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Did you know there are 4 different types of Nappy Rash?
- Most nappy rash is an irritation of the skin caused or aggravated by contact with the wee and poo.
- The nappy rash starts with a slight reddening of the skin in the nappy area and can progress to soreness and discomfort. It can almost appear shiny.
- A normal disposable nappy is made of plastic and traps heat and moisture inside. This combined with the wee or poo, makes a perfect breeding ground for bacteria.
- Any parents note a nappy rash outbreak coincides with an event. These events may change the alkalinity / acidity and bacterial content of their babies’ poo.
- A normal bacterial nappy rash will clear up with some at home treatment.
How to identify Severe Bacterial rash
- If not treated, a normal nappy rash can become infected. Bacterial nappy rash can be identified with broken skin, infected spots or pimples.
- Your baby is also likely to have a fever.
- This type of nappy rash may need antibiotics so it’s best to speak to your health visitor or see your GP for advice, treatment and monitoring as soon as possible.
- A common cause of nappy rash is friction caused by the nappy rubbing against your baby’s delicate skin.
- Whether you use disposable nappies or reusables do check the fit of the nappy.
- It should be snug around the tummy but not too tight – you should be able to fit your finger inside the waist band.
- The tabs should come around the sides and sit on the frontal sticky tape without having to cross over or meet – Most brands have a logo on their tape. You should sit be able to see this once the nappy is fastened.
- The leg ruching should not leave deep red indents in your babies’ skin. If it does, it is too tight.
- Conversely a too loose nappy can cause chafing between the thighs.
FUNGAL / YEAST INFECTION
- A bright red, moist rash with white or red pimples which spreads to the folds of the skin and the genitals can appear slightly swollen..
- This kind of rash can sometimes happen if your baby is on antibiotics or if they have thrush.
- This needs to be treated using an anti-fungal cream, available on prescription from your GP.
- If the nappy rash is fungal it is important that you avoid your usual barrier cream as this can make the condition worse.
- Occasionally nappy rash can become persistent and can be related to other skin conditions like eczema or allergies. Some babies have sensitivities or allergies to the various components of their nappies or wet wipes.
- This is known as Allergic contact dermatitis.
Why would my baby’s nappies contain allergens?
Normal nappies are made using:
- Crude oil
- Latex or PVC
- Chlorine bleached pulp
Your baby will spend a significant portion of their first 24 months wearing their nappy, so its very important that the materials and chemicals do not irritate them.
There are more skin-kind disposable versions available, like Mama Bamboo nappies which avoid the oil-based plastics, latex, PVC and chlorine and choose natural dyes, zero perfume or zero lotion
Mama Bamboo uses 100% bamboo fibre covers, breathable compostable liners, chlorine free pulp, zero fragrance or lotion.
What you can do to avoid & treat mild nappy rash
1.Choose a breathable, natural material nappy
- Either disposable or reusable, natural materials can help to improve airflow and reduce the ‘plastic bag’ effect.
- Choose chlorine free, fragrance free, lotion free nappies
- Bamboo versions in particular have proven effective as they provide a natural antibacterial effect.
- Ensure the nappy is well fitting
2.Change your baby often
- Change them as quickly as possible after they have pooed
- And change them regularly when they have weed
- A baby should be changed every couple of hours in the newborn stages; 10-12 nappy changes a day
- Be sure to use gentle wipes to clean the nappy area and gently pat the area dry before popping on a fresh nappy.
- Nappy free time
- Leave the nappy off for as long as possible to let fresh air get to their delicate skin
- Especially after a nappy change wait a few minutes to ensure your baby’s skin is totally dry before using a fresh nappy
- Nappy cream
- You can use a barrier cream at the first sign of redness to prevent an outbreak, however a cream should not be needed on every change
- Avoid irritants
- Avoid using soaps, detergents or bubble bath that could irritate the skin
If you are interested in comparing ‘eco’ disposable nappies, we have made a handy table in our blog: How to choose an eco friendly nappy
- Choice of Wet Wipes
Baby wipes are made up of 6 components:
- A fabric – polyester, polypropylene, bamboo, cotton or pulp
- Water – ideally over 99%
- Detergents to remove the dirt and reduce the need for scrubbing
- Moisturising agents
- Ph Balancers
Some also include totally unnecessary fragrance
Whilst it is true that baby wipes should contain a high degree of water, it must be noted that water alone is not enough to effectively remove stubborn residues and prevent the growth of microorganisms or maintain a healthy skin pH
There are a few known ingredients in well known brands of baby wipes which are allergens or typical sensitivity triggers. Print out our WIPE WATCH LIST below and check your current wipes carefully:
Polyester and Polypropylene
11 billion plastic wet wipes went into landfill last year in the UK alone!
