Everything you need to know about nappy rash
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Nappy rash is one of those things that some babies are barely ever troubled by, while others suffer with it time after time. And if your baby is affected, you’ll know how thoroughly miserable it can make them (and you).
Nappy rash is very common – in fact, the NHS estimates that a third of babies and toddlers have it any one time.
It’s rarely serious, and can usually be treated at home, but it can be very unpleasant for your baby: think disturbed nights, screaming at nappy changing time, and general grumpiness and whinging.
What is nappy rash?
Babies and toddlers are prone to various types of rashes, so it can be tricky to tell whether your little one is suffering from nappy rash or something different.
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The signs to look out for are:
- Redness in the nappy area: your baby may have patches of red skin, or look sore all over his bottom and genitals. Usually the redness doesn’t extend into the folds in his skin.
- Skin that feels hot to the touch.
- Spots, pimples and even blisters in severe cases.
- Soreness that is worse when your baby has a wet or dirty nappy, and when you're cleaning his nappy area.
Babies aren’t normally too distressed by nappy rash, as long as their nappy is clean and dry. But sometimes, they can seem generally unwell and unhappy, especially if the rash is severe.
The causes of nappy rash
Nappy rash is usually caused by prolonged contact with wee or poo. This can happen if you’re not changing your baby’s nappy often enough, or if you don’t get their nappy area properly clean when you change them.
Some babies are able to stay in a wet or dirty nappy for some time with no ill effects, but others have very sensitive skin and need changing as soon as they’ve weed or pooed to prevent soreness.
Other things that can cause nappy rash include rubbing or chafing from the nappy, a reaction to soap, bubble bath or laundry detergent, and using alcohol-based baby wipes.
Babies and toddlers may be more prone to nappy rash if they’ve got diarrhoea, or if they’re taking antibiotics. Teething sometimes causes a flare-up, and some children seem sensitive to certain food and drink, particularly acidic ones like tomatoes or blackcurrant squash.
Newborns tend to be less likely to get nappy rash than older babies, probably because we change their nappies more often.
How to treat and prevent nappy rash
The best way to deal with nappy rash is to stop your baby getting it in the first place.
This means making sure you’re changing their nappy regularly, and as soon as you can after they’ve done a poo.
You may need to change their nappy as many as 12 times a day during an outbreak of nappy rash (sorry!).
When you change them, clean the whole nappy area thoroughly, making sure you get into all the folds and creases, and wiping from front to back. You can use either cotton wool and warm water or baby wipes.
If you use wipes, always choose an alcohol-free brand. Aldi's Mamia Sensitive Baby Wipes are fragrance-free, dermatologically tested, hypoallergenic and approved by the Skin Health Alliance.
Once you’ve cleaned your baby up, pat their skin dry gently with a soft towel. Don’t rub, as this could make the soreness worse.
Fresh air helps to prevent and heal nappy rash, so whenever you can, give your baby some nappy-free time when you’re changing them.
You can lay them on a towel or loosely wrap a muslin around their bottom to catch any accidents.
Bathe your baby daily, but avoid using soap, bubble bath, lotions or talcum powder, as they could make the irritation worse.
If your baby’s skin seems particularly sensitive, using a nappy cream could help to prevent nappy rash: ask your pharmacist for a barrier cream that containes zinc, and apply it at every nappy change.
This forms a protective layer over the skin so it’s less likely to be irritated by wee or poo.
Washable or disposable nappies?
The jury’s out on whether babies are more or less likely to get nappy rash if they wear cloth nappies.
If you use reusables and your baby is suffering, you could try using disposables for a few days to see if their skin improves: they absorb more wee than cloth nappies, which might help clear things up.
Some parents find the reverse is true, and that their babies seem more prone to nappy rash when they use cloth.
If you use washable nappies, try putting them on more loosely than usual, and avoid plastic covers or wraps, as these keep moisture in: look for breathable nappy covers instead.
If you use disposables, switching to a different brand may help heal your baby’s nappy rash.
The best nappy rash treatments you HAVEN’T tried
If your baby's miserable with nappy rash, you’ll want to try everything you can to make them feel better. These DIY remedies may seem off-the-wall, but many parents swear they really work.
1. Cornflour: it absorbs moisture, keeping your baby's skin dry. Sprinkle a little over their bottom, like talc, before you put a clean nappy on.
2. Breastmilk: not just good for drinking! It has powerful anti-bacterial properties, as well as being soothing, so try expressing a little milk, using it to clean your baby's bottom, and then letting it dry before putting a nappy on.
3. Egg white: applied to the skin with cotton wool, and then left to dry, egg white forms a protective barrier that can stop irritation caused by wee or poo. Be aware, though, that some babies are allergic to egg, so don’t use it if you have a family history of allergies, and stop using it if the rash gets worse.
4. Olive oil: olive oil, or other cooking oils such as sunflower or vegetable, are great for removing dried-on poo without having to scrub at your baby’s skin.
5. Camomile tea: renowned for its soothing properties. Try soaking cloth wipes, a flannel or muslin in cooled camomile tea and using it to wipe your baby’s nappy area.
6. Oatmeal: an oatmeal bath can relieve soreness. Tie a handful of oats inside the foot of an old pair of tights, put it in a lukewarm bath and let your baby sit in the tub for 20 minutes or so.
7. Your hairdryer: to make sure your baby’s skin is properly dry after a nappy change, use your hairdryer on its coolest and gentlest setting.
Need advice?
Our health visitors and nursery nurses are online Monday to Friday evenings to answer your queries on feeding, sleep and child health.
When nappy rash doesn’t get better
Although nappy rash usually clears up if you’re extra careful with changes and hygiene, sometimes it can be persistent.
If it’s no better after a few days, speak to your pharmacist, who can advise you about medicated creams that might help.
If your baby’s nappy rash isn’t clearing up, is getting worse, seems particularly severe or is spreading to other areas, talk to your GP or health visitor, as they may prescribe a more effective cream, such as a steroid-based cream, for short-term use.
You should also see your doctor if your baby has a temperature, as they may have developed an infection as a result of nappy rash.
In addition, be on the lookout for the following changes:
- A persistent bright red, moist rash with red or white pimples, spreading into the folds of the skin: this may be a bacterial infection requiring antibiotics.
- Pus or yellowish crusts on the rash: this could be impetigo, a skin condition that needs antibiotic treatment.
- A bright red, spotty rash that extends into the skin folds and all over (and possibly beyond) the nappy area: this can be a sign of thrush, which needs treatment with an anti-fungal cream.
What’s the best treatment you’ve found to keep nappy rash at bay?
Need advice?
Our health visitors and nursery nurses are on line Monday to Friday evenings to answer your queries on feeding, sleep and child health.
