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Can diaper rash be serious?

What to do if your baby gets diaper rash, and how to tell when it needs more attention than at-home TLC

By Katy Fournier, RN, MPH
September 21, 2018

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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 CareLine asking about it, my first step is to reassure them. Diaper rash happens!

There are things you can do to both help prevent diaper rash, and to treat it at home. Sometimes diaper rash can become more serious, however. But let’s start with regular old diaper rash, and what can cause it.

What causes diaper rash?

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

  • Irritation. Your baby’s skin may be reacting to a brand of diapers or wipes, chaffing from a tight-fitting diaper, or getting dried out from soap.
  • Stool left on the skin, particularly in places where it can hide, like on the scrotum.
  • A dirty diaper that’s been left on for a long time. This is especially true when cloth diapers are used.
  • Diarrhea. This can cause a rash around the anus in particular.

When should I be concerned?

Usually, diaper rash is just a nuisance that you can treat at home. But it is possible for it to turn into something more serious that requires a doctor’s evaluation. That’s why it’s important to watch out for certain signs and symptoms.

Symptoms and treatment for 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 your baby is eating, sleeping and generally acting normal.
  • What you should do: Treat at home. If you don’t see improvement with 3 days of consistent at-home treatment, call your doctor or a nurse line.

Symptoms and treatment for serious diaper rash

  • Your baby’s skin is red and raw or broken, and may bleed.
  • The rash includes red bumps, pimples (which may drain pus, sores, blisters or boils.
  • The rash covers a large area, and may have a bright red border or be worse in the creases and folds.
  • The rash is painful to the touch and/or your baby seems sick, unhappy or unable to sleep.
  • What you should do: Call your doctor or a nurse line. If a fever is also present, call right away.

Serious diaper rash can be caused by a yeast infection or a bacterial infection. Since yeast infections can be the result of using antibiotics, you may see some of these symptoms if your baby has just finished a round of that kind of medicine.

Don’t hesitate to call your insurance company’s nurse line or your clinic for extra help if you’re unsure about where your baby’s diaper rash fits in to all this.

At-home treatments for mild diaper rash

If you are able to determine that the diaper rash your baby has is mild, there are a few things you can do to treat it at home:

  1. Change your baby’s diaper frequently: 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. 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.
  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. Even though they used to be quite popular, I do not recommend using powders or corn starch because your baby could inhale those.

You should see improvement in your baby’s diaper rash within three days if you’re treating it consistently. I know this can be hard for babies with multiple caretakers. So if grandma is taking care of your baby for a while, for example, be sure to share these instructions with her!

If the diaper rash doesn’t seem to be getting better or is instead getting worse, call your baby’s pediatrician. CareLine nurses like me are also always here to answer your questions and help decide if your baby should be seen by a doctor. Our job is to make sure you have all the information you need, at the moment you need it!

For help with diaper rashes, growth spurts and beyond, find a child-friendly doctor at one of our HealthPartners, Park Nicollet or St. Croix Valley locations.

About Katy Fournier, RN, MPH

Katy Fournier has been in Maternal-Child nursing for most of her career since she started it in 2000. And before she started working for HealthPartners, she was one of our patients. After earning her nursing degree from Valparaiso University and Masters of Public Health at Indiana University, Katy and her family moved to Minnesota. She instantly admired HealthPartners’ commitment to connected care and online access and decided she wanted to work there. These days she’s a supervisor at the HealthPartners CareLine nurse triage line. She has three children and is a proud Minnesota hockey mom. She continues to love supporting new moms, especially now that she doesn’t have to change diapers at home herself.

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