Childhood Diseases

Posted by: Carole | 2010-07-13


5 week old with severe nappy rash

Hi, my 5 week old grand-son has severe nappy rash, we have been using bum cream and noe fissan paste, it seems a lot better but it`s not going away, we are also leaving his nappy off for about half an hour before bathing. is there any-thing else we can do or should we take him to see the doctor?

Expert's Reply



It is unusual for such a young baby to have such a severe nappy rash. Also you have treated his rash correctly but with only some improvement.It is possible that your baby grandson has a zinc or biotin deficiency. he should be seen by a paediatrician. Please request and make sure that his blood zinc level is measured.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

user comments


Posted by: Denise Vermeulen | 2010-08-05

What about using good old MAIZENA ......
works wonders............

Reply to Denise Vermeulen
Posted by: From a Mom | 2010-07-13

It might not be nappy rash but a yeast infection. Please read article below, helped me a lot.

What does diaper rash look like?
Diaper rash doesn''t always look the same. But if your baby''s diaper area looks irritated and red, chances are he has it. His skin may also be a little puffy and warm when you touch it.

Diaper rash may be very mild —  a few prickly red spots in a small area —  or quite extensive, with tender red bumps that spread to your baby''s tummy and thighs. There''s no need to panic, though: Dealing with diaper rash is part and parcel of baby care, especially in the first year or so of your baby''s life.

How did my baby get diaper rash?
Diaper rash can be caused by anything from a new food to your baby''s own urine. Here are the most likely culprits:
•  Wetness. Even the most absorbent diaper leaves some moisture on your baby''s delicate skin. And when your baby''s urine mixes with bacteria from his stool, it breaks down and forms ammonia, which can be very harsh.

Although a baby left in a dirty diaper for too long is more likely to develop diaper rash, any baby with sensitive skin can get a rash, even if his parents are diligent diaper changers.
•  Chafing or chemical sensitivity. Your baby''s diaper rash may be the result of his diaper rubbing against his skin, especially if he''s particularly sensitive to chemicals like the fragrances in a disposable diaper or the detergents used to wash a cloth diaper. It could also be that a lotion or powder you''re using for diaper duty doesn''t agree with your baby''s delicate skin.
•  New foods. It''s common for babies to get diaper rash when they start eating solid foods or are introduced to a new food. Any new food changes the composition of the stool, and it might increase your baby''s bowel movements as well. If you''re breastfeeding, your baby''s skin could even be reacting to something you''re eating.
•  Infection. The diaper area is warm and moist —  just the way bacteria and yeast like it. So it''s easy for a bacterial or yeast infection to flourish there and cause a rash, especially in the cracks and folds of your baby''s skin.

In addition, babies on antibiotics (or whose breastfeeding mothers are on antibiotics) sometimes get yeast infections because antibiotics reduce the number of healthy bacteria that help keep yeast in check as well as the harmful bacteria they''re meant to destroy. Antibiotics can also cause diarrhea, which can contribute to diaper rash.

Thrush is a type of oral yeast infection. Some babies with thrush develop a yeast infection in their diaper area too.

Should I take my baby to the doctor for a diaper rash?
It''s probably not necessary. With some diligence, you should be able to say good riddance to your baby''s rash in three or four days without a doctor''s visit.

Do call the doctor if the rash looks as though it may be infected (has blisters, pus-filled pimples, oozing yellow patches, or open sores). She may prescribe a topical or oral antibiotic for your baby.

For a diaper rash caused by a yeast infection, your doctor may prescribe an antifungal medication to use in the diaper area. Also call the doctor if your baby develops a fever or his rash doesn''t go away after several days of home treatment.

What''s the best way to treat diaper rash?
Keep your baby clean and dry by changing his diaper frequently. That may mean getting him up at night for a diaper change.

Rinse his diaper area well at each diaper change. Some parents keep cotton balls and a squirt bottle or an insulated container of warm water at the changing table for easy, gentle cleanups. Pat your baby''s skin dry —  don''t rub!

