Your baby may seem extra fussy (especially on the changing table) and might try to reach inside his diaper. You open the diaper to discover small pink or red pimple-like bumps or welts around his bum, genitals, or lower belly. Tiny blisters, which can ooze, can sometimes appear too. Some diaper rashes are caused by yeast infections, which will look like bright red patches edged with red spots, usually concentrated around the skin folds of the genitals or belly.
Almost all children can develop diaper rash, a type of contact dermatitis, if their skin is in contact with a very wet or dirty diaper long enough. Wet skin is more susceptible to irritation from acids in poop and urine. Some children, due to sensitive skin or food allergies or sensitivities, are more prone to diaper rash than others. Diarrhea may also cause diaper rash.
Since diaper rash is so common, you’ll probably be able to diagnose and treat it on your own (but show your ped at your next well-baby visit, just in case). See a doctor if diaper rash develops open sores, is bright red with dots at the edges (suggesting a yeast infection), or is accompanied by a fever (indicative of cellulitis, a bacterial infection that requires antibiotics).
The best way to prevent diaper rash is to change diapers as often as possible -- especially if your baby has diarrhea. During every change, clean the baby’s bottom thoroughly with warm water or a fragrance-free wipe, and then gently blot his skin with dry gauze or tissue until it’s completely dry. (You can also let his bum air-dry for a few minutes, but watch out for unexpected showers!) Applying a thick layer of a petroleum or zinc-oxide-based barrier cream, before putting on a fresh diaper can also help.
Use warm water or a squirt bottle to clean the irritated diaper area at every change, and let your child’s bottom air out whenever possible. Before diapering, apply a thick coating of a zinc oxide-based cream to protect the rash from further moisture, which can make the rash even worse. You can also ask your doctor for advice about using a mild, topical steroid cream for more severe cases. If you suspect a yeast infection, see a doctor, who can prescribe an anti-fungal cream like over-the-counter clotrimazole (Lotrimin) or prescription nystatin to apply at every diaper change until the rash disappears. If your child has rashes in the diaper area that don’t respond to conventional treatments, see your doctor to make sure the rash isn’t related to another condition.
A daily serving of yogurt or acidophilus, an oral probiotic sold at drugstores, might stave off diarrhea and fight yeast. Ask your pharmacist for a formula and dosage that’s safe for babies.
“My youngest son used to get diaper rash so severe he would bleed. I tried hypoallergenic diapers, yogurt, baking soda and vinegar baths and so on. But it wasn’t until I eliminated juice from his diet that he started having less diarrhea, and the rashes cleared up.”—Denise Saylor, mom to boys, a 2-year-old Storm and 21-year-old Coalton
“My pediatrician taught me this trick: glob Desitin’s original diaper cream on your baby’s bottom as thick as the icing on a cupcake, and then glob on Vaseline over the Desitin. It will be a huge white mess, as if you just sprayed whipped cream all over your kid's tush. However, the goal is to create a barrier between the skin and the moisture from the wet diapers. Then, when you change the baby, you don't need to wipe, unless it’s a poopy diaper. It always worked for me.” —Brady Pendleton, mom to Catherine, 3, and Kenneth, 6 months