Nappy Rash: Causes and Gentle Care

You change the nappy and see a red, irritated little bottom. The first thought is often “What did I miss?”. The answer is usually: nothing. Nappy rash (doctors call it nappy dermatitis – inflammation of the skin under the nappy) happens to almost every baby, even in the most caring families.

The good news is that mild and moderate nappy rash usually clears up with simple things at home and doesn’t need medicines.

The short answer: Change nappies often, clean gently with warm water, pat dry and apply a thin layer of barrier cream at every change. See your paediatrician if the rash doesn’t clear in about a week, spreads, or has blisters, or if your baby has a fever.

What causes nappy rash?

The most common cause is skin being in contact with wee and poo for longer. The moisture and the substances in them gradually break down the skin’s protective layer. Other contributors:

• rubbing from the nappy or clothes;
• harsh soaps, fragranced baby wipes or laundry detergents;
• diarrhoea or a change in feeding, for example when starting solids;
• sometimes – a fungal infection (thrush) or a bacterial infection, which need a check-up.

How to care for sore skin

• Change the nappy often – and straight away when it’s wet or dirty.
• Clean gently with warm water and soft cotton wool or a cloth. If you use wipes, choose fragrance-free and alcohol-free ones.
• Pat dry rather than rubbing. The skin is irritated and doesn’t like friction.
• A barrier cream creates a thin layer between the skin and moisture. According to UK health guidance, apply a thin layer at every change – it doesn’t need to be as thick as cake icing.
• Don’t fasten the nappy too tightly – a little airflow helps.
• Avoid soaps and fragranced bath products while the skin is irritated.

When choosing a barrier cream, ask a pharmacist or paediatrician for advice and read the leaflet. Steroid or antifungal creams are used only if a doctor decides they’re needed.

When to show that bottom to your paediatrician

• the rash doesn’t clear up in about a week, gets worse or spreads beyond the nappy area;
• there are blisters, pus-filled spots, crusts or open, weeping skin;
• bright red, shiny patches in the skin folds with small spots around them – this could be thrush;
• your baby has a fever or seems unusually unwell and tearful.

If your baby is very floppy, isn’t feeding or has a rash on their body that doesn’t fade when you press a clear glass against it, call 112.

For the dads

Regular nappy changes aren’t “Mum’s job” – they’re a team sport. Take the night or morning shifts and become the expert in “nappy-free time”. Keep a spare towel handy. Experience shows you’re going to need it. 😅

📖 Read next: Umbilical Cord Care: Clean, Dry and a Little Patience · Fever in Babies: When to Worry and When Not To

In short

Frequent changes, water instead of rubbing, a thin protective layer and a little freedom for that bottom. Nappy rash isn’t a verdict on your care – it’s just part of life with nappies. In a few days the skin will be peachy-soft again, and you’ll know exactly what to do next time. 💛

Sources: NHS / nidirect – Nappy rash; NHS Wales – Nappy rash (Common Ailments Scheme); The Royal Children’s Hospital Melbourne – Nappy rash.