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Q: What's good for a really bad nappy rash?
- Submitted by Debralee in New York

Dr. Karen Sokal-Gutierrez, M.D., M.P.H.
Pediatrics
A: Debralee, most babies end up getting nappy rashes at some time. With mild nappy rashes, the baby’s skin around the genitals, thigh skin folds and bottom become red and a little sensitive to touch. In more severe nappy rashes, babies can get painful open sores or blisters.

nappy rashes can be caused by:
  • Irritation of the skin by urine and feces staying on the baby’s bottom for too long;
  • Infection with yeast or bacteria;

  • Allergic reaction to the nappy material or chemicals in the nappy wipes or soap.

Babies are more likely to get nappy rash when they begin to eat solid foods, when they have diarrhea, when they’re taking antibiotics for an illness, or when you’re taking antibiotics while breastfeeding your baby.

If your baby has a bad nappy rash that has blisters, sores, or doesn’t go away within three days, follow these steps:

  • Be sure to have the doctor check your baby. She may have an infection and need an antifungal cream or powder for a yeast infection or antibiotics for a bacterial infection.


  • Change your baby’s nappy frequently to prevent irritation from the urine and stool on her skin. If possible, leave your baby without a nappy for periods of time to help dry her skin.


  • Avoid using scented nappy wipes since the alcohol or perfume may irritate your baby’s skin. Look for “hypoallergenic” nappy wipes and consider pre-rinsing them in warm water to remove the chemicals so you can clean your baby with just a moist cloth.


  • If your baby’s bottom is very tender, don’t use a nappy wipe—instead, spray her bottom with warm water from a spray bottle, or rinse her bottom in the sink or tub. Then gently pat her dry (don’t rub) with a towel or washcloth.


  • Bathe your baby with only warm water, or use a mild soap if necessary. Don’t use adult soaps with deodorants or antiperspirants that can irritate her skin.


  • Ask the doctor whether it would be helpful to use an over-the-counter ointment (e.g., with zinc oxide or petrolatum) on your baby’s nappy area. This can help protect the skin from irritation from urine and stool, and help it heal.
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