Isabella Thomas (28), an anxious new mother from Vaikom, Kerala, had a conundrum on her hands. Should she give in to the popularity of easy-to-handle disposable diapers despite having seen her nephew constantly develop diaper rashes from them? Or should she trust her gut and go with reusable cloth diapers for her newborn baby girl?
Thomas says her nephew continued to develop the rashes even after using diaper-rash creams. The reason: he wore disposable diaper all the time. “The parents, being busy, would not change the diaper very frequently and you could see that the baby was walking around in this very heavy, soiled diaper,” she tells Happiest Health.
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Hence, to prevent the rashes, she decided to use reusable cloth diapers for her baby.
“I use the disposable ones only while travelling,” says Thomas. “At home, when my baby is sleeping, I use a cloth diaper and change it frequently. When she’s awake, she often doesn’t wear diapers. This means there are lots of clothes to wash and dry every day. However, I believe this has helped keep diaper rashes at bay. Another bonus is that I believe this has helped train my baby. Now she doesn’t urinate when someone is holding her. And though she’s only one, she has started to poop in the potty stool.”
What causes diaper rashes?
Dr D Dinesh Kumar, a Chennai-based dermatologist and secretary general, Indian Association of Dermatologists, Venereologists & Leprologists, says a soiled diaper that remains unchanged for a long time is the leading cause of diaper rashes among babies.
“The function of a diaper is basically to absorb urine or feces that the baby passes,” he says. “When the diaper is not changed for a long time, the urine or the excrement can irritate the skin. If the diapers are not of good quality or if they are too tight, the friction can also irritate the baby’s skin.”
Dr Kumar says the general sensitivity of babies’ skin — or what is known as atopy (tendency to develop allergic conditions) — can also be one of the causes of diaper rashes.
Wet-wipe woes
Dr Kumar says sometimes parents may use a new product, such as a wet wipe, that contains fragrance and alcohol to clean the baby’s diaper area. “This could lead to irritation of the baby’s skin and, eventually, rashes,” he says. “Sometimes, bouts of diarrhoea can aggravate diaper rashes. In very rare cases, diaper rashes could even be caused by a fungal infection, or they could be caused by deficiencies — a zinc deficiency, for instance.”
How to identify diaper rashes?
Dr Leenatha Reddy N, consultant, paediatrics and neonatology, Kinder Women’s Hospital and Fertility Centre, Bengaluru, says new parents must watch out for the following symptoms:
- Redness/inflamed skin in the diaper area
- Fluid-containing bumps in the buttocks
- Scaly skin/skin that is peeling off
- Baby is irritable, cries a lot.
Dr Reddy says in very severe cases, babies also tend to develop a fever and widespread rashes in the diaper area, including the buttocks and genitals.
She recalls the case of a 23-day-old baby boy from Bengaluru who showed up at the hospital with bright-red rashes all over the buttocks and the genital area. The parents were using cloth diapers, but these had been left unchanged for hours together. “The parents continued to ignore the rashes, which only made things worse,” the doctor says.
Dr Reddy recalls it as one of the most severe cases of diaper rashes. “The boy had fluid-filled bubbles that were rupturing in puss discharge, and in some places the baby’s skin was also peeling off,” she says. “The baby was crying continuously due to pain and discomfort.”
In this case, the doctors had to use a steroid for the treatment since the rashes were so severe that none of the diaper-rash ointments and creams worked. “It took at least 15 days for the baby to completely recover,” Dr Reddy says.
When the baby was passing urine, it would touch the inflamed skin area, causing intense pain. “She was kept in the supine position (lying on the back) in which the urine made contact with the existing rashes and peeled off skin, causing a lot of pain and discomfort,” says Dr Reddy. “The baby cried all the time.”
Dr Reddy adds that the parents, in this case, eventually switched to disposable diapers, which proved to be more comfortable.
“We advise parents to keep checking to see if the baby’s diaper needs changing, and to do so frequently,” she says. “We also advise them not to leave the diaper area wet. Use a cloth to dab it dry.”
Diaper rashes: When to consult a doctor?
“I would suggest consulting a doctor as soon as you spot a rash,” says Dr Kumar. “Take it to your doctor as early as possible because a doctor will be able to help you with some creams and rule out any fungal or yeast infections.”
How to deal with diaper rashes
Since infrequently changed diapers are the No. 1 cause of rashes in the diaper area, the first step towards treatment is to ensure that diapers are changed frequently, as soon as they get soiled, say doctors.
“With proper medication, diaper rashes do go away,” says Dr Kumar, adding that diaper-rash creams and ointments that contain zinc oxide are the go-to treatment method for such rashes.
“Choose diapers which are soft and not too tight-fitting,” says Dr Kumar. “While the diaper should be secure, it should not be too tight. Make sure to pick a diaper which will not rub against the baby’s skin too hard. Refrain from using wet wipes and wet tissues. Use a soft cloth dipped in warm water instead. You can also do a little bit of air drying. Leave it open for some time.”
Dr Kumar says it is not essential that a baby wears the diaper every hour of the day. Parents must ensure that the handler or whoever is handling the baby should also keep their hands clean, he says.
Detailing some of the complications of ignoring diaper rashes, Dr Reddy says in addition to the pain and discomfort the baby goes through, these rashes can also interfere with the baby’s sleep. If ignored, diaper rashes can evolve into a more severe form of fungal infection and sores.
Takeaways
Diaper rashes, although widely prevalent among babies, can get worse if ignored. Infrequently changed diapers are the No. 1 cause of such rashes. Make sure to:
- Check the baby’s diaper often and change it as soon as it gets soiled
- Use diapers that are secure but not too tight and that don’t rub against the baby’s skin too hard
- Refrain from using wet wipes and wet tissues to wipe the diaper area — these wipes and tissues may contain alcohol that can irritate the baby’s skin
- Use a soft cloth dipped in warm water instead. Consult a doctor at the first sign of a rash in the diaper area.
