Dealing with nappy rash

Dr Monda Ang’awa

Nappy rash is an inflammation of a baby’s skin, most often due to its prolonged contact with urine or stool in soiled nappies

The skin around the genital area and anus — sometimes spreading to the tummy and buttocks — gets red and moist. It may develop blisters or peel off leaving raw patches. The skin is very sore, especially when the baby passes urine and it comes into contact with the rash.

Urine is sterile but the germs on the baby’s skin, and in the nappy, changes chemicals in urine into ammonia, which ‘burns’ the skin.

Other factors that can cause nappy rash or make it worse are bouts of diarrhoea or having a fungal infection on the skin such as candida, which is found in the stool and thrives in the dampness under the nappy.

Also, chemicals in nappy soaking solutions, laundry detergents and fabric softeners, baby wipes that contain alcohol, scented soaps or baby lotions could aggravate nappy rash.

Plastic pants may also contribute because they prevent airflow and baby clothes don’t easily get wet. Thus, a baby is left in a wet or dirty nappy for a long time, keeping the skin in contact with urine or faeces.

Rough nappies can rub and chafe at the baby’s sensitive skin too. Some babies only get nappy rash when they have a cold or some other viral illness.

Babies who have rashes on other parts of their bodies, such as cradle cap or eczema (on the face or under the chin), are more likely to get nappy rashes because their skin is extra sensitive.

The best defence against nappy rash is a dry bottom. An ordinary nappy rash can be easily treated at home.

These steps help prevent nappy rash:

Let the rash get some air by leaving baby's nappy off for about an hour a few times a day.

Change baby’s nappy frequently and as soon as possible after it becomes wet or soiled.

Wash baby's bottom with plain warm water and cotton wool every time you change the nappy and dry it carefully.

Use disposable diapers. They absorb the urine quickly, leaving the surface of the nappy next to the skin dry.

Use only soaps made for babies and baby wipes that do not have alcohol.

Always ‘water proof’ baby's bottom with a thin layer of protective ointment during every nappy change using a barrier cream, such as zinc and cod liver oil, zinc and castor oil or pure petroleum jelly.

A good quality 100 per cent aloe vera gel is also good for nappy rash. It heals the rash fast and prevents its recurrence.

Avoid talcum powder because it makes the irritation worse and may also get into baby's lungs.

Fasten diapers lightly to allow baby's bottom to breathe.

Make sure you change cloth nappies often and do not put plastic pants over them whenever possible.

Thoroughly rinse all washed nappies to remove traces of detergents and other chemicals. Then, if possible, dry them in a tumble drier which makes them much softer than drying them in the sun.

Don't put a nappy on baby whenever practical.

When weaning your baby, introduce only one item at a time and wait a few days before introducing any thing else to determine if nappy rash is due to a food allergy.

See your doctor if baby's nappy rash looks severe, is hurting, spreading, does not clear up within a few days or baby develops a temperature.