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2021 Sep

Dealing with Diaper Rash

Is diaper rash the sign of a bad parent?

You are sitting with a nice cup of herbal tea reading a good book on a quiet Friday afternoon. You hear your baby stirring after a nap. You go in to pick up the child and notice a stinky smell in the room. You know a poopy diaper awaits (oh, joy), but how long has the baby been sleeping in the dirty diaper? You had just changed the diaper before naptime!

When you change the diaper, you notice a terrible bright red diaper rash. Oh, no. The poop must have sat on the skin for most of the naptime. The baby seems to fuss when you wipe over the area with a diaper wipe. You think that it must be sore. You feel bad and a little worried. What should you do?

First of all, try not to feel guilty. Diaper rash happens. This does not mean you are a bad parent. Diaper rash is a very common occurrence in infants and toddlers. Even the best, most attentive parent cannot always prevent diaper rash. Give yourself a break. Most children will have a diaper rash at least once in their childhood, and maybe more often.

Diaper rash is simply caused by skin breakdown. This breakdown can occur from the constant heat and moisture in the diaper area. This may occur if a child is not changed frequently enough. Urine sitting on skin can cause irritation. Sometimes diarrhea can cause the problem. Occasionally a child will have a bowel movement during naptime or at night and sleep in the dirty diaper. This can cause irritation and even rash. It can be difficult to prevent.

Once a child has a diaper rash, you need to be vigilant to keep the area clean and dry. Changing diapers frequently helps the area to begin healing. Allowing a few minutes of fresh air during this process can allow the skin to breathe and help to regain vital skin health. Minimizing the use of chemical diaper wipes can aid in healing. Use of a clean warm wet washcloth is a good alternative to diaper wipes.

There are many diaper creams on the market. Look for a cream with zinc oxide. The zinc oxide provides a nice barrier between the moisture of the urine and the skin. The zinc adheres to the irritated skin providing protection. Boudreaux’s Butt Paste or Desitin are both good zinc-containing diaper cream options. Apply the cream generously with each diaper change.

A warm oatmeal bath can be soothing to the diaper area. Dry the irritated area by patting gently with a towel. If you can, leave the diaper off for a few minutes to allow the area to dry completely before putting the diaper back on. Be sure to apply a diaper rash cream again after bathing. Supervise infants and children in tubs at all times. Never leave an infant or child alone in the tub, as sadly, accidental drowning can occur.

If the diaper rash has white heads, large firm areas of abscess, or lesions that are spreading down the infant’s legs or up onto the abdomen, see your pediatric healthcare provider. If your child has fever with any of these rashes, be sure to make a same-day appointment. These types of rashes need appropriate medical care.

Prevention is key to avoiding diaper rash problems. By keeping your child clean and dry, you can prevent diaper rash from becoming an irritating issue. Diaper rashes are very common and generally can be treated at home with fresh air and care. Call your pediatric healthcare provider for an appointment for any rash that is not improving within a few days or sooner if there is fever, behavior changes, or other illness.

The well-check visit is a great time for you to ask any questions you may have about diaper rashes, growth, or development. Infant well checks are scheduled at 2, 4, 6, 9 and 12 months-of-age. Toddler well checks are scheduled at 15, 18, 24, 30, and 36 months-of-age. Be sure to schedule your child’s next well visit. Meanwhile, keep that baby clean and dry. Now, go and make yourself another cup of herbal tea.

Melanie J. Wilhelm, DNP, CPNP

Dr. Melanie J. Wilhelm, DNP, CPNP, is a Doctor of Nursing Practice, and a Certified Pediatric Nurse Practitioner in Norfolk, VA as well as core faculty member at Walden University. Her book, Raising Today’s Baby: Second Edition, is available on