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Nappy rash has become the generic term for any redness on the skin in the nappy area. An adult's skin is 2mm thick, whilst an infant's is only 1mm, so it is only natural that they are more susceptible to irritants. Whilst true nappy rash is not uncommon it is important to be able to distinguish between that and other rashes that come under the "nappy rash" umbrella.
Thrush
A candida infection is indicated by a whitish scaling at the edge of the rash, or small spots. It can be treated with sunshine - yeast hates the sun, and a good anti-fungal crème available from your pharmacist. Using a hemp nappy will help because of it's anti-fungal properties.
Allergy Dermatitis
Can be caused by irritants coming into contact with the skin. Be sure to avoid enzyme-based detergents, rinse regularly and use a sensitive detergent if necessary. Allergy dermatitis is often caused by perfumes and other chemicals involved in the processing of disposable nappies, but the main culprit is the myriad of ingredients in disposable wipes. Use cloth wipes with warm water.
Intertrigo
This rash is caused by the skin remaining wet too long. It is found in the folds of skin in the groin area, under the chin during the "drooling age" and in the armpit area. While some people like to use cornflour, this can lead to further infection as it retains moisture, it is best to use a moisture barrier crème such as zinc oxide or zinc and castor oil. Intertrigo is extremely painful, so avoid rubbing the skin.
Seborrhoeic Dermatitis
If the rash is scaly, yellowing and appears elsewhere, such as behind the ears or under the arms it may be seborrhoeic dermatitis. See your doctor for treatment.
Nappy Rash Proper
True nappy rash is caused by exposure to urine and faeces for too long. How long is "too long" will depend on your baby and his skin's sensitivity as well as his overall health. Urine is sterile until it mixes with bacteria on the skin, in faeces, and in the nappy itself. This changes the chemical composition and produces irritants which can cause nappy rash.
Ammonia
With its very high pH is one of these chemicals. Using a liner over the entire nappy area will wick the moisture away, so that if ammonia forms, it is less likely to irritate the dry skin. Changing nappies regularly will help prevent ammonia from forming.
Excessive Heat
The warm, moist environment inside the nappy is ideal for bacteria formation and a trigger for nappy rash. Do not use PVC pants or disposable nappies as they both use plastics which cannot allow the skin to breathe. Use a PUL, fleece or woollen cover over a cloth nappy to cool baby's skin and allow airflow.
Friction
Rubbing from nappies can cause moist skin to blister. Be sure to use a liner which keeps the skin dry and is a barrier between the nappy fabric and baby's skin.
Ill Health/Food
Illness and teething are major culprits for nappy rash as both urine and stools change composition and are more likely to burn the skin during times of compromised health. Some foods such as juice or chilli can burn the skin within hours. You may need to avoid trigger foodstuffs until the skin is strong enough to cope.
Remedies
The best remedy for nappy rash is no nappy! Allow as much airtime as possible.
Bathe at least twice a day - preferably after each bowel movement.
Change frequently. This is also the best way to prevent nappy rash.
Use a mild camomile tea in your wipes solution. Chamomile is calming for the skin and promotes healing.
To make chamomile solution: Boil up one cammomile teabag in 1 ½ cups water for 5 minutes. Allow to cool.
You can also make a chamomile compress. Soak a face washer with chamomile solution and place over the red area. Then put on the nappy to keep the compress in place. Remove after an hour or so - you should be able to see a difference in that time.
Use a barrier crème. This protects the skin from burning chemicals.
Give extra cuddles! Nappy rash is painful and your little one needs comfort.
If the nappy rash does not get better in a couple of days, or if it spreads, get advice and treatment from your doctor.
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