7 Top Ways to Prevent Diaper Rash

If you have a baby, you’re probably going to have to deal with diaper rash, no matter if you’re using cloth or disposable diapers and even if you’re hyper-vigilant with changes. At Westchester Health, we’ve helped thousands of parents learn how to prevent diaper rash, as well as treat it if it occurs. We’re here to help you too, with tips and advice for keeping your wonderful bundle of joy clean and dry and hopefully rash-free.

What causes diaper rash?

Several factors can cause diaper rash, most commonly:

• Irritation from stool and urine. Prolonged exposure to urine or stool can irritate a baby’s sensitive skin. Diarrhea is especially problematic because feces are more irritating than urine.
• Chafing or rubbing. Tight-fitting diapers or clothing that rubs against the skin can lead to a rash.
• Reaction to the products you’re using. Your baby’s skin may react to the type of baby wipes, disposable diapers, detergent, bleach, fabric softener, lotions, powders or oils you’re using.
• Bacterial or yeast (fungal) infection. The area covered by a diaper — buttocks, thighs and genitals — is especially vulnerable to a bacterial, yeast or fungal infection because it’s warm and moist. These rashes can be found within the creases of the skin, with red dots around the creases.
• Introduction of new foods. As babies start to eat solid foods, the content of their stool changes which increases the likelihood of diaper rash. Changes in your baby’s diet can also increase the frequency of stools, which can also lead to diaper rash. If you’re breastfeeding, your baby might develop diaper rash in response to something in your diet.
• Sensitive skin. Babies with skin conditions such as atopic dermatitis or seborrheic dermatitis (eczema) may be more likely to develop diaper rash. However, the irritated skin of atopic dermatitis and eczema primarily affects areas other than the diaper area.
• Yeast infection. When a baby is given antibiotics, “good” bacteria that keep yeast growth in check may be erased, resulting in diaper rash due to yeast infection. Antibiotics also increase the possibility of diarrhea. Breastfed babies whose mothers take antibiotics are also at increased risk of diaper rash.

How to know if it’s diaper rash

If your baby has a diaper rash, the skin in the diaper region — buttocks, thighs and genitals — will be red, irritated and tender-looking.  Also, your baby might seem more fussy than usual, especially during diaper changes, and might cry when the diaper area is washed or touched.

7 simple ways to stop diaper rash before it starts

The best way to prevent diaper rash is to keep your baby’s diaper area clean and dry. Here are some simple things you can do to help decrease the likelihood of your baby developing a rash, recommended by Mayo Clinic:

1. Change your baby’s diaper often

Change wet or dirty diapers promptly. If your baby is with a babysitter or in child care, make sure they do the same.

2. Rinse your baby’s bottom with warm water at each diaper change

Use a moist washcloth, cotton ball or baby wipes to clean the skin. Do not use wipes with alcohol or fragrance. If you use soap, make sure it’s for sensitive skin and fragrance-free.

3. Gently pat your baby’s skin dry with a clean towel. Better yet, let it air dry

Always pat, never scrub, your baby’s bottom. This can irritate the skin and possibly invite infection. When possible, let the skin air dry before re-diapering.

4. Don’t fasten diapers too tightly

Tight diapers prevent air from getting into the diaper region, which sets up a moist environment that encourages diaper rashes. Tight diapers can also cause chafing at the waist or thighs.

5. Give your baby’s bottom time without a diaper

When possible, let your baby go without a diaper. Exposing skin to air is actually the best way to let it dry. To avoid accidents, try laying your baby on a large towel or sheet while he/she is bare-bottomed (outdoors if it’s warm enough).

6. Use ointment or cream with each diaper change

Pastes, ointments or barrier creams such as A+D, Balmex or Desitin contain petroleum jelly or zinc oxide to soothe the skin and feces and other irritants from coming into direct contact with your baby’s skin.

7. After each diaper change, wash your hands thoroughly

Hand-washing can prevent the spread of bacteria or yeast to other parts of your baby’s body, your body or other children.

How often should you change your baby’s diaper?

According to ReviewThis, newborns urinate approximately 20 times per day, which means you should change your newborn’s diaper every 2-3 hours. If you’re using cloth diapers instead of disposables, you should change them every 90 minutes. If your baby is sleeping peacefully, a diaper change can wait until your child wakes up on his/her own or when you wake him/her for a feeding.

It’s especially important to change a poopy diaper as soon as possible because bowel movements can irritate a baby’s skin. This is even more crucial with baby girls because feces that are allowed to stay in contact with their genitals can cause a bladder infection.

What not to do

When it comes to preventing and treating diaper rash, less is more, says Healthline.com. You should not:

• Use highly fragranced products, including fabric softeners and dryer sheets. Hypoallergenic and fragrance-free items are less irritating.
• Cover your baby’s diaper in rubber pants or a tight plastic cover. This creates a moist, hot environment which promotes diaper rash. Instead, dress your baby in clothes that are breathable.
• Use baby powder. Your baby can inhale it, which can harm his/her lungs.
• Use cornstarch. Like baby powder, your baby can inhale it which can irritate the lungs. In addition, cornstarch can worsen diaper rashes caused by the fungus candida.

Contact your pediatrician if the following conditions develop

Although diaper rash can look painful and irritated, it usually doesn’t bother your baby. The exception is when the rash becomes infected, which needs immediate treatment from your pediatrician.

Symptoms of an infected diaper rash include:

• blisters on the diaper area
• fever
• redness
• swelling in the diaper area
• pus or discharge that drains from the diaper area
• rash does not get better after 4-7 days of treatment, or gets worse
• rash spreads to other parts of your baby’s body
• rash is accompanied by a bacterial infection (impetigo) that needs to be treated with antibiotics. Symptoms: pus-like drainage or yellowish-colored crusting
• you’re not sure what is causing the rash
• diarrhea for more than 48 hours
• your child is difficult to console or seems to be in pain related to the diaper rash

Helpful articles we recommend

• What to Do When Diaper Rash Won’t Go Away
• 11 Best Diaper Rash Creams
• The Diaper Wars: Cloth vs. Disposable
• Yeast Infection vs. Diaper Rash in Toddlers

You’ve got questions, we’ve got answers

At any age, count on the pediatricians of Westchester Health and Northwell Physician Partners for vital information to help you raise happy, healthy kids. Whether you have teenagers, adolescents, toddlers or newborns, we’ve got years of experience helping parents take care of their children and we’re here to help you with yours. Please call us at (914) 232-1919.

Want to learn more about preventing diaper rash? Come see us.

If you want more tips on preventing diaper rash or diapering your baby, or have questions about any aspect of taking care of your newborn, call (914) 232-1919 to make an appointment to come in and see one of our Westchester Health pediatricians. We’ll share our years of experience with you and take as much time as needed to answer all your questions. Most of all, we want to help you raise a happy, healthy child and feel confident as a parent. Whenever, wherever you need us, we’re here for you.

By Lauren Adler, MD, FAAP, Lead Pediatric Physician with Westchester Health, member of Northwell Health Physician Partners