I have decided that once every two weeks I will cover a topic on babies. I decided to do this for two reasons. First of all we all know what great treasures babies are. They are cure, innocent, require our full attention, they are the next generation of our families and our society and an extension of our life into the future. The second reason is that I really enjoyed my clinical rotations in pediatrics and cherished seeing a big smile on mom and dad's face when their baby was happy and healthy. I have decided to begin this journey of baby topics by talking about diaper rash. This is a very common condition, very unpleasant to the baby, and surprisingly, easily prevented.
So what is diaper rash? Well from the visual point of view it is the reddening of the skin in the diaper area. It causes itching and substantial discomfort to the baby. The major cause is prolonged wetness in the area when the diaper is left for too long or when the skin is not allowed to dry during the process of changing the diaper. The prolonged wetness makes the skin softer and the presence of urine raises the pH (i.e. making the environment more basic as opposed to more acidic), which activates certain enzymes in fecal material called proteases and lipases. These enzymes start breaking down the skin surface which is now even more susceptible due to its softness and natural thinness. The result is the rash, which is itchy and at times painful, especially when friction occurs between the baby’s skin and a new diaper.
So what can we do to prevent this and make our babies just as comfortable as the cute baby in the picture above? Well there are a few things to keep in mind. First of all prevent the diaper area from being moist, especially for prolonged periods of time. This can be done by checking the diaper more frequently. Before putting on a new diaper make sure the area is washed thoroughly with gentle soaps and then gently wiped and dried.
It also a good idea to use the new generation of so called “superabsorbent” diapers. These diapers contain a “superabsorbent” microfiber cloth placed in a pocket within the diaper which pulls moisture into the diaper and keeps the skin dry for a longer period of time.
Another thing to keep in mind is that most diaper rashes occur between the ages of 8 to 12 months. It is theorized that this occurs due to the baby's diet being changed from soft to solid food. The same thing may occur during a change from feeding with breast milk to soft foods. The change in diet cases changes to fecal material composition, which in turn predisposes the baby to diaper rash. Thus it is good to change the diaper more frequently during these periods.
A change in fecal material composition may also occur after the baby is on antibiotics or when the baby experiences diarrhea. During these periods it is also a good idea to be more vigilant with checking the diaper, changing it when necessary and keeping the diaper area dry and clean.
The other way to prevent excessive moisture build up is to use certain powders, salves, balms and creams. I am not a proponent of powders because they disperse in the vicinity of the babies face and the baby then inhales them, which is certainly not healthy as it may cause respiratory problems. However there are some natural safe powders. On the other hand natural oils, creams, and salves, especially the ones with the addition of herbs that soothe the skin and which have anti-bacterial and anti-fungal properties, are especially helpful. They also soothe the skin once the rash is present and accelerate the healing process.
One thing to keep in mind when using these great products is to make sure to apply them on dry skin. When applied on wet skin they will trap moisture between the cream and the skin surface which defeats the purpose.
One last important point. If the diaper rash does not go away, and if it becomes more inflamed (redder and more swollen), or even worse when pustules show up (they look like pimples full of fluid), the area may have become infected by either bacteria or fungi (such as Candida albicans). In this case a physician’s attention and the use of a cream that contains a corticosteroid with either an antibiotic or an anti-fungal agent may be necessary.
That’s it for my first episode of the baby journey. I hope you have found the information useful. Stay healthy my friends and keep your babies happy.