Prevention of diaper rash (nappy rash)

Diaper rash is a common condition seen in babies between 9 to 12 months of age. Although mild cases may be easy to treat, more severe cases may become secondarily infected and lead to recurrences and long term therapy requirement.

Good skin care and hygiene often prevents occurrences of diaper rash and may also prevent recurrences. These methods are applicable for treatment of mild cases of nappy rash as well. Skin care regimen and routines for prevention of diaper rash include (1-6):-

• The baby should be kept off the nappy for as long as possible. This keeps the skin dry and helps prevent nappy rash.

• The baby should be placed over an absorbent towel without the nappy and the towel needs to be changed each time the baby soils it. While asleep the nappy may be avoided.

• The baby should be allowed stomach time without the nappy to dry the buttocks and area around the anus.

• Nappy should be changed frequently and the baby should not be allowed to remain in a soiled diaper. This is especially true if the nappy is soiled with faeces.

• Only water should be used to wash the baby’s bottom. Soap can leave the skin dry and lead to increased risk of nappy rash.

• After each wash the skin needs to be patted completely dry with a soft towel or cotton cloth.

• A barrier cream containing zinc oxide or simple petroleum jelly may be applied after each nappy change. The barrier cream needs to be applied in a thin layer. This preserves the breathability of the skin while protecting it from the wetness.

• Lotions, oils that may contain perfumes or other additives should be avoided.

• Tight fitting plastic pants should not be put over nappies

• Talcum powders are not recommended when changing nappies. Unlike a barrier cream the powders do not protect the skin from wetness, urine and faeces. In addition it may also cause friction and irritate the soft skin. Talcum powders in addition may also be breathed in by the baby leading to irritation of lungs.

• All cloth nappies need to be washed in mild detergents and they should be rinsed thoroughly to remove the traces of the detergent completely. Fabric softeners, bleach, presoaks etc. should be avoided as they may remain on the clothes causing irritation.

• In case the stools are loose fruit juices, apple juice etc. should be avoided. These are acidic and may irritate the skin around the anus and lead to diaper rash.

Disposable versus cloth diapers

It is believed that babies who never wear disposable diapers are not the ones who never get diaper rashes.

Both cloth nappies and disposable diaper wearing babies are equally susceptible to diaper rash. The advantage of cloth diapers is that they can be worn without plastic pants.