Dealing with diaper rash on baby's bottom

Diapers should be changed as soon as they are wet, soiled or full, as these conditions will encourage the growth of bacteria and yeast. — Positive Parenting

One day, while changing your newborn’s diaper, you may notice his bottom or groin area has turned reddish and he seems uncomfortable when you touch it.

Your little one most probably has diaper rash.

This is a typical condition affecting babies and toddlers wearing diapers and is most common in babies less than a year old.

It is characterised by reddened, inflamed skin in the diaper region, which includes the thighs, buttocks and genitals.

Most babies will get diaper rash at some point, but it is usually treatable at home.

If you know what to do and how to manage it properly, the rash will subside quickly.

Possible causes

Before looking into ways to manage diaper rash, it is good to understand what causes it, as different causes may require different treatments.

> Irritation

This is the most common cause.

Exposure to urine and stool for an extended period causes irritation to a baby’s sensitive skin, especially if one is using less absorbent diapers.

Very tight diapers can also cause irritation as the material rubs against the baby’s skin.

If the material lining is coarse, it can also create friction and this will lead to a rash too.

> Candida overgrowth

A type of yeast called Candida can be present on normal skin with no symptoms or negative effects.

However, if it overgrows, it can cause secondary infection in the nappy area.

Overgrowth often happens in warm, moist and softened places with higher skin pH, such as under a wet diaper, armpits, neck and breast folds.

> Bacterial infection

Certain types of bacteria transmitted from other people or in the environment may cause a diaper rash or worsen it.

A streptococcal infection causes bright red rashes around the anus, while a staphylococcal infection may appear as yellow crusting, boils or pimples.

> Allergy

Babies with eczema or allergies may develop diaper rash after being exposed to irritants or triggers that are present in products used or applied on them, e.g. diapers, baby wipes, soap, lotions, oils, creams, etc.

Rashes that are caused by an allergy may also appear on other parts of the body.

> Other causes/factors

Diaper rash is more likely to happen when your baby starts eating solid foods or has changes in her diet.

Other rare skin conditions such as seborrhoeic dermatitis or paediatric psoriasis may also appear as a diaper rash.

Manage and prevent

Other than medication or treatment that may be prescribed by your baby’s paediatrician, good diaper care is so important.

> Pick suitable diapers

The right size, according to the baby’s weight, will determine a good fit.

Fast and effective absorbency, as well as breathable and soft materials, are some important factors when selecting diapers for your baby’s sensitive skin.

Fragrant-free diapers also reduce potential irritation triggers.

> Change diapers frequently

Wetness from urine and stool causes great discomfort and irritates the skin if left in contact for too long.

Yeast and bacteria also love wet and warm places.

Be sure to change a wet, soiled or full diaper promptly.

> Clean the skin gently

Rinse your baby’s bottom with warm water when changing diapers.

You can also use alcohol- and fragrance-free baby wipes or non-soap cleansers to do this.

Gently pat the skin with a towel or let it air dry, but do not rub.

> Go bare-bottomed

Let your baby’s skin dry and breathe naturally for a while as it also helps with the healing process before putting on a fresh diaper.

> Use a barrier cream regularly

This cream acts as a shield for the skin against urine and stool.

Products containing zinc oxide or petroleum jelly are good for this purpose.

Apply a thick layer every time you change his diaper.

> Don’t overtighten the diaper

Diapers that are too tight can rub against the skin, prevent airflow and trap moisture, giving rise to suitable conditions for rashes to develop.

This is especially important for overnight diapers.


It is time to see the doctor if:

  • The rash worsens or does not improve after five days of home treatment.

    This includes the use of barrier cream, frequent nappy changes, rinsing with warm water and five minutes of allowing baby to go bare bottom once every six hours.
  • The rash spreads to the skin folds of the groin with new red pimple-like spots (known as satellite lesions) seen along the edges of the rash.
  • The rash bleeds, itches, oozes or has open sores.
  • Your child has a fever or looks sick.
  • Your child seems to be in pain or discomfort.

Babies will usually recover from a diaper rash within a few days with early and careful management.

However, severe cases or infections may require further attention and prescribed medication.

Always consult your paediatrician if you have any concerns.

Dr Leong Kin Fon is a consultant paediatric dermatologist. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners. For further information, please email The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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Child health , skin , diapers


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