Q. My baby's bottom often looks bright red and bumpy. Is this normal? What can I do?
A. This is probably a diaper rash triggered by yeast and is very common in babies. It starts as angry red patches with raised areas that spread if left untreated. Sometimes they can look scaly. They can also be painful.
Certain things can increase the chance of a yeast diaper rash, such as:
Antibiotic use. We all have yeast in our intestines, and the bacteria there keep its growth in check. Antibiotics can throw off that balance, allowing the yeast to multiply and seep into a baby's poop, resulting in a rash on his bottom.
Dirty diapers. Yeast loves warm, moist environments.
Oral thrush. These white patches in the mouth are also caused by yeast, and if left untreated, the yeast can travel into a baby's intestine and onto the diaper area.
Immune deficiencies. These are uncommon, but if your baby gets sick often, is prone to a lot of infections, and/or isn't growing well, talk to your pediatrician to see if an immune problem may be the cause.
Luckily, yeast diaper rashes are easy to treat at home. Try an over-the-counter antifungal cream, such as clotrimazole or miconazole; if it doesn't work, your doctor can prescribe others. I've found that mixing some antifungal cream with a small dab of zinc oxide cream works really well to soothe my baby's yeast rashes.
If your child's taking antibiotics, feeding him yogurt with active cultures may help prevent rashes, but check with your doctor first -- some babies with food allergies or a family history of them shouldn't have milk products before a year. Whether he's on antibiotics or not, change his diaper frequently, or let him go diaper-free when it's feasible, to keep him dry. And if the problem still doesn't go away, talk to your pediatrician -- he can suggest other treatments to try.