A health professional’s guide to your baby’s nappy rash problems
Most babies will get nappy rash at some point. Although it is common and mild cases are easily treatable, it can be a cause for concern. Here Midwife Heather Morris discusses nappy rash from a professional’s perspective.
At any one time around one in three nappy-wearing infants will have nappy rash. Girls and boys are equally affected, but it is less common in new-borns. The peak incidence of nappy rash is between the ages of nine to twelve months.
What is nappy rash?
The term ‘nappy rash’ describes an acute-inflammatory reaction of the skin in the nappy area. This is most commonly caused by an irritant contact dermatitis.
The most recognisable clinical feature of nappy rash is a well-defined area of redness around the surface of the skin which is in contact with the nappy, together with scattered papules.
The baby may appear agitated and uncomfortable as the rash may be itchy and painful. In severe cases, there may be skin erosions, ulceration and oedema.
Risk factors for nappy rash
Including how often nappies are changed and the skin is cleaned. Prolonged skin contact with urine and faeces is a main cause of nappy rash.
The type of nappy used
Super absorbent disposable nappies can help as there is less contact between the skin and irritants.
Exposure to chemical irritants
Such as soaps, detergents, or alcohol-based baby wipes may irritate an infant’s delicate skin.
For example, friction from skin contact with nappies or over-vigorous cleaning and drying.
Recent broad-spectrum antibiotics may heighten the risk, alongside other drugs that increase stool frequency.
Pre-term infants are at increased risk of contagion and secondary infection due to the reduced barrier function of immature skin.
And conditions associated with increased stool volume and pH. Such as gastroenteritis, malabsorption, and liver conditions such as hepatitis (rare) increase the risk.
Everyday tips for prevention of nappy rash
- Using a nappy with high absorbency.
- Leaving nappies off for as long as possible.
- Changing the nappy frequently and as soon as possible after it is wet or soiled.
- Using water, or fragrance and alcohol-free baby wipes.
- Drying gently after cleaning, by patting dry rather than rubbing.
- Avoiding potential irritants such as soaps and bubble bath.
If there is mild redness and the child is not showing any symptoms, it is advised to use barrier preparation to protect the skin, such as Metanium® everyday barrier ointment, which should be applied thinly at each nappy change.
If the rash appears inflamed and is causing discomfort in infants over one month of age, consider using Metanium® nappy rash ointment with every nappy change until the symptoms settle.
If the initial treatment is unsuccessful, any underlying cause of treatment failure should be investigated, and you should contact a doctor.
Most cases of nappy rash are mild and easily treated in the community without the need for referral. Uncomplicated nappy rash should settle with appropriate treatment, and typically lasts about three days.
Metanium® everyday barrier ointment and nappy rash ointment are available from most pharmacies and retailers.
More info here
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