Nappy rash – red patches on your baby’s bottom

You’ve likely heard or read about the skin problem known as nappy rash (nappy dermatitis). It’s worth learning the symptoms and treatments so you can spot inflammation early and start soothing it quickly.

The sooner you restore the skin’s condition, the fewer the discomforts – and you can avoid complications. If you know what might trigger symptoms, you can identify your baby’s specific causes and prevent recurrence, which, unfortunately, is possible.

Parents usually notice nappy rash while it’s still mild and begin effective home care in time – but this does take attention.

What happens to a baby’s skin during nappy rash?

Red, inflamed skin caused by nappy rash

Inflammation ranges from a few scattered, superficial red spots to large areas of deeper erosion. Every stage is uncomfortable – it burns, stings and itches.

If you catch the problem right at the start and recognise it, you’re in luck: with appropriate care – and if baby’s body responds well – the inflammation needn’t spread. A more severe state can develop within hours if, for example, a nappy change is missed: the skin becomes very red, stings, and may weep.

Damaged skin no longer protects well against bacteria and fungi, so any soiling in the nappy can more easily cause infection.

The symptoms of nappy rash are characteristic

What changes might you see on your baby’s skin?

On the bottom, thighs, groin folds and genitals, the skin is red/inflamed, itchy and tender
Sores can also appear
Changing nappies becomes difficult; baby is fussy and may cry

What can cause nappy rash in babies?

Parents of multiple children often notice that while one child had no issues in the nappy years, a sibling may get repeated flare-ups – even when care routines are identical.

Some babies – like some adults – have more sensitive skin that is easily thrown off balance by irritation. Triggers include a wet, warm nappy, especially when urine and stool are present together, or diarrhoea.
Urine and stool contain substances that can erode the skin.
If baby has eczema (atopic dermatitis) or seborrhoeic dermatitis, be extra vigilant – the risk rises.

Infrequent changes also raise the risk – the longer delicate skin is in contact with a warm, wet, soiled, irritating environment, the faster inflammation develops and the larger/deeper the affected area can become.

Chafing can cause tiny abrasions that easily progress to inflammation. An overtight nappy or very snug clothing around the thighs can also trigger rashes on the bottom and in the folds.

If you’ve found skin-care products you trust and use regularly, a sudden switch can provoke sensitivity. A new brand of wipes, nappy, detergent or fabric softener can cause rashes – so think twice before changing.

Mum feeds her little girl baby food

It isn’t just cosmetics – changes in diet can alter stool and its frequency. When new foods are introduced, stools may become more frequent or change in composition. With breastfed babies, even mum’s diet can play a role – although that’s hard to pinpoint.

Teething time can also coincide with nappy rash.

Antibiotics in baby – or in mum if breastfeeding – can increase the risk because they reduce bacteria that keep fungi in check. Antibiotics are also known to increase the chance of diarrhoea.

What should we do if we notice nappy rash symptoms?

Because you need to start care immediately – and sensitised skin is prone to flare again – it helps to split the to-dos into two parts.

Treating existing nappy rash

If you spot the earliest signs during a change, you can start right away. Simple home methods often work well, but do ask your GP/health visitor for advice – they can recommend barrier/healing creams that help prevent infection and promote healing.

If your baby’s bottom looks red, adjust a few care habits and observe how the skin responds. Improvement can take several days.

During treatment, avoid chemicals as much as possible. Healthy skin may tolerate the additives sometimes found in wipes or nappies, but inflamed, broken skin can be strongly irritated, slowing or preventing healing.

At every change, rinse gently with clean water – no rubbing. Ideally under running water or in a small tub, wash the bottom and thighs gently. Pat dry with a soft cloth – avoid rubbing that could cause micro-injuries. You can also air-dry.

Choose a suitable nappy cream. During healing, it’s ideal to use a product that keeps moisture away, reduces inflammation, and contains the most natural ingredients possible. Ask your GP/health visitor to help you choose.

Baby lies without a nappy

Be extra diligent about frequent changes – and if there’s stool, change immediately. Continue this at night until healed. Allow nappy-free time several times a day so skin can air.

If symptoms don’t improve after a few days, consult your GP – they may recommend medicated creams or, in case of infection/complications, antibiotics.

Preventing nappy rash from coming back

Once your little one’s skin has healed, you can ease some of the strict measures – but stay alert. If the same conditions return, the inflammation can too.
Because a soiled, overheated nappy is the main issue, change more often. Prevent prolonged contact with urine/stool. Don’t fasten nappies too tightly.
Choose the most natural baby-care products you can. If previous items worked well – and you don’t suspect any caused sensitivity – return to them. If you’re happy with a product’s quality, avoid swapping.
Dress baby in clothes that allow easy movement, are stretchy, breathable and don’t make them sweaty. Cotton is great; bamboo blends – like LiaaBébé bamboo-fibre babywear – offer top quality and comfort.
If antibiotics are needed, ask your GP about a suitable probiotic to help prevent diarrhoea.
Find a nappy type that breathes well and uses materials as close to natural as possible. In hot weather, ultra-thin nappies changed more frequently can help.
Many parents report that reusable nappies and washable wipes helped them leave rashes behind – fewer chemicals, better airflow.
A quick water rinse in the day can also help prevent recurrence – make it a routine after changes with a little bowl of water, so the skin meets only clean water.