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Bottoms Up: The Low Down on Diaper Rash

Written by Melanie Williams, M.D. on Aug 7, 2019 8:08:00 AM

When it comes to changing your baby’s diaper, you never know what you’re going to get. Will it be solid? Liquid? Gas?

But one thing you know you don’t want to see when you fold back that diaper is a case of diaper rash.What Is Diaper Rash?

Diaper rash is a broad term to describe any skin irritation that forms in the diaper area. If you do discover that your baby has diaper rash, you are not alone. More than half of babies between 4 months and 15 months of age have diaper rash at least once in a two-month period.

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There are several reasons a baby may get diaper rash, including:

  • Too much moisture
  • Chafing or rubbing
  • Urine or stool touching the skin for long periods of time
  • Yeast infection
  • Bacterial infection
  • Reaction to diaper material
  • Reaction to food

Moisture from a soiled diaper can harm your baby's skin and make it more prone to chafing. When this happens, a diaper rash may develop. Signs of diaper rash include slightly reddened skin and an area that may be warm to the touch. This is more likely to occur when babies:

  • Aren’t kept clean and dry
  • Have frequent stools, especially when the stools stay in diapers overnight
  • Have diarrhea
  • Begin to eat solid foods
  • Are taking antibiotics or mothers of nursing babies are taking antibiotics

What to Do

Most cases of diaper rash can be treated at home with over-the-counter products. Your first goal should be to keep the affected area clean and dry.

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When you change your baby’s diaper, clean the area gently with water and a soft washcloth. Pat, don’t rub, and allow the area to fully dry. Disposable diaper wipes may also be used. We suggest avoiding wipes that contain alcohol and fragrance. Instead, use soap and water if the stool does not come off easily. If the rash is severe, use a squirt bottle of water so you can clean and rinse the area without rubbing.

Once the area is dry, apply a layer of protective ointment or cream (such as one that contains zinc oxide or petroleum jelly). These ointments are usually thick and do not have to be completely removed at the next diaper change.

Finally, keep the diaper loose so that the wet and soiled parts don’t rub against the skin as much.

Although diaper rash is fairly common, it’s important to understand that some cases of diaper rash can be severe and may require a visit to the doctor. We recommend calling your child’s pediatrician if:

  • Treatment has been unsuccessful after two to three days or symptoms continue to get worse.
  • The rash spreads to other parts of the body such as the abdomen, neck, face, or arms.
  • You notice other skin eruptions like blisters, pimples, bumps, or sores.
  • The baby develops a fever.
  • The rash occurs within the first few weeks after birth.

How Do We Keep Diaper Rash from Coming Back?

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Once you’ve gotten the rash to clear up, here are a few tips to help prevent diaper rash from returning:

  • Expose your baby's bottom to fresh air by leaving the diaper off whenever possible.
  • Be aware and change your baby’s diapers as soon as they are wet or soiled.
  • Use mild detergent to wash your baby’s clothes and linens.
  • Carefully observe any changes in your baby’s skin and digestion when introducing new foods.

In addition, research suggests that diaper rash is less common with the use of disposable diapers.

Diaper rash can be unsettling, but rest assured once it is treated properly, your baby will be sitting pretty. If you have any questions about diaper rash, be sure to contact your Kelsey-Seybold pediatrician.


Dr. Williams is a pediatrician at Kelsey-Seybold’s Clear Lake Clinic. Her clinical interests include developmental disorders and delays, blood disorders, and normal development of babies and toddlers.


Topics: diaper rash, what to do about diaper rash, how to treat diaper rash

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