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What to do about nappy rash

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What does nappy rash look like?

It’s common for babies to develop red, angry skin in the nappy area. The affected area can be dry or moist and sometimes it even looks pimply. The inflammation of your baby’s skin is known as an irritant dermatitis and is caused by contact of his skin with the chemicals in the urine.

What causes it?

The main cause of nappy rash is moisture from a wet nappy. The germs on your baby’s bottom and on his clothes come into contact with his urine, which is actually sterile. This contact with the germs makes ammonia, which can burn the skin because ammonia breaks down the protective barrier normally formed by your baby’s skin. The wet nappy then rubs against the skin, or prevents air from reaching your baby’s skin, which means that your baby’s skin stays wet for a long time and gets irritated. Disposable nappies lessen the risk of nappy rash, because they are more absorbent and have a coating in them that separates the wet nappy from your baby’s skin. Nappy rash may also be caused by seborrhoeaic dermatitis, which is a condition of the skin where there’s an excessive production of sebum. An infection of the skin with the yeast Candida may cause a nappy rash, or even make it worse.  Triggers of nappy rash may include illness, particularly diarrhoea, when your baby’s skin is more sensitive. Even teething or starting a new food can set off a rash for some babies.

What to do about nappy rash: 

It’s important to treat a nappy rash when it appears, as it can develop into something worse such as a fungal infection like yeast, or a bacterial infection.
  • Try keep your baby’s skin as dry as possible; change nappies often or even have time when your baby has no nappy on at all 
  • Wash your baby’s bottom very gently so that you don’t rub the skin, but remember to keep the skin clean 
  • Only use skin wipes that are made for babies. Skin wipes that are made for adults contain alcohol, and this can cause pain and discomfort 
  • Use a barrier cream every time you change your baby’s nappy. These creams help keep dampness away from the skin and help soothe damaged skin 
  • Nappy rash is painful, and your baby may be more irritable than usual. A dose of baby paracetamol can help relieve this pain 
  • Use good quality disposable nappies. They have linings that absorb the urine and keep your baby’s skin dry 
  • If you are using towelling nappies, change them often and wash them in detergents that are specifically formulated for sensitive skin 
Take your baby to the doctor if the nappy rash does not go away after a few days. Sometimes it doesn’t clear up because there is an infection, such as thrush, on the damaged skin. Your doctor will then prescribe an anti-fungal cream. There could also be an underlying skin condition present, such as eczema. In the case of eczema, there may be a rash on other parts of the body.
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