Diaper rash is something most of us will run into at some point in time. No matter how carefully you wash your child’s diaper area, how thoroughly you wash your diapers, and how frequently you change your little one, diaper rash can still happen.
What Causes Diaper Rash?
There are numerous causes of diaper rash. Consequently, the first thing to do is find out what’s at the root of the issue so you know what to fix. This advice applies to every outbreak because what causes a rash one month may not be the same as what causes a rash next month.
#1. Urine & Feces on the Skin
The number one cause of diaper rash is pee or poop, or both, in contact with the skin. This can happen when a baby:
- Spends too long between changes in a wet or soiled diaper.
- Is changed often but doesn’t have their bottom cleaned thoroughly enough.
- Suffers from diarrhea.
- Is dehydrated and has especially “strong” urine.
When a baby has a diaper that is too tight or otherwise poorly fitting, the diaper can rub against their sensitive skin, causing red marks, chaffing, and broken skin.
The skin can then become inflamed or more easily infected, causing a painful rash.
#3. New Solid Foods
Once you begin to introduce solids, your baby might poop more often, which can sometimes lead to a diaper rash. New foods or drinks can also make your baby’s pee and poop more acidic than usual.
Then, when that more acidic pee or poop sits against the skin, even for a short period, it can cause diaper rash.
Foods most likely to cause this type of reaction are oranges, lemons, and other citrus fruits, strawberries, tomatoes, pineapples, and other “tart’ tropical fruits.
#4. Food Sensitivities
A true food sensitivity is unlikely to cause a diaper rash in isolation. An allergy or sensitivity will result in your child having other symptoms. For example, in the case of a milk allergy, you may see blood in the stools or a rash elsewhere on the body.
Some food sensitivities may cause more loose, more frequent stools, which results in your child having feces against their skin more frequently. The additional washing and cleaning of your baby’s bum can then further irritate the skin.
#5. Sensitivity to Mom’s Food
Foods in a mom’s diet can cause a breastfed baby to produce pee or stools that are more acidic than usual. They can also cause diarrhea which in turn can cause diaper rash.
For example, grazing on grapes for most of the day because you don’t seem to find time for a proper meal can cause your breastfed baby to produce vast amounts of semi-solid poop, meaning you have to change them two or three times more often than usual. And yes, this is precisely what happened to me twice before I realized what was causing my little one to poop so much.
Is It Diaper Rash?
Rather than diaper rash, your child may be suffering from:
A skin condition such as eczema or psoriasis. There is a genetic element to these conditions, so if you have a family member with either of them, it is possible your baby may also develop them.
However, because eczema is unlikely to affect the diaper area because of the moisture levels found there.
Impetigo is a bacterial infection caused when the bacteria that usually live on the skin’s surface find their way into a break in the skin.
In this case, the rash is more likely to have tiny, raised, fluid-filled blisters that can burst and cause honey-colored crusting around the red areas.
Is it Diaper Rash or Yeast?
Candida or yeast infections do not usually develop without your baby first having a diaper rash. Instead, a yeast infection usually happens when the diaper rash has not cleared up after a few days.
If the diaper rash has evolved into a yeast infection, you will see dark red areas of skin that may develop blisters filled with a yellow fluid that burst, cause a crusty yellow appearance and flake.
You will need to take your child to the doctor as soon as possible for some anti-fungal treatment. You will also have to wash and sanitize all of your diapers to ensure there is no yeast on the to cause reinfection.
Diaper Rash and Cloth Diapers
Whether you’re searching articles on the internet or speaking with other parents, you’ll come across plenty of “evidence” telling you that:
- Babies in cloth diapers have fewer instances of diaper rash.
- Cloth diapers are associated with less severe diaper rash.
- Babies in disposable diapers have fewer instances of diaper rash.
- Disposable diapers are associated with less severe diaper rash.
When it comes down to it, there are no independent studies to conclusively prove that either cloth or disposable diapers are better or worse for diaper rash.
If your baby is in cloth diapers and develops diaper rash, be sure to consider and exclude each of the five possibilities we mention above. You can then start to work through the potential, cloth diaper-specific causes.
#1. Fitting Problems
If your diapers are too tight, they can cause chaffing, which in turn can lead to diaper rash. The elastic at the leg of the diaper should sit within the crease at the top of the leg.
A slight red mark that disappears a couple of minutes after the diaper is removed is not a problem. Think of the kind of mark left behind when you take off your socks.
If you remove the diaper and your baby has dry, rubbed, or broken skin, you need to adjust their diaper fit.
#2 Barnyard Smell
While the barnyard smell itself is not going to cause diaper rash, it is caused by the same thing that can cause diaper rash - diapers that are not clean enough when they come out of the machine.
If you notice a slight pee or poop smell when your diapers come out of the wash, or they seem to stink the second your baby pees in them, you will need to look at and tweak your wash routine.
The most common issue is not enough detergent. Many new cloth diaper users worry that too much detergent will cause their baby’s skin to react, so they dial down the amount of detergent used to wash the diapers.
However, it is important to use the detergent maker’s recommended amounts to ensure your diapers are thoroughly clean. That is why we recommend an additional, water-only rinse after your main wash. Most machines will wash all traces of detergent in the main wash, but this extra rinse minimizes any chance of detergent residue.
The Solution: Run all of your clean diapers through the wash with the recommended amount of detergent and water that is hot enough to kill bacteria.
