Diaper rash is the result of the breakdown of the outer layer of skin. The moisture and compounds in urine and feces penetrate and soften the skin causing it to lose its protective toughness. This makes it much easier for bacteria and fungus to penetrate the skin and find an environment which promotes their growth. Like other aspects of health, the key is prevention. In countries where infants do not wear diapers (and there are many!), there is no diaper rash. The use of plastic pants also promotes the trapping of moisture. There are now diaper overpants made of wool which work well to keep the moisture off of the baby’s clothes…….they allow a bit more air circulation.
The key to prevention is checking often for wet and dirty diapers and changing them immediately. Use of a zinc oxide ointment or cod-liver oil ointment is helpful, but powders should NOT be used due to the risks of your baby inhaling talc particles.
The beginning signs of diaper rash are redness and swelling. As soon as you see this, try not to cover it up with another diaper. It is perfectly alright to place the baby on top of towels or cotton diapers and clean up as they get wet or soiled……this is how most of the rest of the diaperless world deals with this……and they don’t have to deal with diaper rash!
Simple diaper rash is not necessarily an indication of a skin infection. However, infection is a possible complication. Once the skin begins to lose its protective abilities both bacteria and fungus can get a toe-hold. If the baby’s skin starts to slough off, or if raised or crusted sores appear, you should take the baby in to see your clinician. Your baby may need medicines to help heal a fungal or bacterial infection.