Most babies get diaper rash at one point or another. It was a bit of a struggle for me, too, when my kids were young! Diaper rash is a pretty common side effect of, well, wearing a diaper. So when moms call the HealthPartners CareLine asking about it, my first step is to reassure them. Diaper rash happens!

The good news is that most diaper rash can be treated at home. But sometimes it can become more severe, and it’s important to be able to spot severe diaper rash symptoms.

Read on to learn about what causes diaper rash, mild and severe diaper rash symptoms, at-home treatments, and when you need to get your little one into the doctor.

What is diaper rash?

Diaper rash is a common form of inflamed skin that appears on diaper-wearing children’s bottoms.

What causes diaper rash?

Unfortunately for you and your little one, a whole list of things can cause diaper rash. They include:

  • Irritants. When a baby is born, their skin isn’t used to dyes, scents or soaps. Because of that, babies can have skin reactions during their first few months of life. If your baby has diaper rash, it may be connected to the diapers or wipes you’re using. So, consider swapping products. If you’re using cloth diapers, try washing them in a detergent designed for sensitive skin.
  • Dry skin. Frequent bathing can cause your baby’s skin to dry out and lose its natural moisture barrier. That’s why it’s so important to moisturize baby’s bottom, especially after a bath.
  • Rubbing or chafing from a too-tight diaper. Yes, it’s possible for a diaper to be too tight. If you can’t get your finger between your baby’s belly and the diaper, it’s too snug. As long as you can’t fit your entire hand in there, it’s tight enough.
  • A dirty diaper that’s been left on for too long. Because baby’s skin is so new and sensitive, sitting – or lying – around in a wet or poopy diaper can take a toll. That’s why doctors recommend you change the diaper as soon as you notice it’s dirty.
  • Yeast infection. A yeast infection diaper rash is a severe type of diaper rash. This can happen when a baby takes antibiotics, either directly or through breastmilk if mom has been on that type of medicine.
  • Bacterial infection. A bacterial skin infection can start small and quickly grow in the warm, wet conditions of your baby’s diaper. This type of severe diaper rash can be dangerous if not treated.

Diaper rash symptoms: How to tell the difference between mild and severe diaper rash

What does diaper rash look like? If your baby’s bottom is covered in patches of bright red skin, chances are it’s diaper rash. Usually, diaper rash is mild and you can treat at home. But when it’s something more serious – such as a bacterial or yeast infection – you should talk to your baby’s doctor. That’s why it’s important to watch out for certain diaper rash symptoms and signs.

Symptoms of mild diaper rash

  • Your baby’s skin is pink and dry.
  • The rash does not seem painful, or is only mildly uncomfortable for your baby.
  • Your baby may react when urine or stool touches the rash, but otherwise they are eating, sleeping and generally acting normal.

Symptoms of severe diaper rash

  • Your baby’s skin is red, raw, broken or bleeding.
  • Your baby has a rash with blisters, pimples (which may drain pus), sores, boils or other red bumps.
  • The rash covers a large area. It may have a bright red border or be worse in the creases and folds.
  • The rash is painful to the touch.
  • Your baby seems sick, unhappy or unable to sleep.
  • There’s blood in baby’s poop.
  • You may be wondering “Really? Can diaper rash cause fever?” While it seems weird, the answer is yes if baby’s severe diaper rash is the result of a bacterial skin infection.

Call a nurse line or your baby’s doctor for severe diaper rash treatment next steps

If you notice one or more symptoms of a severe diaper rash, you should call a nurse line or your baby’s doctor for recommendations on what to do next. Call right away if your baby has a fever of 100.4° or more. If your little one has a bacterial infection, your doctor will want to start treatment as soon as possible to prevent it from getting worse.

Diaper rash treatment tips

If your baby’s diaper rash is mild, you can treat it at home. If you’re treating it consistently, you should see an improvement within three days. I know this can be hard for babies with multiple caretakers. So, if someone is taking care of your baby, be sure to share your diaper rash treatment instructions with them.

Doctor-recommended home remedies for diaper rash

  1. Change your baby’s diaper frequently. How much is enough? Baby should be changed every two hours while they’re awake, and at least once during the night. This will help keep the skin under and around the diaper clean and dry, which is how diaper rash gets better. This also prevents it from happening again in the future.
  2. Bare bottom time. Consider letting your baby spend some time without a diaper on, or put the diaper on loosely. Exposure to air will help the rash heal.
  3. Add a few tablespoons of baking soda to your baby’s bath. The baking soda will neutralize the acid in stool and urine. It can help to give baby a daily bath while their diaper rash is healing – just make sure to moisturize baby’s skin afterwards.
  4. Avoid using diaper wipes while there is a rash. Instead, use warm water and a mild soap, and then pat (don’t rub) the area dry.
  5. If there’s a rash around the anus, you can use Vaseline or other over-the-counter ointments to help. Be sure to wash your baby’s skin before applying it. And even though they used to be quite popular, I do not recommend using powders or cornstarch because your baby can inhale those.

Other natural remedies for diaper rash

In addition to the tried-and-true diaper rash treatments recommended by doctors, there are homeopathic remedies that you may consider, too. These treatments haven’t been scientifically proven to treat and heal diaper rash, but they’ve been around and used by many parents for a long time.

Before starting anything new, call your child’s doctor or clinician. Or make it one of your questions at baby’s next wellness check. That said, here are some popular options that can be used in combination with those tried-and-true methods.

  1. Witch hazel. Available in the pharmacy section of stores, witch hazel is known for its anti-inflammatory properties. So, it may provide your baby some relief from diaper rash. If you want to give it a try, dilute the witch hazel with equal parts water and then use a cotton ball to brush it onto baby’s bottom.
  2. Aloe vera. For many of us, aloe vera gel is a go-to choice for soothing sunburns and helping to heal cuts. So, it’s not a big surprise that aloe vera is also used by some parents for diaper rash. But choose a gel that’s 100% aloe vera – that way you can avoid ingredients that may be harsh on your baby’s skin.
  3. Calendula. Similar to aloe vera, calendula is a plant-based extract that comes from the marigold plant. It’s known for its healing qualities and has a pleasant smell. Calendula oil and water-based calendula creams can work well for diaper rash, and are readily available online and at some pharmacies.
  4. Shampoo clay (bentonite). Yeah, it seems a little weird to use a shampoo ingredient to treat diaper rash, but lots of parents swear by the stuff. In a study published in Nursing and Midwifery Studies, shampoo clay was actually more effective at treating diaper rash than calendula.

When to get help for your baby’s diaper rash

Diaper rash happens. While it’s tough to see your little one so uncomfortable, you both will get through this.

At-home remedies are usually enough to help baby’s bottom to heal – but not always. If you don’t see improvement within three days of consistent at-home treatment, or you notice what could be signs of severe diaper rash, call your baby’s doctor or a nurse line right away. This is especially important if your baby has a fever of 100.4° Fahrenheit or more.

HealthPartners patients can call our CareLine at 800-551-0859. Park Nicollet patients can call their clinic directly during regular business hours, or 952-993-4665 if it’s after hours. For questions and advice on new baby care, you can also call our 24/7 BabyLine at 612-333-2229.

If you want to speak with a doctor, go ahead and make an appointment. Both in-person and virtual appointments are available.

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