Nappy Rash

Infant and Children | July 6, 2017 | Author: Naturopath

infants

Nappy Rash

Most babies get nappy rash at some stage which can lead to discomfort and an unsettled child. Nappy rash is caused by a disruption in the protective barrier of the skin – due to fungal infections, moisture, irritation, diarrhoea and it can even occur if the child has a viral infection such as a cold. Most cases of nappy rash can be cared for at home but if the rash is severe and doesn’t clear up within a few days a visit to your GP may be needed.

Symptoms of nappy rash

The symptoms of nappy rash include:nappy rash crying baby

  • Inflamed skin within the nappy region, most commonly affecting the genital area and anus
  • Blistered skin which may peel, leaving areas of ulceration
  • A rash that spreads to the tummy and buttocks
  • Small ulcers can sometimes form on the outer perimeter of the rash on healthy skin
  • An unsettled child, especially if the nappy is soiled, as this irritates the skin

Causes of nappy rash

Babies who have sensitive skin, especially if they have rashes on other areas of their skin such as eczema and cradle cap are more susceptible to nappy rash. Some factors that can lead to nappy rash include:

Ammonia in the urine and faeces: Both these components can irritate the skin, especially if there is diarrhoea or loose stools. If the nappy changes are infrequent then this could increase the likelihood of nappy rash occurring.

Fungal infection: Candida spp. thrive in the damp environment of a soiled nappy. Fungal infections are a common cause of nappy rash especially if the baby has been given antibiotics.

Chemical exposure: Some baby wipes contain chemicals which may cause an allergic reaction or irritate the skin. This can also happen with soaps or creams and certain brands of nappies.

Plastic pants: This plastic outer layer used to cover cloth nappies, prevents airflow and may lead to excess moisture—worsening the skin irritation.

Care at home

Nappies

Disposable nappies are the best choice to prevent nappy rash as moisture is quickly absorbed away from the skin, keeping the area dry.

nappy rashWhile cloth nappies certainly have a lot of advantages, they don’t have the same level of absorbency. If you are using cloth nappies, avoid using the plastic pants which allows the skin to breathe.

When washing make sure the rinse cycle adequately removes any chemicals in the detergent and consider using the clothes dryer as they come out softer compared to drying in the sun.

 

Nappies should be changed at least five to seven times a day in children under 12 months, to avoid the length of time that urine and faeces are in contact with the skin.It’s a good idea to allow as much time as possible for a child to have their nappy off so that the area can remain dry—ideally with a small amount of sunlight exposure.

Wipes

Babies wipes often contain a long list of chemicals, including parabens, alcohol and other irritating chemicals. If a child already has a sore bottom, using these wipes can cause extreme discomfort. Consider using better quality wipes, or even dampened ‘chux’ style cloths or dry bamboo wipes that are designed for use on the skin. If there is ulceration and extreme nappy rash consider cleaning the area in a lukewarm salt bath instead of using wipes. This helps to discourage any further irritation and promotes healing.
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Barrier cream

nappy rash calendula creamA barrier cream can be applied generously to a clean bottom at each nappy change. This will prevent the skin from coming into contact with irritants and moisture. A formula containing zinc oxide usually works very well. Other suggestions include formulas containing calendula, marshmallow (white mallow) or chamomile. If there is a fungal infection, one drop of tea tree, lavender and German chamomile essential oils can be added to 30mls of coconut oil and calendula infused oil. Talcum powder should be avoided but instead corn flour could be used only if necessary to help keep the skin dry.
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Probiotics

Probiotics can help heal nappy rash fast. They are very effective in preventing fungal infections and supply the baby with beneficial bacteria to make the stool less irritating. They are particularly indicated if the child has diarrhoea, loose stools, has taken antibiotics for an infection and if the nappy rash is of fungal origin. A formula, specifically for babies and children should be used, which can then be added to baby formula after it has been heated, mixed with food or mixed with cooled boiled water and syringed into the mouth. Ideally Saccharomyces boullardii (a non-colonising yeast effective in the treatment of opportunistic yeasts such as Candida spp.) should be used alongside a multi-strain probiotic.

Dietary advice

nappy rash 1If your child has commenced solids and the nappy rash is fungal related avoid too much sugar in the diet. Don’t add sugar to foods and check the labels of baby foods to make a better selection.

Lactofermented foods can be incorporated into the diet to provide active probiotics needed to recolonise the gut with beneficial microbes.

Cod liver oil, high in omega 3 and vitamins D and A, can help reduce inflammation and infection in nappy rash.

A few drops can be supplemented in an infant and up to 2mls can be given to a child over 6 months.
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References

http://www.rch.org.au/kidsinfo/fact_sheets/Nappy_rash/

https://www.betterhealth.vic.gov.au/health/healthyliving/nappy-rash

Hechtman L (2014). Clinical Naturopathic Medicine. Churchill Livingstone, Australia

Goldman M, Lodhi I. A real-world evidence study evaluating a treatment for nappy rash. BR J Nurs. 2016 Apr 28-May 11;25(8):432-9

https://www.ncbi.nlm.nih.gov/pubmed/27126752

Panahi Y, et al. A randomized comparative trial on the therapeutic efficacy of topical aloe vera and Calendula officinalis on diaper dermatitis in children. Scientific World Journal. 2012;2012:810234

https://www.ncbi.nlm.nih.gov/pubmed/22606064

Demirel G, et al. Prophylactic Saccharomyces boulardii versus nystatin for the prevention of fungal colonization and invasive fungal infection in premature infants. Eur J Pediatrics. 2013 Oct;172(10):1321-6

https://www.ncbi.nlm.nih.gov/pubmed/23703468

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