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Recurrent diaper rash?
Q: How do you keep a diaper rash from reoccurring? My daughter sleeps 12 hours without a diaper change. I work the night shift and it's hard for me to come home and wake her up to change her diaper because she wants to stay up.

Is there any way I can prevent this rash from coming back? We started to use baby power with cornstarch, and the rash came back worse. We have been A&D ointment on her, which seems to work better.
A: Jessica, you're fortunate that your baby is a good sleeper. Most parents would envy you for that! Understandably, your baby may stay wet overnight and be prone to diaper rashes.

Diaper 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 or allergic reaction to the diaper material or chemicals in the diaper wipes or soap. In addition, babies are more likely to get diaper 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.

Here are ideas for preventing your baby's diaper rash:
  • At night, put your baby in the most absorbent diaper possible. If you use cloth diapers, double them. If you use disposable, choose a super-absorbent diaper. For either type, consider adding a diaper liner, which can help keep baby drier. These are available at some grocery stores, baby supply stories and through various online sites.
  • Continue to use an over-the-counter ointment with zinc oxide, petrolatum and vitamins A and D on your baby's diaper area, especially at night. This can help protect the skin from irritation from urine and stool, and help it heal. But don't use cornstarch or baby powder, as these could be irritating.
  • During the day, change your baby's diaper frequently to prevent irritation from the urine and stool on her skin. If possible, leave her without a diaper for periods of time to help dry her skin.
  • Don't use scented diaper wipes since the alcohol or perfume may irritate her skin. Look for hypoallergenic diaper 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 diaper wipe at all. 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.
  • If the diaper rash doesn't go away, 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.
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician