How to Deal With a Really Bad Diaper Rash (And How To Avoid Them)

One of the least enticing aspects of new parenthood is diaper duty, and its dreaded companion, diaper rash.

A diaper rash is the term used to describe a rash or irritation in the area covered by the diaper.

The first sign of diaper rash is usually redness or small bumps on the lower abdomen, buttocks, genitals, and thigh folds—surfaces that have been in direct contact with the wet or soiled diaper.

Luckily for you, mom, diaper rash is highly treatable and usually resolves within days or weeks. And, don’t be too hard on yourself when it shows up on your baby: nearly every baby will get diaper rash at least once during the first 3 years of life.

So, here’s your ultimate guide to the world of the diaper rash.

You’ll learn why diaper rash occurs and some simple, but effective ways you can rid your baby of the scourge of this particular form of dermatitis. And we’ll let you know in which cases the rash may require a conversation with your pediatrician.

When does diaper rash occur?

In clinical practice I see diaper rashes among a range of ages but for a variety of reasons. In the neonatal period, diaper rashes are most commonly due to frequent stooling. Breastfed infants can often pass small stools up to six times a day. This frequent skin contact with stool can cause irritation. Prolonged exposure to moisture is a common cause of diaper rash in older infants and toddlers. This can be due to not changing the diaper frequently enough or from sweating during warm weather months. Toddlers who are toilet training often develop rashes overnight from a soiled pull-up.

Dr. Leah Alexander, MD, FAAP

You’re most likely to notice diaper rash when your baby at an age when he or she  is sitting most of the time, and also eating solid foods that alter the acidity of his/her bowel movements.

There are, however, certain factors that can make your baby more prone to diaper rash. Chafing, skin sensitivity, and wet or infrequently changed diapers are often the culprits, according to Mayo Clinic.

Diarrhea or frequent bowel movements can also make your baby more likely to get diaper rash, says Johns Hopkins’ Health Library.

Also according to Johns Hopkins’ Health Library, babies taking antibiotics or who are breastfed by mothers taking antibiotics are more susceptible.  This usually leads to a yeast infection in the diaper area.

How can you treat diaper rash at home?

Sometimes, despite your best efforts, a diaper rash is inevitable.

Luckily, you don’t necessarily have to bring your baby to the doctor to treat his or her rash. Follow these simple steps for a few days at home if the symptoms of your baby’s diaper rash appear mild to moderate.

• Avoid products that seem to trigger your baby’s rash, and be cautious about introducing new ones (Mayo Clinic).
• Avoid soaps and wipes that contain alcohol or fragrance (Mayo Clinic). I happen to like WaterWipes, a natural and chemical free alternative to classic wipes, whose sole ingredients are water and grapefruit seed extract.
• Wash your baby’s bottom with water after each diaper change (Mayo Clinic). Then, make sure your baby’s skin is dry before putting on a new diaper (Mayo Clinic).  When a rash is present, you may want to dry the area with a small fan or cool setting of a blowdryer before putting on a clean diaper.
• Give your baby as much diaper free time as possible to air out the skin (Mayo Clinic). If you’ve got a little boy, you may want cover his genitals loosely with a diaper whilst doing this so you don’t accidentally get peed on.
• Change your baby’s diapers frequently and apply a diaper cream, lotion, paste, or ointment as a barrier between your baby’s skin and a dirty diaper (Mayo Clinic). I like to use Triple Paste because it’s fragrance free, hypoallergenic, and creates a smooth, thin film that protects my baby’s delicate skin.

I often recommend Triple Paste to my parents when the diaper rash has open, bleeding skin. This particular cream tends to be more soothing of raw, painful skin.

Dr. Leah Alexander, MD, FAAP

The Mayo Clinic also offers some additional home remedies.

What if the rash persists?

To make the most of your pediatrician visit, Mayo Clinic provides some helpful suggestions. First, list your baby’s signs and symptoms, and for how long your baby has had them.

You will also want to list key information about the baby’s medical conditions and food intake. If you’re breastfeeding, include any medications or new foods your baby may have been exposed to through breast milk.

Then list all products that come into contact with your baby’s skin, including all laundry detergent, diapers, soaps, lotions, etc. You may even want to take a snapshot of the ingredient lists on the products with your cell phone so your doctor knows exactly what’s in them.

Finally, list any questions you have so you don’t miss a beat.

How might your pediatrician treat your baby’s diaper rash?

A severe or persistent diaper rash may require treatment beyond what you can do at home without a prescription. According to WebMD, if your child appears to have a candida (yeast) infection, your doctor may recommend antifungal creams or medications.

In these situations, it is important to ONLY use the prescribed antifungal treatment. Applying other barrier creams during additional diaper changes can prolong a fungal infection (yeast seams to grow more in petroleum jelly and zinc oxide). Once the fungal rash has resolved, the usual rash protection creams may be resumed.

Dr. Leah Alexander, MD, FAAP

If your child has impetigo (a bacterial infection), your pediatrician may prescribe antibiotics. In many cases, your doctor may recommend a brief course of mild topical steroid cream or ointment if the rash doesn’t appear linked to an infection.

How can you prevent diaper rash moving forward?

Following certain habits on a regular basis are likely to decrease the possibility that your baby will get diaper rash. You may want to consider making these practices a part of your normal diaper routine, according to WebMD.

A final word on diaper rashes.

Diaper rash is a nearly inevitable consequence of diaper use, so don’t beat yourself up if it happens to your baby.

The key is to identify diaper rash before it gets severe, then take steps at home to treat the rash to hopefully avoid a trip to the pediatrician. If you do have to go to the pediatrician, the rash should be an easy fix and is likely not cause for major alarm.

Have you avoided diaper rash with your baby? If so, what worked for you? If your baby got diaper rash, what solutions were the most effective? Please share your experience in the comments section so other moms can learn your tricks!