This is completely unnecessary. There are several good brands of fully compostable ones available.
Choose a 100% plant based zero plastic material like bamboo, wood pulp or organic cotton to avoid these and do your bit for the environment and stop using plastic wipes full stop.
Should You use Cotton and Water?
So why chance it…should I use just cotton and water?……Well no!
Several independent clinical studies* have demonstrated that the use of modern baby wipes were superior to using water and cotton to clean delicate skin.
In all trials babies skin was visibly improved by using wipes:
- Better cleansing without scrubbing leading to a decrease in the severity of nappy rash in the folds
- Improvement in water loss and hydration
- Significantly lower pH balance (Higher alkalinity is linked to dryness)
- Better barrier function due to the moisturising impact.
Also cotton itself is highly polluting.
Cotton is one of the most water intensive crops to grow. And unless its organic cotton it uses a significant amount of pesticides as well. And most cotton wool and cotton pads are bleached in chlorine.
- Nappy Cream
On the whole, you shouldn’t need a barrier cream with every nappy change. It really only needs to be applied when a little redness is beginning to show. And should only be used for a few days.
There are many creams around and we would steer you towards natural, organic ingredients wherever possible.
Just like wipes you should look for the magic words…..
- Paraben free
- Phthalates free
- Petroleum free
- Fragrance free
Other things to specifically watch for include:
- Lanolin: Lanolin is essentially an excretion of a sheep’s skin. The problem is that sheep are often sprayed directly with pesticides to fight off mites and other pests.
- Boric acid / sodium borate: This is a potential skin irritant, which is even worse because nappy rash cream is typically applied to broken skin
- Talc: On this point your grandmother is not correct! Talc is not a good thing to be adding to your babies’ bottom. It is very drying and irritating.
One thing your barrier cream should include is zinc or zinc oxide. Zinc should account for at least 5% of the formulation to be effective.
And it goes without saying you should be looking for the Leaping Bunny or Cruelty Free badges on all products.
Many babies do get nappy rash at some point. It does not mean you have done anything wrong.
There are things you can do to help avoid it but it may still happen occasionally:
- natural material nappies
- choosing a good fit nappy
- regular changes and immediate changes after a poo
- extra drying nappy free time
- gentle wipes
- avoiding allergens
If it does occur, there are things you can treat it with at home:
- more nappy free time
- check ingredients in your brands and make a swap
- use a barrier cream for a few days
However, if it doesn’t clear up within a few days, do seek medical advice – it could have developed into a bacterial infection or it may be a fungal infection.
Our mission is to make nappy rash a thing of the past.
*Referenced studies and articles:
1.Ehretsmann C, Schaefer P, Adam R. Cutaneous tolerance of baby wipes by infants with atopic dermatitis, and comparison of the mildness of baby wipe and water in infant skin. J EurAcad DermatologyVenereol. 2001;15(Supplement 1):16‐21.
2.Lavender T, Furber C, Campbell M, et al. Effect on skin hydration of using baby wipes to clean the napkin area of newborn babies: assessor‐blinded randomised controlled equivalence trial. BMCPediatr. 2012;12:59.
3.Adam R, Schnetz B, Mathey P, Pericoi M, de Prost Y. Clinical demonstration of skin mildness and suitability for sensitive infant skin of a new baby wipe. Pediatr Dermatol. 2009;26:506‐513.
4.Visscher M, Odio M, Taylor T, et al. Skin care in the NICU patient: effects of wipes versus cloth and water on stratum corneum integrity. Neonatology. 2009;96:226‐234.