Nappy rash

nappy change

Nappy rash is very common but a good nappy-changing routine and plenty of nappy-free time can help your baby avoid it. If nappy rash does strike – telltale signs are inflammation, a red bottom and your baby seeming uncomfortable – don't panic. It's usually mild and there's lots you can do to help to clear it quickly.

What does nappy rash look like?

Distinctive red patches around your baby's nappy area, which sometimes spread to his genitals or other areas that have been been in contact with his nappy or its contents. Your baby's bottom will look sore and inflamed and may be hot to touch, with small spots. In severe cases, those small spots and redness can develop into blisters. You'll also notice that your baby is uncomfortable and may become upset when he wees.

If your baby develops other symptoms, including a high temperature or blisters on other areas of his body, such as his hands or feet, then it may be a skin infection rather than a simple nappy rash and you should speak to your GP.

What causes nappy rash?

Nappy rash can be caused by a number of things but the most common culprit is infrequent nappy changing. If your baby is left in a wet or dirty nappy for too long, the urine or stools can irritate the skin and cause the rash. Young babies usually get through 10 to 12 nappy changes every 24 hours while older babies will need changing six to eight times in a day on average.

Other causes of nappy rash include:

  • Chafe. A nappy that is tied too tight can rub against your baby's skin and cause a rash to appear.
  • Skin sensitivity. Products that you use to clean your baby, or detergents used to wash his clothes may be too harsh for his delicate skin. Whether it's wipes or washing powder, try brands that are specifically designed for sensitive skin.
  • An infection such as breastfeeding thrush. This condition can see the candida bacteria travel through your baby's digestive system, infecting his bottom. If the rash is accompanied by white spots inside your baby's mouth, then he may have thrush rather than simple nappy rash and might need to be seen by your doctor. If he has thrush, it's likely you have it, too, and you'll both need to be treated together.
  • Food allergies such as lactose intolerance.
  • Diarrhoea. Even if you are changing your baby's nappy frequently, a bout of diarrhoea can often be accompanied by nappy rash.
  • Teething. Many mums notice that a rash appears when their baby is cutting teeth. While it's unlikely that teething is a direct cause, it can often cause diarrhoea which could be responsible for the rash.
My daughter had bad nappy rash several times when she was tiny. I tried everything from egg whites to every cream available. It was very sore and raw looking with some bleeding. Nothing stopped it so I took her to the doctor. Turns out it was thrush. I got cream and powder from the doctor and it was gone in two to three days.

How do I treat nappy rash?

Nappy rash is usually easy to treat and rarely requires a trip to the doctor. The rash should clear up within three to five days of taking the following steps:

  • Change your baby's nappy frequently. Avoid letting his bottom come into prolonged contact with a wet or dirty nappy. If you find it hard to tell whether your baby's nappy is wet or not, you could try using a nappy with a wet indicator on it.
  • Clean your baby's nappy area thoroughly but gently. Ideally use cotton wool and water and wipe front to back, including the genitals. You could also use unfragranced, alcohol-free wipes.
  • Apply a nappy rash cream after cleaning and before putting on a clean nappy. A thin layer of this will act as a barrier between any stool or urine and your baby's skin.
  • Bath your baby once a day and gently pat dry. Do not rub the skin as it may cause further irritation. Do not bath more than once a day as this may cause the skin to dry out.
  • Avoid strongly fragranced products such as soap and talcum powder. These can irritate the skin further.

If the rash is persistent or is getting worse and you notice blisters appearing, speak to your health visitor or GP. Your doctor can prescribe a treatment cream to apply alongside the steps above.

dad changing son's nappy

How do I prevent nappy rash?

Again, frequent nappy changing is the best way to help prevent nappy rash. In addition, a few simple tweaks to your nappy-changing routine can make all the difference:

  • Clean your baby properly every time time you change his nappy.
  • Allow your baby some nappy-free time each day. Place him on a towel or his changing mat and let his skin breathe.
  • Don’t put his nappy on too tight. Doing so can cause chafe. Check that your baby is wearing the right size nappy for his age and weight to prevent discomfort and leaks.
  • Use a barrier cream to limit contact between the contents of his nappy and his skin. Don’t put on too much as it won’t absorb into the skin properly. Some mums use a simple product like petroleum jelly but creams containing zinc oxide are the most effective.
  • Super-absorbent nappies will help to reduce the amount of urine his skin comes into contact with. If you use cloth nappies and are having frequent bouts of nappy rash, consider changing to disposable ones, which are more absorbent.

Mumsnetters give their top tips on treating nappy rash:

  • ''No creams really worked for my son so I put Oilatum in his bath and, after a week, it cleared up.''
  • ''My little one suffers from terrible nappy rash and nothing had worked until I found a cream called Kamillosan. You can find it in chemists and it works wonders.''
  • ''Metanium is brilliant. My daughter had terrible nappy rash. It was red and bleeding in parts. Washing with water and cotton wool, patting dry and then putting the cream on after worked a treat. You might also mix the Metanium with a little Sudocrem – it makes it easier to clean off.''
  • ''I always find that washing with warm water and cotton wool at every nappy change then leaving the nappy off as long as you can helps. Also Drapoline is really good.''
  • ''My son’s nappy rash got so bad that it was weeping the whole time. He winced every time I touched it, poor thing. I used a warm flannel at every change and patted him dry and then left the nappy off for as long as possible.''
  • ''Make a cup of camomile tea, let it cool then dip cotton wool in it and gently wipe the area.''
  • ''Leave their bottom to air dry, then put cream on. I used washable nappies and the rare times my boys got rashes, I would soak a nappy liner in camomile tea and put it in the nappy next to the skin. Worked a treat every time.''