Written by Claire Burgess, Family Consultant

Nappy rash can be a real pain in the bottom (sorry but it had to be done!) for little one and their parents.  It can affect children to varying degrees and is not pleasant for anyone involved as it can be painful and sore and cause little ones to be extremely unsettled. 

What is nappy rash?

Nappy rash does not typically happen with newborns, however, as they get older, babies and young children can develop it at some point during their nappy-wearing stage.  Nappy rash is caused due to babies’ and young children’s skin being thinner, more permeable and with a higher ph level. For some little ones it will only be very occasional occurrences whereas for others it might be a regular issue that needs attention. Nappy rash can be mild, which would be red patches on the bottom or the whole area is red through to where the skin may feel hot to touch and look sore, some little ones can develop spots or blisters.  If you do find that your newborn develops nappy rash then it is very likely to be a reaction to the nappy that you are using.  Look to change the nappy brand in the first instance to see if this helps resolve the problem. 

What can cause nappy rash?

• The nappy brand that is being used, all nappies are not the same and some babies can have reactions to certain brands.

• Nappy rubbing on the skin

• Nappy not being changed frequently enough.  Some children can be very sensitive to having wee or poo close to their skin for too long, so regular changing is required.

• Having the bottom area damp from changing the nappy and using wipes or cotton wool and water.

• Alcohol based wet wipes.

• Teething - lots of parents notice that nappy rash can occur when teething which could be due to the acidity of the wee or poo during this time. 

• Lotions, bubble baths or washing detergent (toilet trained children in pants can still experience ‘nappy rash’).

• Illness

• Weaning – changes in what a baby is eating can sometimes affect them in relation to bowel movements, so they might have loose stools or diarrhoea which can then cause the bottom area to become sore. 

• Thrush can also happen in young babies and children so if you suspect that it may be thrush you should get medical advice and use the creams prescribed.

What can I do to stop nappy rash happening?

• Some children are prone to nappy rash so it is all about putting in place a series of strategies in order to reduce the frequency or severity:

• Check that the brand of nappy that you are using is suiting your baby, it might be that you need to look at changing brands a couple of times until you can see that it is getting better. 

• If you are using wet wipes and you find your baby has a sensitivity try to avoid the alcohol-based wipes and try to use natural, fragrance free wipes. If your baby’s bottom is very sore then use water to clean their bottom.

• After each nappy change try to make sure that you dry the bottom area with a tissue or clean towel (only used for the bottom area) so that it reduces the dampness in this area. 

• Always check the size of nappy that you are using, nappies which are too small can cause rubbing and this can in turn lead to nappy rash.

• Always clean the bottom area from front to back, making sure that you clean in all the creases etc so not leaving any wee or poo behind. 

• Regular nappy changes and changing a nappy as soon as possible after your little one has done a poo will help to stop irritation.

• Nappy-free time where they can lie or roll around without a nappy on.  Letting the air get to the bottom will help with the healing process if they have nappy rash or will help to keep it a bay by the exposure to fresh air. 

• Avoid using strong lotions, soaps or bubble baths on that area, keep things as natural as possible.  You do not need to use creams at every change as this can sometimes block the pores on the skin and also stop the nappy (if using disposable) from working effectively.  At the first signs of redness you want to try the above techniques but also have your ‘go to creams’ which always help.  There are a huge range on the market and it is very much about personal preference and what works for your child, however some of the creams that I have always found effective are:

o   Metanium – this is a very thick yellow cream, you do not need a lot of it and sometimes it can be easier to mix it with a little Vaseline to make it easier to coat the bottom area. You only need to use this when there is redness appearing, this is not an everyday cream. 

o   Kit and Kin Magic salve – this is a very light product which seems to work well when you start to see redness start.  This is also great for dry skin on the face or body, and lips which can get sore in the winter!

o   Sudocrem – this is an old favourite and most people have a tub of this in their bathroom cupboard.  This is an antiseptic cream and is for nappy rash, however avoid using on rash free skin as it can be quite drying on healthy skin. 

Other brands are Child’s Farm nappy cream, Weleda, Aveeno baby, Expert Midwife ‘no harm bum balm’ and many more! When applying creams avoid putting a thick layer on, it needs to be a thin layer over the area that is sore so that the skin is still able to breath whilst being protected (hence the term barrier cream) from wee or poo in the nappy. 

• Bathing can help to soothe nappy rash - clean the area gently if it is extremely sore for your little one.  Avoid bathing more than twice a day though as this can dry out the skin. 

• Pat the area dry rather than rubbing it as this can cause discomfort.

• The antibodies in breast milk may also help with nappy rash – just rub a small amount onto the affected area a few times a day.

What do I do if it doesn’t go away?

If you do some or all of the above and, after 3 days, the nappy rash is still not showing signs of improvement then you need to speak to your health visitor or pharmacist for a recommendation for treatment.  If the nappy rash is bright red, moist with white or red pimples then this might indicate an infection so this needs to be checked by a health visitor or GP.  As with any rashes, if you are concerned then you must seek medical advice. 

If you are interested in finding out more about how to care for your newborn check out ‘Your guide to caring for your newborn’! For more information - click here

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