Diaper Rash (Toddler)

What is diaper rash?

By the time your child reaches the toddler years, you've probably already seen your share of diaper rashes: red, inflamed skin hiding under the diaper or training pants. The rash -- usually found in the genital area, the inner thighs, or the buttocks -- can be either dry or moist. Sometimes the rash looks pimply, making the expression "smooth as a baby's bottom" seem like a misnomer.

Even if the diaper rash doesn't leave your toddler uncomfortable, you should take it seriously. If the rash isn't treated, it can grow with the help of bacteria or a fungus into something worse, such as a bacterial or yeast infection. Bacterial infections can be accompanied by fever and may develop into oozing yellow patches or pus-filled pimples. Yeast infections, which often occur when your child is on antibiotics, typically begin as tiny red spots that multiply and form a solid red blotch. A diaper rash caused by yeast is often located in the skin folds -- moist areas where yeast likes to grow.

What causes it?

The main culprit is wetness. Even the most absorbent diaper or training pants are apt to leave some moisture on a toddler's skin. If your child stays in a dirty diaper too long, he's more likely to develop diaper rash. However, it can strike even kids whose parents are diligent diaper changers, often because the children are having an allergic reaction to diaper wipes, a disposable diaper, a laundry detergent that was used to wash cloth diapers, or a new food in their diet. Toddlers who are sick or taking antibiotics may get diarrhea (a side effect of the medication), which can also lead to diaper rash.

What's the best way to treat it?

The best remedy is to keep your child clean and dry by changing his diaper frequently. If he can play in a room with an easy-to-clean floor, leave his diaper or training pants off for as long as possible to let the air keep him dry and speed healing. If fresh air isn't enough, try an over-the-counter lotion containing zinc oxide. You might also want to switch your brands of diapers and detergents to ones that are free of fragrance and additives -- that should clear up the problem if the diaper rash stems from allergies.

A normal diaper rash clears up after three or four days of treatment at home. If your child's rash persists, spreads, or worsens, call your pediatrician. He or she can prescribe topical medication to treat the rash and help you determine what's causing the inflammation -- bacteria, food allergies, or a yeast infection.

How can I help prevent diaper rash?

The best defense against diaper rash is a dry bottom. For maximum dryness, follow these four easy steps:

• Change your child's diaper as soon as possible after it becomes wet or soiled.
• Clean your child's genital area thoroughly after each bowel movement and allow it to dry.
• Coat his bottom with a thin layer of protective ointment, but skip the powder or corn starch (both can get into your child's lungs).
• Don't secure diapers so tight that there's no room for air to circulate. Plastic pants, diapers, and clothing must fit somewhat loosely to let your child's bottom breathe.

References

Pantell, Robert H. M.D., James F. Fries M.D., and Donald M. Vickery M.D. Taking Care of Your Child: A Parent's Illustrated Guide to Complete Medical Care, Eighth Edition. Da Capo Lifelong Books.