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Sore Bums
by Stacy Jones Tolentino

The Truth About Diaper Rash

You just changed your baby's diaper and noticed that once again his bottom is red, rashy, and blistered. It's the third diaper rash this week and by now you're beyond frustrated. You're worried that you're doing something wrong which may be causing your baby's sore bum. You've called the doctor for an appointment and you're about to ditch your disposables for a soft gentle batch of cloth diapers. You're on the right track! Read on to find out what may be causing your baby's sore bum and how you can prevent future bouts of diaper rash.

The Root of it All

Dr. Alan Greene, a Northern California pediatrician who answers house calls about children's health via his web site www.DrGreene.com, says that, "Ever since children began to wear diapers, diaper rash has been the most common skin disorder of infancy."1 Greene says that while rashes may be caused by a variety of things, it's skin wetness and yeast organisms that are most commonly associated with this problem. "Urinary wetness increases skin friction, raises the skin pH, [and] makes the skin less cohesive,"2 he explains. "With this protective layer breached, it is easy for microorganisms such as yeast or bacteria to invade the inflamed skin,"3 he adds.

Disposable Diapered Bums

Many parents are hesitant to cloth diaper because they believe that the constant wetness will cause ongoing bouts of diaper rash. Instead, they opt for what they believe to be a simpler and healthier diapering method--single use disposable diapers. Proctor & Gamble, the manufacturers of Pampers, have reported, though, that "Two-thirds of infants get diaper rash some of the time and one-third regularly."4 So, oddly enough, although 95% of American babies are diapered with super absorbent disposables, it is obvious that wetness is still a problem. How can this be? It's simple; many parents and caregivers who diaper with disposables do not change their babies' diapers often enough. Super absorbent diapers hide wetness, so it is not uncommon for parents who diaper with disposables to go 4-5 hours or more between their baby's diaper changes. On the other hand, parents who diaper with cloth are able to easily check for wetness and usually change their babies every 2-3 hours. This is critical for healthy diaper care. A dry feeling diaper may still be a wet diaper. And a wet diaper that isn't changed quickly enough can easily lead to a cycle of diaper rash.

Cloth Diapered Bums

According to those who operate Tiny Tots Diaper Service, based in Campbell, California, "Wetness does not cause a rash."5 And they mention this in their diaper service manual. Does this statement have any validity? Perhaps, because if wetness is the sole cause of diaper rash, then just about every cloth diapered baby would have ongoing diaper rashes due to spending 10-12 hours every night without a diaper change, but that is not the case. In fact, very few parents who cloth diaper their babies complain of diaper rash problems.

The Dirty Dozen

But if wetness doesn't always cause diaper rash, what else could be to blame? The truth is diaper rashes may result from a dozen or more causes, including: wet or soiled diapers that are not changed immediately, acid and ammonia build up, chemicals in disposable diapers, chemicals in disposable baby wipes, food allergies (breastfed babies may be allergic to something mommy is eating), yeast infections (often caused by antibiotics given to babies or breastfeeding mommies), germs, bacteria, lotions, powders, salves, and skin that is not able to breathe.

Ten Steps for Diaper Rash Prevention

To avoid diaper rash or at least minimize it, make it a point to follow these ten steps:

  1. Change your baby's diapers as soon as they become wet or soiled.

  2. Wash your hands thoroughly after changing diapers to avoid spreading germs to other babies who may need a diaper change.

  3. Wipe your baby's bottom gently when using diaper wipes to avoid injuring his skin.

  4. Use cloth diapers and cloth diaper wipes on your baby. They are a natural gentler choice and will allow your baby's bottom to 'breathe' better. Disposable diapers and disposable wipes contain irritating chemicals, plastics, papers, dyes, perfumes, and soaps that are not healthy for your baby's skin.

  5. Allow your baby to go without a diaper for at least a few minutes each day or longer, if you can. Fresh air can do wonders on a sore and rashy bum and it can keep a healthy bum rash free!

  6. Avoid using standard lotions, powders, soaps, and diaper rash creams on your baby's skin. Even salves that claim to be non-irritating, like Eucerin, contain some very irritating ingredients like petroleum and alcohol. Purchase natural skin care baby products instead. Many cloth diaper business owners sell a variety of natural skin care baby products and diaper rash salves that are much healthier than ones sold elsewhere.

  7. If your baby has very sensitive skin consider diapering with organic cloth diapers which are the most pure, natural diapers available. These diapers are free of pesticides, dyes, perfumes, and chemicals.

  8. Eat healthy foods, especially if you're breastfeeding, because whatever you eat may affect your baby's system and may cause your baby to get a diaper rash.

  9. Nurse your baby. "Breastfeeding has been shown to lower fecal pH, which may help to protect the natural barrier function of the skin, making infections and, consequently, severe diaper rash less likely."6

  10. Antibiotics may lead to yeast infections because they reduce "the amount of the skin's 'good' bacteria that fight infection."7 Therefore, if your baby is given a course of antibiotics he may be more susceptible to diaper rash. If you are breastfeeding and you are given a course of antibiotics, your baby may still get a diaper rash, so be on the look out. In the meantime, eat natural yogurt which will increase the 'good' bacteria in your stomach and fight the yeast. If your baby is eating solids and your pediatrician approves, give your baby natural yogurt as well.
Remember, prevention is the best treatment for diaper rash. You won't have to treat a rash it if it doesn't exist, so be sure to follow the steps above to keep your baby's bum as healthy as possible!

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Notes:
  1. Diaper Rash--Dr. Greene's HouseCalls. World Wide Web. article.

  2. Ibid.

  3. Ibid.

  4. "Proctor & Gamble Eyes Lead in Diapers." Advertising Age, 04/05/99, Vol. 70 Issue 15, p14.

  5. How It Works Manual: Welcome to Tiny Tots Diaper Service, Inc. Campbell, CA, 1997.

  6. "Breastfeeding May Reduce Occurrence of Diaper Rash." Dermatology Times, Jul 97, Vol. 18 Issue 7, p3.

  7. See note (1) above.
Disclaimer: This article is based on the opinion of the author and is not meant to take the place of medical advice. Always consult your pediatrician regarding diaper rash and other skin and health problems that your child may have.

Copyright 2001 Stacy Jones Tolentino/ Homefront Publishing
This article may not be copied, reproduced, republished, abstracted, posted, transmitted, or otherwise, in whole or in part, without the express written permission of Homefront Publishing. Single copies may be made for your personal, non-commercial use provided this copyright notice remains intact. For permissions send an email to readabook@aol.com.

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