In this article, I’m going to explain the causes of nappy rash and give you some hints on how to avoid it and deal with the rash

Nappy Rash or not?
Nappy rash relates specifically to a rash caused by urine reacting with bacteria from poo, which then creates ammonia and basically burns your baby’s skin. Although it’s easily dealt with, left untreated it can result in open sores. First you need to be sure that you are actually dealing with nappy rash, and it’s worth checking the following causes of rash out first.

Reaction to washing powder – if you are using too much washing powder, then there is a chance that some of it will be left behind on the nappy. You only need to use around a third of the amount suggested on the box, and if you can still see soap bubbles in the washing machine during the final rinse then you’re using too much. If your usual detergent suddenly starts to irritate your baby’s skin, then consider switching to a milder detergent such as Filetti.

Reaction to Tea Tree oil – although a good anti-bacterial agent, some babies can be sensitive to tea tree oil. Consider swapping to using lavender oil in your nappy bucket.

Heat or sweat rash – This will show around the waistband of the nappy/wrap, as well as in other areas where the baby gets hot overnight such as the armpits and neck. My children often got heat rash on their tummy when they slept on their front.

Thrush – This will present as small red spots which do not clear with the usual tactics for nappy rash. You will need to see your doctor for a prescription to clear it up, and will need to make sure that your baby's nappies are completely clear of the thrush spores, so give all of them as hot a wash as they will take (minimum of 60ºC)

Diet - If your baby’s skin goes red immediately after a poo, then this might be down to either teething or because something they have eaten is irritating their skin. Citrus fruits, strawberries and tomatoes are common culprits – it might be worth keeping a food diary to see if there’s any correlation between what they are eating and when the redness occurs. If their poo is very caustic, perhaps because of teething, then a very thin smearing of Vaseline can help protect the skin from the poo - however Vaseline prevents the skin from breathing, so it's not good for long-term use



Preventing Nappy Rash
A common misconception about cloth nappies is that they make children more likely to have nappy rash. A study carried out by Bristol University concluded that children are no more likely to have severe nappy rash when wearing cloth nappies than if they wear disposable nappies. In fact, I think that parents who choose to use real nappies are more aware of the need for frequent nappy changes and to clean the nappy area well, which reduces the occurrence of nappy rash.

A wet nappy will not normally cause nappy rash as this develops when the bacteria in poo reacts with stale urine on the skin and produces ammonia. This is why a baby can wear a nappy throughout the night without getting nappy rash, as they are unlikely to poo in their sleep. However, it is important to change wet nappies regularly to prevent stale urine remaining on the skin, and this is even more important at the first nappy change of the day.

Be sure to clean the entire area covered by the nappy very thoroughly, not just around the genitals. If you find that your baby is developing a rash around the top of the wrap and on the thighs, then you’re probably not cleaning thoroughly enough.

You don’t need to use a nappy cream for every change – too much cream can actually reduce the skin’s ability to ‘breathe’, which will make nappy rash more likely. Only use cream if your baby’s skin is looking red, and use a thin application of cream rubbed in well. I found the Red Clover cream very effective in dealing with redness for my sons.



How to deal with nappy Rash

• When your baby has any redness on their bum, it’s a good idea to make nappy changes more frequent and more thorough, to reduce the amount of stale urine left on the skin.
• Avoid commercial wipes – the alcohol in these will irritate your baby’s rash and make it harder for you to ensure that the nappy area is thoroughly cleaned. Swap to cloth wipes or thick kitchen roll with either plain water or one of the recipes listed here.
• Red Clover is a traditional cure for nappy rash – I found Earth Friendly Baby Red Clover Cream to be very effective, and it is available from the THM Shop.
• Consider switching to silk liners for a while – raw silk has healing properties and these liners may help heal nappy rash.
• Giving your baby some nappy free time is always a good idea – and if redness does set in then it is even more beneficial.
• If the rash appears with wet nappies alone, then you should sterilise the nappies by washing them at the highest temperature they will take (60ºC minimum) as well as taking the actions above.

.