• Katie Ramirez

Diaper Rash - How to Prevent and Treat


I am an aunt again! My sweet baby niece was born just before Christmas! She is just the cutest little thing ever (check out her pictures below!)! At just a week old, however, she started to develop a diaper rash that progressed to a blistery, open sore, bleeding rash. If there is anything more heartbreaking than a crying new baby, it’s a new baby that screams almost hourly when you try to clean her excruciatingly painful bleeding diaper rash. Sadly, she is not the only baby with an awful diaper rash. In fact, 1 out of 5 times a baby goes to the doctor for a skin issue, it is because of diaper rash.

Let’s begin by covering the basics for prevention of diaper rashes, because as with everything, although prevention can take effort, it is much less effort than treatment.

What Causes Diaper Rash?

If we understand what causes diaper rashes, we can learn how to prevent them.

  • Too Much Moisture - The presence of urine can lead to over-hydration of the skin, making the skin surface more fragile and allowing more irritants to enter the skin.

  • Poop - The presence of stool on the skin can not only irritate the skin, but also damage it.

  • Skin Breakdown - Once the skin is broken down, inflammation occurs and a rash begins.

  • Small Diapers - Friction can also cause irritation of the skin leading to a mild rash.

How to Prevent Diaper Rash?

So, what should we do since babies poop and pee into their diapers all day long – constantly being exposed to things that can cause diaper rash?

Know your ABCD's!

  • Air – Allow diaper free time – as much as possible throughout the day.

  • TIP: After a diaper change, sit your bare-booty-baby on a pee pad and do tummy time or give her some toys to help her stay put for a minute.

  • Barrier – Apply barrier cream (cream with zinc oxide or petroleum) on babies at risk of diaper rash or those with a diaper rash.

  • See below for details on which cream to choose!

  • Cleaning – Gently clean the diaper area – avoid rubbing the booty too hard!

  • TIP: Washcloth with water or diaper wipes are fine – surprisingly, research shows that (mild/fragrance free) wipes are just as mild as washcloth on skin. Be sure to wipe at every diaper change – even if there is just pee!

  • Diapering – Use a super absorbent diaper. More absorbent diapers absorb the things that irritate your baby’s skin (urine and stool), leading to less irritated skin, and thus, less diaper rash.

  • TIP: Disposable diapers have been found to be much more absorbent than cloth diapers, so if you have a baby that has a bad diaper rash, consider temporarily switching to a disposable diaper. And if you have a baby who gets frequent diaper rashes, your cure may be simply switching to disposable diapers. It may at least be worth a try!

  • TIP: Change your baby’s diaper at least every 1 to 3 hours during the day (and once during the night if she has a diaper rash).

How to Treat a Diaper Rash

“Typical” diaper rashes clear up within about 3 days – and rejoice if you have “only” “typical” rashes to manage! Here’s the million-dollar question, however. When a rash does appear, what products do you use? Do you alter the way you change diapers compared to your normal daily routine?

If you notice redness in your baby’s diaper area, you can go back to your ABCD’s – but you may want to modify a few things.

  • Air Time - Allow more air time – time without a diaper. This allows the skin to adequately dry, provides time away from things that irritate the skin (urine and stool), and is friction-free time – all things that cause or perpetuate diaper rashes.

  • Disposable Diapers - If you use cloth diapers, switch to a super absorbent disposable diaper until the rash is cleared up.

  • Check Diaper Size - Check to be sure the diapers you are using aren’t too small, as friction can cause diaper rash.

  • Water Only Wipes - If there are any open sores, avoid using diaper wipes, and instead use water only wipes or a washcloth with water.

  • Lots of Products - Apply a thick coat of a barrier cream with each diaper change.

How to Apply Barrier Cream

Barrier creams provide a protective film that prevents exposure to irritants (urine and stool), while allowing the skin to heal underneath.

Apply the cream in a thick coat (think icing a cupcake!) to all areas of skin under the diaper. Thick application is key!

TIP: You do not need to completely remove the cream and reapply at each diaper change – simply remove the cream that is contaminated with stool and reapply another layer as needed.

Which Products to Use? - Zinc Oxide and Petrolatum

The consensus from research is that products with either zinc oxide or petrolatum are the best options for providing a barrier to the skin/promoting healing underneath. Most diaper products contain one or both of these ingredients. So, which to choose?

✔️Creams – fine for mild diaper rash, but least protective ✔️✔️Ointments – are thicker and more protective ✔️✔️✔️Paste – are thickest, contain both petrolatum and higher concentrations of zinc oxide, and are most effective

TIP: You can also consider covering the paste with a thin layer of Vaseline/petroleum jelly to keep the paste on the skin and off the diaper.

For a full scientific review of diaper rash product ingredients and popular products check out Diaper Rash Product Review!

Katie Ramirez, RN, BSN, CLC

Born Happy, Owner and Coach

Katie Ramirez is a Registered Nurse, Certified Lactation Counselor, and Coach for parents of babies and toddlers. She has spent more than a decade serving patients at major university hospitals such as Vanderbilt University and Penn State University Medical Centers. Katie now spends her time supporting and empowering parents of babies and toddlers as owner and coach for Born Happy.

Katie is the proud mother of two beautiful children, Roberto (age 5), and Veronica (age 3). She has a passion for health, wellness, and happy children, and believes that, with the necessary knowledge and support, all parents can live happy.

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