Diaper rash is a fairly common problem in children, specifically in young infants (a baby from birth to about 2 months of age). It is generally painful for the infants and also causes pain to the parents, owing to the discomfort that infants go through. Many parents complain that it keeps occurring repeatedly. 

Diaper rash is redness and rash on a baby’s bottom or genital area. It is a very common rash and most babies will get it from time to time. It is seen in infants and children younger than 2 years, but the rash can also be seen in some kids until the age of 3 years. 

Causes of Diaper Rash in Infants

Here are 9 most common causes of diaper rash in infants:

1. Wetness: Infants do not have control over their bowel and bladder. So, when they pass urine and stools, it remains in their diapers for a long time. If the caretaker is not attentive, it may stay there for a prolonged period and become worse. These young infants have immature and soft, thin skin that becomes red, itchy, and swollen. Wetness also attracts bacteria and fungus, giving them a good environment to grow in there.

2. Urine and faeces (waste matter from the digested food which is expelled out from the anus): Urine contains chemicals like uric acid which are harmful and can irritate the skin, if they stay in contact with the skin for a long period of time. Stools also contain bacteria and lipids (oils, greases, fats, and fatty acids) which allow bacteria to multiply and grow. The chemicals of the baby’s urine and stools slowly start to damage the skin around the diaper area and cause a diaper rash.

3. Not changing diapers frequently: If a baby’s diaper is not changed frequently, it is most likely to remain wet. Infants normally pass stools 8-10 times a day and also urinate many times. If diapers are not changed frequently, all of this gets accumulated in one single diaper, making it a perfect breeding ground for bacteria and fungus to grow and thrive. 

4. Bacterial infection: Bacterial infection can cause a diaper rash and this condition is known as impetigo. Certain types of bacteria (like staphylococcus sp. and streptococcus sp.) can cause diaper rash or make an existing one worse. 

5. Chemical irritants: The chemicals in diapers, especially the new ones may cause rash and irritation. In the case of washable diapers, the remnants of detergent, bleach, or fabric softener in the diaper may cause irritation. Additionally, baby clothes made of dyed synthetic fibers can also result in a diaper rash. It is advisable to wash all new clothes of a baby before using them. The use of various baby products such as creams, lotions, baby wipes, etc., can also cause allergies and diaper rash.

Parents must make a note if a particular brand of diapers or detergents or clothes is causing the diaper rash. If the brand is identified, it is advisable to change and use another one, after consulting their paediatrician.

6. Fungal infection: Fungus is a hidden enemy of infants. It likes to stay on the soft, immature skin of infants and babies. The fungus grows rapidly in a wet, humid environment, just like bacteria do. Leaving a baby’s diaper wet or not changing wet diapers regularly can lead to a fungal infection and thus cause diaper rash.

7. Ammonia diaper rash: Stool and urine left in a diaper for too long can combine to make ammonia, which can cause a mild chemical burn on the baby’s skin, causing a diaper rash.

8. Zinc deficiency: Zinc is a trace mineral that is important for the growth and development of infants and babies. A deficiency of zinc in infants and children can cause acrodermatitis enteropathica (a rare disorder characterized by severe diarrhea). When a baby has severe diarrhea, there is frequent passage of watery stools. Diarrhea stools contain enzymes that digest food and irritate the skin, causing a diaper rash.

9. New clothes: New clothes, owing to their colour, dyed fibers, material, and texture cause irritation, diaper rash, and skin allergies, mostly in older babies. In a young infant, it is a very rare cause of diaper rash. 

Symptoms of Diaper Rash

The most common symptom of diaper rash is red, tender-looking skin in the diaper area (buttocks, thighs, and genitals). It could be just a few spots, or the rash could have spread all over the diaper area. 

Diaper rash can make the baby fussy or cry as soon as the area is touched or cleaned. In severe cases, diaper rash can cause pimples, blisters, or other sores in a baby’s diaper area. If the rash is left untreated, it may cause an infection, leading to inflammation, swelling, and redness.

Complications of Diaper Rash

If any of the above symptoms become worse, it can lead to further problems such as:

  • Boils or small ulcers (painful lesions that develop in the genital area)

  • Bleeding in the area of the rash

  • Mild fever

  • Spreading of the rash to other areas, such as the arms, face, or scalp

Prevention of Recurrent Diaper Rash

  • Changing diapers more often and focus on preventing skin contact with stool.

  • Rinsing a baby's skin with lots of warm water when cleaning off the stool can help. Diaper wipes alone may not cleanse the skin fully.

  • Cleaning stools of the skin folds is also necessary. 

  • Washing new baby clothes and washable diapers before use can help reduce the chances of a diaper rash.

  • Introducing zinc-rich foods in a baby’s diet to prevent zinc deficiency. Infants between 0 to 6 months of age require about 2 milligrams of zinc per day and children aged 7 months to 3 years old, need about 3 milligrams of zinc per day. A paediatrician can guide as to what foods/supplements can be included and how to introduce them in the baby’s diet.

  • Changing your baby’s diapers regularly, good food habits, and cleaning the genital area thoroughly will prevent the recurrence of diaper rash. Consult a pediatrician if diaper rashes are a frequent occurrence in your baby. Do not neglect a diaper rash!

    Disclaimer: This article is written by the Practitioner for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.