No matter how diligent parents can be about changing a baby’s diaper, they are likely to develop a rash. As a neonate, the skin is very delicate and stooling is very often, so the skin often gets red around the anus. A good barrier cream with zinc oxide is very helpful for this kind of rash. Overall rashes are usually just irritant type and again, a good barrier cream applied frequently is the best treatment. If the baby is having diarrhea, using a small amount of baby powder, just in the diaper area, can help absorb some of the liquid. I often suggest that when cleaning the skin, to gently remove the stool, but not to completely clean off all the cream. Then continue to add layers of cream for protection. The thicker the cream, usually the better the protection.
Yeast infections, however, need an anti fungal treatment. These rashes are more reddened, tend to be in the groin creases or just in the front and sometimes have little red circles outside of the main part of the redness (satellite lesions). These are very common after a baby has had antibiotics for an infection. While over the counter anti-fungal medicine may be helpful, this usually requires a doctor’s visit for a prescription medication. Sometimes the babies also develop a yeast infection in their mouth called thrush. Both are usually caused by a fungus called Candida. This fungus likes warm moist places which is why they appear in the diaper area and in the mouth. These creams are usually applied to the skin three to four times a day, and you can also use regular diaper cream in between prescription cream application.
It is practically impossible to keep a baby’s bottom completely dry! But changing the diaper often can help a lot!
Debbie Ainsworth, MD
Washington Pediatrics, PA