I can still remember when my youngest daughter had a particularly intense bout of nappy rash. She cringed and screamed every time I tried to wipe her sensitive bottom, and I started to worry that maybe our new brand of nappies was the culprit. After a few days of this torture, we saw our doctor to treat what looked to me like severe nappy rash. He recommended a powerful cream to treat eczema and her rash cleared up fast. I was relieved, but surprised that the same eczema my baby was getting on her head and cheeks could actually occur down there, too! But, in fact, it’s pretty common.
So, how can an anxious mama (aka: me!) tell the difference between a run-of-the-mill nappy rash and something more serious, like a yeast nappy rash?
For starters, treat redness and/or irritation on your baby’s groin, thighs, and/or bum, with a good nappy rash treatment at every nappy change, says Dr Jonathan Blau, a neonatologist with Staten Island University Hospital in New York City. It’s most likely irritation from a wet or poop-filled nappy that your baby has sat in for too long. But, if the rash doesn’t improve within a couple of days — or it gets worse — it’s time to see your doctor. One of these culprits may be to blame:
1. Yeast infection
Most stubborn nappy rashes are actually yeast infections, which need to be diagnosed and treated by your doctor. Treatment is painless; you’ll apply a cream to your baby for around 14 days.
2. Allergic reaction
If you’ve recently changed nappy brands, or you’re using a new cream or soap on your baby, her skin may be irritated. Tell the doctor about any new products that you’ve used during your visit.
3. Too tight nappy
If there are dry red papules or bumps along the lines of the nappy elastic, your baby’s nappy might be too snug, which can irritate her skin, says Dr Hugh Gilgoff, a paediatrician in private practice in Brooklyn, New York.
Some infants have dry, sensitive skin, which can lead to eczema on your baby’s bottom. Your doctor can prescribe a special moisturiser or, in some cases, a hydrocortisone ointment, says Dr. Blau.
5. Bacterial infection
Just like yeast infections, bacterial infections are common in the nappy area. Strep — the same bug that causes nasty sore throats — may be the source of your baby’s uncomfortable rash, says Dr. Gilgoff. Another common culprit? Staph.
6. Rare disorder
Finally, there are some rare — very rare — disorders, like psoriasis and a form of cancer called histiocytosis, that your doctor can diagnose during a routine exam.
Remember, there’s no need to panic if the rash on your baby’s bum doesn’t go away with an over-the-counter cream (and trust me, I have definitely panicked, so I know what I’m talking about here). Chances are, your doctor will be able to fix the problem fast.