dear apikali nappy rash

Nappy Rash: The causes and the cures


dear apikali nappy rashLets chat about nappy rash , why it occurs and the potential cures. *Please note this is general advice and does not take into consideration your personal or child’s health. Please consult your GP or family doctor for any nappy rashes as they may indicate an underlying condition.*

Nappy rash can occur due to 1 of 4 causes:

1) General nappy rash can be caused by the chemicals used in laundering cloth nappies (such as bleach, whiteners or some soaps), by not changing the nappy often enough, disposable nappies or frequent loose poos. The rash will be red, slightly rough and/or scaly.

2) Ammonia rash is caused by the urine itself. The skin is burned by the ammonia that is formed when the urine is decomposed by normal bacteria on the skin. These rashes can be worse after the child has been asleep or been in the nappy for a longer period of time. It can be identified by the smell of ammonia when changing and in extreme cases the peeling of the skin on the buttocks area.

3) Allergy rash may be caused by soaps/perfumes/lotions that are being applied to the area, food allergies or medicines that have been given. In the first instance, the soap/perfumes/lotions have been applied directly to the skin. You will see a red rash where the items have been applied. For food allergies, this may present with a rash on the skin located any place on the body and/or mainly around the anus. Medicines are taken orally or applied on the skin. Rashes will occur where the medicine was applied on the skin or in the genitalia area, if consumed.

4) Rash from infections or contagious disease, with the most common being Candida albicans (thrush) or gastro. In the case of thrush, the rash will look nasty with potential yellow discharge, blisters and/or extreme redness. For viral rashes caused by gastro, the anus will be the reddest and sorest part of the rash.

The best cure for nappy rash is prevention and basic hygiene.

These 5 ways can assist in preventing General Nappy Rash.

– Nappy free time

– Frequent nappy changes, at least every 2-3 hours or when a poo has arrived.

– A pre or post rinse cycle when washing your cloth nappies to ensure all detergents are removed

– Using a barrier between your baby’s bottom and the cloth nappy, this could be in the form of a liner or a cream.

– Allowing the sensitive skin of baby to breathe by not bathing too often or extensively, and avoiding synthetic products.

READ  5 Steps to Preventing Nappy Rash
To assist in reducing the discomfort of each kind of nappy rash, you can try the following, and we have included some of our own experiences for you:

1) General nappy rash by applying a barrier cream until the rash has cleared up. The barrier cream can be any product you find effective. We have had more success with thick pastes when the nappy rash was very red, sore with possible lesions. If the nappy rash was red and scaly then a normal cream or balm is appropriate. Adding a layer that is thick enough to prevent wee/poo resting on the areas until the next change, is ideal. Do not use a powder if there are open wounds.

2) Ammonia Rash is reduced with frequent changing, lots of nappy free time, and a nappy cream you have had the most success with. In some cases you may need to experiment. Ensure there is frequent cleaning of the area with water and a pat dry. NEVER RUB the area, it will only provide further irritation. Using a barrier between your baby’s bottom and the cloth nappy, this could be in the form of a liner or a cream.

3) Allergy Rash can involve a little more investigation. If it is a food allergy, look over the last month of any new foods that have been introduced to their diet or yours if you are breastfeeding, or a change in formula. Stop those foods for a time, you may wish to consult a dietitian or your GP.

If the rash is caused by a medicinal reason, you can apply creams to soothe the area, frequent nappy changes and frequent bathing can assist until you see your GP for further advice.

Allergies due to materials or lotions/perfumes/soaps can take some investigating. We suggest stopping any new lotions or materials you have started in the past month. Then gradually add them back in, systematically, to find the culprit. Some babies and their parents have sensitive skins. If you are sensitive, its more than likely your baby is too. Start the elimination with your sensitivities, and move on until you find the culprit.

4) Nappy rash due to bacterial or viral contagions involves identifying if the nappy rash is infected or is present due to illness. If the rash is present due to illness, such are diarrhea, then the application of barrier creams or powder, frequent change, bathing and nappy time are the best cure. If the rash begins to look more raw or yellow in nature, then there is an infection. This can be due to thrush (Candida albicans) or other conditions. You will need to visit your GP for advice and assistance.

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A Disturbing Rash

Sometimes a nappy rash can lead to open wounds or exposed lower layers of skin with weeping. In this case, we want to help the skin heal as quickly as possible.  This sort of rash can occur with any of the causes above, but at this point we want to allow the skin to breathe and heal. From our personal experience (please consult your GP or medical specialist before trying any of these) we have found the following to be successful:

– Bath only when necessary and then only in warm water. Don’t try to remove all of the bottom cream while bathing.

– Pat dry, dont rub or scrap. Its ok if its a little damp, you are going to give nappy free time now.

– Nappy free time for as long as you can and as often as you can.

– Use a good layer of nappy cream to prevent any urine or poo touching the wounds.

– Change every one to two hours. If you think its wet or smelly, change the nappy.

– Use a powder that does NOT contain talc. This can help absorb any wee before it touches a wound.

– Consider using a combination of cream and powder.


Lastly it can take up to 2 weeks for bad cases to be healed. Its O.K. and does not mean your parenting is faulty. Identify the issue, apply the strategies and you will be on the road to a beautiful baby bum to start kissing again.

In a future blog we will advise how to prepare and manage your cloth nappies during and post a bacterial or viral illness.

We have suggested the use of barriers creams for cloth nappies in this blog extensively. You can use any barrier cream, as long as you use a liner that does not allow seepage through to the cloth nappies. There is also a great range of cloth nappy safe creams available. Sally has also written a great blog about cloth nappy safe creams, check it out here.

For further information on cloth nappy prevention, we have more in-depth information available in a previous blog.

Let us know what your experiences have been. Which barrier cream do you love?

cloth nappy doctor chat soon

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