Almost all parents with a baby know the problem: a red, sore bottom causes (great) discomfort for the baby if the skin in the nappy area has become inflamed. This is known as nappy rash. I also receive enquiries about this in my online midwife consultation or in my Baby care course I am constantly receiving enquiries from worried mums and dads. I would therefore like to summarise the most important facts about nappy rash for you here.
What is behind the symptoms of nappy rash?
Nappy dermatitis in babies is a common skin condition, especially in the first few months of life when the child's immune system is not yet fully developed. Dermatitis is an inflammation of the uppermost layers of the skin, the dermis (dermis) or epidermis (epidermis). Dermatitis is classified differently in its various forms, one "category" of which is nappy rash. This name reveals at first glance which part of the body is affected: the bottom and the genital area. Adults who are dependent on nappies can also be affected.
Reddened, sore and "softened" areas of skin are symptomatic. The entire region itches and/or burns or hurts, for example when the baby urinates, when the inflamed areas of skin are touched or when they rub against the nappy or clothing during movement. It is equally unpleasant for the child if the inflamed areas come into contact with the "big business".
It is undoubtedly obvious that affected babies feel very uncomfortable with such complaints and usually cry more often or are at least very tearful. Some children with nappy rash also have a poor appetite and some sleep more restlessly than usual.
At an advanced stage, nappy rash can spread to the thighs, back or stomach. Pimples or (weeping) pustules can also form on the affected areas. It is not uncommon for this to be an infectious fungal infection (nappy thrush), as a certain yeast fungus also likes to settle on sore baby skin. This can also be characterised by white, scaly patches of skin. In rarer cases, bacteria can also penetrate the affected skin and cause oozing or purulent wounds.
You will certainly present your child with nappy rash to your paediatrician. If the doctor suspects that your baby may also have a fungal or bacterial infection, a skin swab will be taken to clarify the exact diagnosis.
What causes nappy rash?
In most cases, babies' skin is exposed to urine and/or faeces for too long. Certain components in these irritate the baby's sensitive skin. Added to this is the fact that germs and pathogens can multiply particularly well in the warm, damp nappy environment. In plain language: the nappy has been changed too infrequently or its material promises too long a drying time on the skin.
However, diarrhoea is often also involved. In this case, not only are the substances in the stool more aggressive and attack the skin more severely, but it is also simply more difficult to ensure that the nappy climate is always dry: the fresh nappy is barely on before it is no longer fresh.
Sometimes, however, the cause cannot be determined exactly at first glance. For example, a sore bottom can also be associated with an infection in the child or with erupting milk teeth. Existing underlying illnesses such as neurodermatitis also favour nappy rash. The same applies to a lack of vitamin B7 or zinc, as various studies have shown.
However, babies' bodies may also react to ingredients in their diet that they absorb with breast milk. Nevertheless, there are no rules for breastfeeding mothers. After all, babies do not always get a sore bottom if their mum has eaten acidic or spicy foods or spices, for example. So feel your way around, try out different foods and observe your baby's skin. The same applies if your child is already Complementary food receives. Children can react very differently to certain foods.
I have also heard some parents suggest that their child may be allergic to materials or ingredients contained in the nappy if their baby's bottom is sore. These parents' assumptions are in line with my experience as a midwife. However, this does not apply to every Nappy type. Nappy dermatitis is caused by the nappy if it is too tight and therefore rubs against the baby's delicate skin, or if the material can absorb so much moisture that it draws moisture from the baby's skin. Super dry nappies therefore do not protect young babies in particular from a sore bottom.
Fragrances or preservatives, etc., which are hidden in the care products used, are also triggers for sore patches of skin on babies. You can find out more about gentle baby care here read; or you can get access to my Infant care course.
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What can be done against nappy rash?
If the worst comes to the worst, rapid countermeasures are important in order to get the baby's skin inflammation under control quickly. Often just a few measures can help the irritated skin to recover and alleviate the inflammation.
Change nappies more often: A warm and humid climate is created for the skin under the nappy. If this lasts too long, skin problems can develop. You can avoid this by changing nappies frequently. Put a fresh nappy on your child after three to four hours at the latest. And as soon as you have noticed that your child has done a small or large poo, make sure that the nappy is changed. immediately for a fresh nappy.
For disposable nappies or cloth nappy systems, also opt for air-permeable models.
Skin-friendly cleaning of the bum: To remove urine or faeces residues from baby's skin, lukewarm clear water and a soft flannel are sufficient. For stubborn build-up, you can also use a little Almond oil use. But if possible, avoid using disposable wet wipes. This is because they contain ingredients that can (additionally) irritate baby's sensitive skin. After cleaning the genital area, it is important to gently and carefully pat the skin dry, including the skin folds.
Apply additional skin protection: Special Wound protection ointments with the active ingredient zinc or dexpanthenol support the healing of nappy rash. They have an anti-inflammatory effect and protect the skin from moisture. Ask your paediatrician's practice or pharmacy for advice. A few drops of breast milk applied to your baby's irritated skin is also a tried and tested home remedy that can provide relief.
Another tip from a midwife is: Healing wool on the affected areas of skin! There is no need to apply additional cream during application. However, the natural wool should not come into direct contact with open wounds. In this case, a fine mesh fabric (e.g. a piece of thin gauze bandage) between the skin and the healing wool will help. Read more about this natural "miracle cure" here.
You can also prepare a lukewarm sitz bath with camomile for a sore baby's bottom. As babies should not take chamomile sitz baths that contain alcohol, the classic extracts are not suitable. Therefore, use the following for the sitz bath Camomile tea.
Allow plenty of air and light: Babies love to romp around freely "topless". And it's precisely this that is so good for their stressed, irritated skin! If plenty of air and light reaches the sore areas, this ensures that the unpleasant symptoms subside more quickly and helps the skin to heal. A hair dryer is not suitable for keeping baby's sensitive skin dry. This is because it dries out the baby's skin even more with its airflow and heat.
Give a lot of attention: You can imagine how awful a sore bottom must feel for your child. So it's no wonder that it's now more grumpy or fussy. They might even feel uncomfortable in your arms because they might be pressing on the irritated areas. In this situation, they need a lot of understanding and comfort. So when carrying your child, make sure that they can always find comfort with you without additional pressure or irritation of the bum area. And talk to your child a lot now: tell them that you know how stupid nappy rash is, promise them that it will get better soon and let them feel your understanding in every way. They won't understand your words yet - but they will still feel safe and comforted.
Seek help at the paediatric practice: In most cases, parents can manage nappy rash themselves with the appropriate measures. However, if you are unsure or the condition does not improve, do not hesitate to seek medical advice! If there is also a fungal or bacterial infection, the doctor will prescribe the appropriate ointment or treatment anyway.
If nappy rash occurs more frequently in your child or is repeated several times and/or can only be treated with little success, further medical examinations may be necessary to get to the bottom of the matter.
You can find out more about other skin abnormalities in babies on my blog here.
