From the time Penelope was four days old until she was about seven months old, she had a severe diaper rash. When I say severe, I mean the skin in her diaper area was red, raw, and bleeding. It was awful. I think I cried about it every day. Ultimately, I found out the cause of it was an undiagnosed cow’s milk protein allergy. The milk allergy was causing her to have frequent, runny stools, which in turn caused the diaper rash. Once I started giving her Alimentum, a hypoallergenic formula, the rash completely cleared up. Over the course of that seven months of diaper rash, though, I learned many tips and tricks for alleviating a bad rash, and I would like to share these tips with all of you.
To start with, you need to consider the cause of the rash: For example, is there anything unusual about your baby’s poop? I’m hesitant to describe what abnormal stool may look like- there is a wide range of stool that is considered “normal” and I don’t want to cause anyone any unnecessary alarm. What I will say is this: trust your instincts. If your baby’s stool is typically soft and brown and then suddenly becomes greenish and runny and you don’t think it’s normal, then talk to your doctor. Personally, I knew that Penelope’s stool was not normal, despite being told several times that I shouldn’t worry about it, and I was proven right when she was finally diagnosed with a cow’s milk protein allergy. But I digress- my point is this: if you can figure out the underlying cause for the rash, it will be easier to treat, so be sure to speak with your baby’s health care provider when dealing with a persistent rash. Discovering that underlying cause, however, can take a long time, and in the meantime, there are things you can do to alleviate your baby’s discomfort.
The first thing you must do is immediately stop using wipes. Believe me, I know it seems impossible- how else are you supposed to clean up all that disgusting poop? I had a hard time letting go of wipes, but once I did, I never looked back. Even the so-called “sensitive” wipes are too harsh for babies with a diaper rash. There are a few options for cleansing baby’s bum during diaper changes. The gentlest option, which was recommended to me by Penelope’s dermatologist, is, unfortunately, also the most difficult, and the procedure is as follows: fill a small basin with warm water. Take off your baby’s bottoms and the diaper. Dip baby’s bum into the basin and gently splash water around the soiled area. There is to be NO wiping at all. The gentle splashing of the water should be enough to remove most if not all of the stool. Do not wipe off any diaper cream that remains on the skin. Remove baby from the basin of water and gently pat dry the diaper area. Again, NO wiping. Once skin is dry, apply a thick layer of barrier cream (I will discuss barrier creams later) and apply the diaper. This procedure should be followed with every stool diaper. If it is only a urine diaper, no cleansing is necessary, just reapply barrier cream and apply the diaper.
Obviously, given that some babies will poop upwards of eight times a day (which is what Penelope was doing), this routine can get tiresome. So I adjusted it a little, and made up some “poop rags” out of old blankets and towels. Whenever the “bum bath,” as it came to be known in our household, wasn’t feasible for whatever reason (at 3am or if we were out of the house) I would instead very gently wipe up the stool with a moistened rag and then pat dry the diaper area. Later, I discovered these:
And I abandoned the bum bath once and for all. Curity Cleaners are dry, disposable wipes. You simply wet a few wipes when you know you are about to change a stool diaper, and it is very gentle on your baby’s bum- and since they are disposable, there’s no need for bleaching disgusting, stool-covered rags. If your baby’s rash is really severe- as in, broken, bleeding skin- then I would still use the bum bath method until it heals up a bit. Once the skin is no longer broken and bleeding, you are probably safe to try these gentle wipes.
Now, let’s discuss barrier creams. A barrier cream can be any zinc-based diaper cream. In my experience, creams like Zincofax or Sudocream, while they get bonus points for being high in zinc (which aids in healing the rash), they are simply not thick enough to provide a protective barrier. No matter how much cream I would slather on Penelope’s bum, it would always have rubbed off by the time the next diaper change rolled around. The only diaper cream I have found to be thick enough is Ihle’s Paste. And I prefer the store brand available at Shopper’s Drug Mart.
*Note: I believe it used to be sold under the Life Brand label, but I recently noticed that the logo has changed to “Atlas” brand- that is the cream to which I am referring. Here is a picture:
This cream is very thick, but not quite as thick as the Ihle’s Paste brand, which is very difficult to spread. When you apply the cream, you will need to put on a very thick layer- think of the thickest layer of frosting on a cake you have ever seen- that is what you are aiming for. You shouldn’t be able to see any skin through the cream. It takes some getting used to- it will be very messy at first, so make sure you have something available at your diaper changing station with which to wipe your hands. Putting that much cream on will feel wrong at first, but it will help. If you want to thicken up the Ihle’s Paste even more, you can also add something to it called ostomy powder. It will help the Ihle’s Paste adhere to the skin. This is an example of ostomy powder:
Now, some babies may have prescription ointments containing ingredients like hydrocortisone to help with the rash. Be sure to apply these ointments BEFORE applying the barrier cream. This can be extremely tricky. The ointments are greasy, and the Ihle’s paste won’t stick to the skin. The best thing to do is to get a big glob of barrier cream and start applying it outside the area where you applied the ointment, and then you kinda drag it over top of the ointment. Again, this is something that will be messy and take practice- just do your best, and then apply a good thick layer of barrier cream at the next diaper change.
Now, speaking of diaper changes, let’s talk about diapers. When I was struggling to get a handle on Penelope’s rash, I asked her dermatologist if switching to cloth diapers would be beneficial. She said that the disposable diapers made today are quite breathable, and so switching to cloth wasn’t necessary to help the rash. I’m not jumping into the whole cloth vs. disposable diaper debate here. I don’t know what effect, if any, cloth diapers would have had on her rash. I did try several different brands of disposable diapers, and I found Huggie’s Snug and Dry diapers to be the best. The worst were Pamper’s Swaddlers- that netting they have in the lining of the diaper seemed to really irritate Penelope’s skin. It may be worth trying out a few different brands of diapers to find out what works best for your baby.
If, despite your best efforts and the treatment your baby’s family physician or pediatrician provides, the rash does not improve, then do not hesitate to ask for a referral to a dermatologist. Initially, I kinda felt like, “Oh, it’s just a diaper rash, a dermatologist isn’t going to care about that,” but I was wrong. Penelope’s dermatologist was extremely helpful, and I only wish I had gone to her sooner.
A persistent diaper rash can be extremely stressful, especially for new parents. I was very upset over the state of Penelope’s bottom- I felt like it was an indication that I was a bad mom. Of course, it absolutely does not mean that. If you find yourself in tears, looking at the red skin on your baby’s bum, just remember that you are not alone and it most definitely is not a reflection of your parenting skills. Unfortunately, sometimes getting rid of a rash involves a lot of trial and error and it can take time. Just try to be patient. And feel free to contact me in the comments or on Facebook if you have any questions about any of the tips I outlined here or if you just need to vent- I’ve been there, and I know how overwhelming it can be. As well, please share this post with anyone whom you think may benefit from some diaper rash tips- chances are they will take any help they can get. And take them out for a drink at the earliest possible opportunity- I bet they will jump at the chance to blow off some steam. Good luck, and happy diapering!