Most babies will suffer from nappy rash at some stage, it is very common especially at 8 – 12 months of age. It is usually caused by contact with urine and faeces which irritate the skin of the nappy area. It is a red rash on the buttock area and other parts of the body are generally not affected. A different condition, caused by a fungus (Candida Albicans – like Thrush) can complicate matters - this shows up as small red lesions near the perimeter of the affected area and in skin creases. Diarrhoea can worsen nappy rash.
A description of the rash may be important, to distinguish between simple nappy rash and infected nappy rash. A bacterial infection would show yellow crusting and be very inflamed with weeping skin. A fungal infection would show as small red lesions as described above. It is important to ascertain whether the skin is broken or not. A sore mouth and throat may also be present if the baby has a fungal rash, due to oral thrush that is often associated with this condition.
One of the most important means of treating and preventing nappy rash is frequent nappy changes and thorough skin care at the time of the change.
The age old remedy of frequent changing of the nappy is the best – take care not to use wipes at this time because the alcohol in them may irritate the area further. Cotton wool and water is better. Leaving the nappy off for as long as possible and 'letting the air at it' is very beneficial.
If you are concerned about nappy rash, call in to your local pharmacy and give the healthcare advisor details of the condition including the treatment tried already.
In general you should try to avoid nappy rash occurring by establishing a good nappy changing routine. When the nappy is changed the nappy area should be cleaned and patted dry. (Many bath preparations, cleansing lotions and baby wipes contain ingredients which irritate the baby's skin.)
A nappyrash cream or ointment may be used, to soothe the baby's bottom. The cream/ointment is applied before powder and works under, to restore fluids to the skin area, thus acting as a moisturiser and barrier, keeping irritants away from the skin. This is very important for good skin care in the area, which will ultimately prevent recurrence. The cream should be applied in a smooth even coating at each nappy change.
- Nappies should be changed as frequently as necessary. Babies up to 3 months may pass urine up to 12 times per day.
- Nappies should be left off wherever possible so that air can circulate around the skin, helping the affected skin to become and remain dry. Lay the baby on a towel with a waterproof sheet underneath.
- Waterproof pants prevent moisture evaporating and worsen nappy rash. These should only ever be used for a short period of time.
- Thorough cleansing at each nappy change is vital, as is careful drying. Talcum powder should only ever be applied to dry skin as clumping may cause further irritation.
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