symptoms. Plus advice on available treatment, remedies, and prevention of nappy rash.

What is nappy rash?

Nappy rash is a red rash which covers the skin of the nappy area – the genitals of boys and girls and the area around their back passage and the surrounding skin. It may also extend over their buttocks, groin area and upper thighs – refer picture.

Nappy rash is extremely common – most babies get it at one time or another. It is certainly not a sign of carelessness on the caregiver’s part, but much can be done to reduce or prevent it.

What causes nappy rash?

Nappy rash is caused by urine and/or faeces coming in contact with the skin for a period of time. Some parents report that nappy rash is worse when their baby is teething; others suggest that a change from disposable to reusable nappies – or vice versa – causes the flair up of the rash. Certain detergents may also trigger it in some children.

Nappy rash could also be caused by products such as scented baby wipes, so using cotton wool or a flannel and plain luke-warm water when you are at home is good advice. Save the baby wipes just for when you are out an about, or for that particularly horrid nappy! You know the ones I mean!

What are the signs and symptoms of nappy rash?

• A red, sore skin in the nappy area
• There may be broken skin
• This may extend to the groin, buttocks, upper thighs
• Your baby may be distressed at nappy changing time
• There may be small raised spots visible too

What is the treatment for nappy rash?

Nappy rash is usually treated by mums at home, with a bit of advice from friends, Plunket nurses, grandparents and of course the internet!

Here are some tips that are proven remedies for most cases of nappy rash:

• Frequent nappy changes, every 3-4 hours and straight after a dirty nappy
• Clean baby’s bottom with lots of warm water, soft flannels or cotton pads
• Leave baby nappy free for a play after every change (except night changes), with an old towel under their bum, to catch any wees!
• Apply a cream, such as a zinc and castor oil cream
• Check out your local health store if you prefer natural ingredients
• Using a soft nappy liner may help to keep your baby more comfortable.

Are there any risks associated with nappy rash?

Occasionally nappy rash does not disappear with home treatments, in which case a visit to your Plunket nurse or doctor is advisable.

• Nappy rash may be exacerbated by eczema, which may need to be treated with prescription medicines, such as a steroid cream. If you have allergies in the family, be particularly careful about products that you use on your baby’s skin.

• Nappy rash may not heal spontaneously because an infection has developed. Usually this is identified by the appearance of ‘pimples’ “blisters” or a skin swab taken by the nurse or doctor. This will usually require antibiotics, prescribed by your doctor.

• Nappy rash may also be associated with a fungal infection such as ‘thrush’ which needs to be treated with an anti-fungal cream. Thrush is often identifiable by little white spots.

Remember that most nappy rashes will clear in a few days with home treatments.

What can I do to prevent my baby or toddler from getting nappy rash?

All the ideas that help to treat nappy rash will also prevent it:

• Frequent nappy changes
• Try different types of nappies to see which ones seem to suit your baby best
• Avoiding baby wipes as much as possible
• Leave baby nappy free for a play after every nappy change
• Apply a protective cream, such as a zinc and castor oil cream
• Avoid soaps on the baby’s skin, especially perfumed soaps. Water is just perfect for a baby’s skin.

In addition be very careful with your laundering of reusable nappies:

• Rinse dirty nappies before you wash them
• Wash nappies in a hot wash cycle of the washing machine, which has a long rinse cycle
• Use the washing line as much as possible, even if you have to finish them off in the dryer in the winter – the fresh air and sunlight will be great at preventing bugs growing on those nappies.

Useful articles

For more information on Eczema, visit our Kiwi Families article

The Nappy section gives great information on the different types of nappies available to Kiwi Parents.