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Vital Facts About Diaper Rash
  Rash won't go away? It may be something else. Is baby powder safe?
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Diaper rash doesn't always look the same. But if your baby's diaper area looks irritated and red, chances are he has it. His skin may also be a little puffy and warm when you touch it.

Diaper rash may be very mild, a few prickly red spots in a small area, or quite extensive, with tender red bumps that spread to your baby's tummy and thighs. There's no need to panic, though: Dealing with diaper rash is part and parcel of baby care, especially in the first year or so of your baby's life.

How did my baby get diaper rash?

Diaper rash can be caused by anything from a new food to your baby's own urine. Here are the most likely culprits:

  • Wetness. Even the most absorbent diaper leaves some moisture on your baby's delicate skin. And when your baby's urine mixes with bacteria from his stool, it breaks down and forms ammonia, which can be very harsh. Although a baby left in a dirty diaper for too long is more likely to develop diaper rash, any baby with sensitive skin can get a rash, even if his parents are diligent diaper changers.

  • Chafing or chemical sensitivity. Your baby's diaper rash may be the result of his diaper rubbing against his skin, especially if he's particularly sensitive to chemicals like the fragrances in a disposable diaper or the detergents used to wash a cloth diaper. It could also be that a lotion or powder you're using for diaper duty doesn't agree with your baby's delicate skin.

  • New foods. It's common for babies to get diaper rash when they start eating solid foods or are introduced to a new food. Any new food changes the composition of the stool, and it might increase your baby's bowel movements as well. If you're breastfeeding, your baby's skin could even be reacting to something you're eating.

  • Infection. The diaper area is warm and moist, just the way bacteria and yeast like it. So it's easy for a bacterial or yeast infection to flourish there and cause a rash, especially in the cracks and folds of your baby's skin.

In addition, babies on antibiotics (or whose breastfeeding mothers are on antibiotics) sometimes get yeast infections because antibiotics reduce the number of healthy bacteria that help keep yeast in check as well as the harmful bacteria they're meant to destroy. Antibiotics can also cause diarrhea, which can contribute to diaper rash.

Thrush is a type of oral yeast infection. Some babies with thrush develop a yeast infection in their diaper area too.

How can I prevent diaper rash?

Here are some good preventive measures:

  • The best defense against diaper rash is a dry bottom, so change your baby's diaper as soon as possible after it becomes wet or soiled.
  • Clean your baby's genital area thoroughly with each diaper change. Pat his skin dry, never rub it.
  • If your baby seems prone to diaper rash, coat his bottom with a thin layer of protective ointment after each diaper change. There are several good barrier ointments on the market, including petroleum ointment and white zinc oxide (which is thicker and good for protecting very sensitive skin). It's okay to use plain petroleum jelly as a barrier, but it rubs off easily.

    Skip the talcum powder, as the dust is harmful to your baby's lungs if he breathes it in. If you want to use powder, choose the safer cornstarch-based type. Shake powder into your hand, away from your baby; never directly on or near him, and keep the container well out of his reach at all times. At every diaper change, carefully wash away any powder that accumulates in your baby's skin folds.
  • When your baby starts eating solid foods, introduce one new item at a time. Waiting a few days between each introduction will make it easier to determine whether sensitivity to the food causes a diaper rash. If it does, you can eliminate that food for the time being.
  • Don't secure the diaper so tightly that there's no room for air to circulate. Loose clothing will let your baby's bottom breathe. Avoid plastic pants and other airtight fabrics.
  • Don't wash cloth diapers with detergents that contain fragrances, and skip the fabric softener, both can irritate your baby's skin. Use hot water and double rinse your baby's diapers. You might also add half a cup of vinegar to the first rinse water to eliminate alkaline irritants.
  • Breastfeed your baby for as long as you can. Breastfeeding boosts your baby's resistance to infections in general and makes him less likely to need antibiotics, which can contribute to diaper rash.
  • If your baby goes to daycare, make sure that his caregivers understand the importance of taking these measures to prevent diaper rash.
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