Diaper Rash

by T. Berry Brazelton, M.D., author of Toilet Training: The Brazelton Way

Diaper rash occurs in all babies. It's a pimply rash that may appear suddenly and is scattered. It cannot be completely avoided and may appear even after meticulous cleanliness. But here are a few suggestions for cutting down on how often diaper rash occurs, how severe it becomes, and for avoiding a few other rashes that can affect infants in diapers.

How to Cut Back on Diaper Rash

1. I have recommended that parents use petroleum jelly after each cleanup of stool and urine. This usually helps prevent a rash because the grease keeps moisture that can cause diaper rash away from the baby's skin. "Unpetroleum jelly," is available in natural food stores for those concerned about petroleum derivatives.
2. Frequent changes can cut down on diaper rash by limiting the time the baby's skin is exposed to moisture, and irritants in urine and stool. It helps a great deal to change diapers soon after each bowel movement, and every few hours.
3. Be sure not to wash and wipe your child's skin too often—this can cause dryness and make the skin vulnerable to breakdown. When you do wash and wipe after a bowel movement, be careful to pat the skin dry and avoid vigorous rubbing.
4. Though powder in the diaper may sop up the ammonia from urine, many powders can build up along a baby's skin creases and then cause skin breakdown. Breathing in powder, especially talcum, can cause respiratory problems. Talcum powder is not safe for babies, so corn starch has replaced it. But I do not recommend these products.
5. When a rash is already present, zinc oxide cream or ointment makes a protective coating so the rash can heal.
6. Be sure to give your baby's skin a chance to air and avoid retaining moisture. Stay away from clothing such as plastic underwear, which can hold moisture in.
7. It's wonderful in warm weather to be able to air babies' bottoms. They love it. They'll kick and squirm with pleasure. Older babies begin to explore themselves at such an uncovered time. Don't be surprised or horrified.

Sometimes diaper rash can be caused or worsened by irritants in the diapers themselves (or from the soap that cloth diapers are laundered in), in baby wipes, or in lotions and creams meant to protect the skin. If your baby's diaper rash won't go away or is getting worse, try the following steps.

When a Diaper Rash Won't Go Away

1. Try a different kind of diaper, or if you use cloth diapers, try washing them in a mild, hypo-allergenic soap or detergent.
2. Stop using baby wipes and try using a gentle cloth with lukewarm water and a mild, hypo-allergenic soap.
3. Stop using the lotion or cream you'd been applying to your baby's skin after changes or baths. Instead, try using a simple moisture repellent ointment such as petroleum jelly or vitamin A and D ointment, and be sure that these are unscented.
4. Talk it over with your baby's pediatrician. She or he certainly has had plenty of experience helping parents fight diaper rash. The pediatrician will also want to be sure that a rash that isn't responding to usual remedies isn't caused by something else (for example, thrush).

Excerpted from:

Excerpted from Toilet Training: The Brazelton Way © 2004 by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Perseus.

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