Using a barrier ointment —  one that forms a protective layer on the skin —  after every diaper change can help protect your baby''s irritated skin from stool and urine. There are several good barrier ointments on the market, including petroleum ointment and white zinc oxide, which is thicker and good for protecting very sensitive skin.

Put your baby''s diaper on loosely or use a diaper that''s a little big on him to allow for better air circulation. If your baby wears cloth diapers, don''t use plastic pants. If you buy disposables, try a different brand to see if that helps.

When the weather is warm and your baby can play outside or in a room with an easy-clean floor, leave his diaper (and ointment) off for as long as possible every day. Exposure to the air will speed healing.

Consider letting your baby sleep with a bare butt whenever he has a rash. A plastic sheet under the cloth sheet will help protect the mattress.

How can I prevent diaper rash?
Here are some good preventive measures:
•  The best defense against diaper rash is a dry bottom, so change your baby''s diaper as soon as possible after it becomes wet or soiled.
•  Clean your baby''s genital area thoroughly with each diaper change. Pat his skin dry —  never rub it.
•  If your baby seems prone to diaper rash, coat his bottom with a thin layer of protective ointment after each diaper change. There are several good barrier ointments on the market, including petroleum ointment and white zinc oxide (which is thicker and good for protecting very sensitive skin). It''s okay to use plain petroleum jelly as a barrier, but it rubs off easily.

Skip the talcum powder, as the dust is harmful to your baby''s lungs if he breathes it in. If you want to use powder, choose the safer cornstarch-based type. Shake powder into your hand, away from your baby  never directly on or near him, and keep the container well out of his reach at all times. At every diaper change, carefully wash away any powder that accumulates in your baby''s skin folds.
•  When your baby starts eating solid foods, introduce one new item at a time. Waiting a few days between each introduction will make it easier to determine whether sensitivity to the food causes a diaper rash. If it does, you can eliminate that food for the time being.
•  Don''t secure the diaper so tightly that there''s no room for air to circulate. Loose clothing will let your baby''s bottom breathe. Avoid plastic pants and other airtight fabrics.
•  Don''t wash cloth diapers with detergents that contain fragrances, and skip the fabric softener —  both can irritate your baby''s skin. Use hot water and double rinse your baby''s diapers. You might also add half a cup of vinegar to the first rinse water to eliminate alkaline irritants.
•  Breastfeed your baby for as long as you can. Breastfeeding boosts your baby''s resistance to infections in general and makes him less likely to need antibiotics, which can contribute to diaper rash.
•  If your baby goes to daycare, make sure that his caregivers understand the importance of taking these measures to prevent diaper rash.

How do you treat a yeast infection?
The best treatment for a yeast infection is a topical anti-yeast or antifungal cream such as Lotrimin AF, Nystatin, or Monistat. These are available without a prescription in the drugstore. Use it as directed on the label. The rash will take a few days to clear up.

Do I need to see a doctor about my baby''s yeast infection?
Not right away. Try the topical antifungal cream first. If the rash isn''t improving within three days of starting the medication, call your baby''s doctor.

How can I prevent yeast infections in the future?
If your baby is taking an antibiotic or has recently recovered from a bout of thrush, you may not be able to prevent a yeast infection completely. But you can avoid creating the kind of environment that yeast love —  that is, a dark, moist place. What to do (these tips also prevent run-of-the-mill diaper rash):
•  Change your baby''s wet and soiled diaper as soon as possible.
•  Clean your baby''s bottom thoroughly after a bowel movement and give it a chance to dry before you slap on the next diaper
•  Don''t put diapers on so tightly that no air can circulate around your baby''s skin.

Reply to From a Mom

Want to comment?

Thanks for commenting! Your comment will appear on the site shortly.
Thanks for commenting! Your comment will appear on the site shortly.