Do not overload your washing machine and give your diapers enough room to move. The ratio of diapers to water should look like a stew. Diaper “soup” has too much water, and diaper “chili” has too much.
#3. Ammonia Burns
Ammonia burns are a rare but serious chemical burn to the skin and can turn from mild to severe exceptionally quickly. An ammonia burn will result in a baby with a blistered bottom that is angrily red wherever the wet diaper has touched the skin.
You’ll know straight away if you are dealing with an ammonia burn because the ammonia smell will burn your nose, sting your eyes, and make your eyes water. It is entirely different from the urine, poop, or “barnyard” smell some people experience when their diapers are not coming up clean.
Ammonia burns are caused by a build-up of ammonia in diapers that are not clean enough when they come out of the washing machine. There is excess residual waste in the diaper, and when this meets with the minerals in your hard water or excess detergent, it causes a chemical reaction, which creates ammonia.
The Solution: First, strip your diapers to remove the ammonia. Then prevent the same thing from happening again by increasing the amount of detergent you use in the machine.
This works in two ways; it makes sure that all of the waste is being cleaned from your diapers, and it also minimizes the chance of mineral build-up. You also need to ensure the water is getting hot enough to kill bacteria.
Rinsing your diapers before putting them in your diaper storage can also help as this dilutes the urine, reducing the amount available for chemical reactions.
#4. Detergent Build Up
While detergent build-up does not cause diaper rash, it can create conditions where diaper rash is more likely.
First, if your baby is mildly sensitive to your detergent, they may not react to it on their other clothes or on your cloth diapers without build-up. However, the skin in the diaper area is fragile and sensitive, so a build-up may be enough to take your child from ok to developing a reactive diaper rash.
The Solution: Give your diapers a swish test by swishing and squeezing a clean diaper in a bowl of warm water. If soapy bubbles appear and then gather at the edges of the bowl, you have detergent build-up, and you should run your clean diapers through the laundry a few times, without detergent and with plenty of warm water rinsing.
In addition, look at how much detergent and how much rinsing there is in your wash routine. You may have to slightly reduce your detergent or increase your rinsing to prevent detergent build-up again.
How to Treat Diaper Rash
First and foremost let us make it clear, we are not medically qualified, and if you have any concerns about your child’s health you should visit a qualified medical professional. This is especially important if your child could be suffering from an ammonia burn, yeast infection, or another skin condition.
If you are confident that it’s diaper rash and a first line at-home treatment is appropriate then try the following.
The first thing to do when you first notice diaper rash is to wash the area gently but thoroughly with warm water and allow your baby’s skin to dry naturally. If this is not possible, pat the diaper area dry.
Do not use any powder containing talc because inhaling even the tiniest amount can cause issue for your baby.
Change your little one’s diapers more frequently than usual, being sure to do so the moment you notice they have peed or pooped.
Use a cloth diaper safe barrier cream or diaper rash ointment.
- Petroleum based creams can be used in cloth diapers but you will need to use a liner to prevent the cream coating the fibers and causing repelling issues.
- Creams that contain zinc oxide, clays, or waxes can stain your diapers so, again, consider using a liner inside.
If this is not enough to clear things up consider a trip to the doctor’s office your baby is suffering from something more than basic diaper rash.
How to Prevent Diaper Rash
Sometimes, no matter what you do, your baby will develop a diaper rash. This doesn’t mean you’ve done anything wrong, or you could have prevented it; it can just happen.
However, to reduce the chances of your baby developing diaper rash, you can:
- Change your child’s diaper as soon as possible after they have soiled it. This will minimize the time your baby’s skin is in contact with pee or poo.
- Use a stay-dry diaper liner in your diaper to reduce the amount of wetness that’s against the skin.
- Give your child plenty of time without a diaper. Fresh air is a beautiful way to minimize the chances of diaper rash in cloth diapers.
Diaper Rash and Disposable Diapers
Some parents find that their baby develops fewer issues with diaper rash when wearing disposables. This is because disposable diapers quickly draw the moisture into the absorbent core, so your baby is less likely to have urine sitting against their skin.
For this reason, when all else has failed, a few days in disposables can be a good way, in some cases, to help clear up a severe case of diaper rash.
Disposable Diapers, Allergies & Chemical Burns
You will hear and read a great deal about allergic reactions and even chemical burns from disposable diapers.
Allergic reactions to the materials in disposable diapers are rare. An allergic reaction will cause redness, itching, and occasionally scaling or blistering. This reaction is likely to happen in every area the diaper touches, not just where your baby’s skin is exposed to pee or poop.
So, if your baby is allergic to something in the diaper, you will see the same reaction in other areas, for example, around their waist, all the way down to where the diaper ends.
In addition, the gel used inside disposable diapers is an inert substance and cannot cause chemical burns. Conditions that some parents worry about are chemical burns are usually diaper rash. If you have any concerns about your baby’s health or wellbeing, it is essential to see a medical professional as soon as possible.
When to Visit the Doctor
You should take a trip to the doctors office if:
- You are concerned the rash is something other than a basic diaper rash.
- You’ve tried basic home remedies for several days but it doesn’t seem to be responding.
- The rash suddenly becomes especially hot, red, or inflamed.
- Your child appears to be in pain, or the discomfort from the diaper rash is affecting their eating or sleeping.
- There are blisters or yellow crusty areas in the rash.
- Your child seems to be otherwise sick, for example they are running a fever.
In addition, don’t be afraid to go to the doctor if you have the feeling that something is wrong.