The best ways to prevent diaper rash

By Donya Betancourt

SANUR, Bali (JP): Nothing can be more disheartening than changing your baby's diaper and finding red raw patches or red pimples all over the diaper area. We call it diaper rash. It is probably the most common type of rash seen in babies under two years old.

Almost every child will get a diaper rash in their life no matter how clean we try to keep them. And the rash can occur with both disposable and cloth diapers.

No specific type of the diaper is better than the other in term of rash prevention. The best preventative approach is "keep your baby dry and clean", no matter what kind of diaper you choose.

Question: What is the cause of diaper rash?

Answer: It can be caused by irritation and infection. Irritation may come from:

* strong urine

* wearing wet diapers for long periods, especially with plastic or nylon pants

* using strong soap and detergents when cleaning cloth diapers

* loose stools or diarrhea

* powder, creams and perfumed lotions

* certain acidic foods.

Q: Signs of infection:

A: * Bacterial symptoms are blisters, sores with pus or opened skin

* Yeast (candidal) rashes are common, typically red, sometimes raw or raised with small bumps. The rash starts in the creases (where there is most moisture) and spreads out over the thighs and pubic, scrotal and labial areas.

This is in contrast to the typical contact-type rash, which appear on parts of the baby's skin covered by the diaper.

What is thrush?

Thrush is an oral fungus and yeast infection. It causes white patches in the mouth and on the lips, cheeks and tongue. These areas should be checked and treated orally if symptoms are present.

Q: What to do with diaper rash?

A: The general treatment for diaper rash is to keep the area clean and dry.

* change diapers frequently and immediately after a bowel movement

* expose the baby's bottom to air

* when rinsing the baby's bottom, try putting a little vinegar in the water in the basin. Dip the baby in warm water and gently clean the bottom, avoid scrubbing with a cloth. Allow the vinegar-water to air dry.

* use a barrier ointment such as Vaseline or Aquaphor to help keep the area free from urine and stools

* use a diaper paste that acts both as a barrier and a drying agent (usually contains aluminum acetate) to promote quick healing

* your doctor may recommend 1 percent hydrocortisone cream to treat inflammation

* if it is a yeast infection, your doctor may prescribe clotrimazole twice a day along with your usual cream. If your child has oral thrush, Nystatin will be also prescribed

* See the doctor when:

* large blisters more than 1 inch (2.5cm) in diameter appear

* the child is acting sick.

* there is no improvement in 3 days.

* blisters, sores or crusting develops.

Q: How to prevent diaper rash?

A: Some babies have very sensitive skin and a rash may be difficult to prevent. These guidelines may help to prevent or reduce diaper rash:

* Change diapers frequently and immediately after a bowel movement.

* Do not use plastic or nylon underwear.

* Always wash the diaper area from front to back to prevent contamination from feces.

* Use baby wipes containing no alcohol.

* Avoid using bubble baths and bath oils when bathing your baby.

* Vinegar helps neutralize the ammonia in urine. You can add two cups of vinegar to one tubful of water for the final rinse when you wash diapers.

* Protective ointments such as drapolene may be helpful.

* Do no use powder and corn starch in the diaper area.

Q: Which are best? Disposable or washable diapers?

A: There are no conclusions on this. It is true that, for parents, disposable diapers are easy and convenient to use. Concerns on their use focus on their price and the waste generated from them. Washable diapers can be reused but also have to be washed, causing pollution from detergents and bleaching chemicals that drains into canals or rivers.

For the baby, it probably does not matter which are chosen as long as they are dry and changed often enough.

The writer is a pediatrician based in Bali. Feel free to email questions, comments and concerns to drdonya@hotmail.com.