Diaper rash is a common skin problem in your baby’s groin and buttocks region caused by a lack of fresh air, wetness, and irritation. Infrequent diaper changes and exposure to urine causes the pH of your baby’s skin to change from acidic to basic, which increases the risk of infection with bacteria and fungi. Long-term contact of the skin with urine is also a direct skin irritant.
Diaper rash can be recognized initially by skin wrinkling, slight redness, and swelling. Overtime, the redness and swelling increases and eventually the skin can break down resulting in an ulcer. This dramatically increases the risk of infection. Diaper rash is thought to occur in up to 1/3 of newborns, and typically develops between the 9th and 12th month of life. In fact, it is the most common skin condition in infancy and is a top reason for a trip to the pediatrician!
Treatment of diaper rash focuses on two main areas: speeding up the healing of damaged skin and prevent the rash from coming back. A universal truth is that diapers should be changed often. Experts recommend hourly changes in a newborn and every 3 to 4 hours in the first year of life, which allows your baby’s bottom to get fresh air. You should also allow your baby’s skin to dry fully after cleaning.
But what else can you do? Barrier creams such as zinc oxide and petroleum jelly are useful to protect the skin against diaper rash and to treat diaper rash when it develops. Direct application of human breast milk to the skin has also been shown to protect newborn skin from bacteria and fungi through its natural anti-inflammatory effects. But which is more effective?
That was the question of a new study which compared the effectiveness of human breast milk versus a barrier cream containing zinc oxide for the treatment of diaper rash. The study included 70 full-term and preterm infants in a neonatal intensive care unit (NICU) in Turkey who developed diaper rash while being treated there. Now, obviously, these were sick kids if they needed to be in an ICU, but it allowed the researchers to control for things like antibiotic use, type of wipe used, and other potential confounding factors.
The study found that the skin of preterm infants is thinner and more permeable to water compared to full-term ones. No surprise there. Interestingly, they also found that things like the use of antibiotics, feeding method, and diaper area cleaning method did not impact the development of diaper rash. The barrier cream was more effective in terms of improvement of the rash compared to human breast milk overall. About 60% improved in the breast milk group compared to more than 90% in the barrier cream group. The results were most dramatic in the moderate to severe diaper rash group.
The researchers concluded that proactive prevention of diaper rash, particularly in preterm babies, is extremely important for both their skin health and general well-being. Although zinc oxide is a chemical and most parents want to avoid unnecessary chemical exposure in their newborns, improvement of more severe diaper rash is difficult without it. Breast milk is still somewhat effective and may be enough for more mild cases.
Ultimately, an ounce of prevention is worth a pound of cure. Some suggestions for protecting your baby from diaper rash include limiting antibiotics, changing diapers frequently, allowing your baby’s bottom to get plenty of fresh air, using water instead alcohol containing wipes, and giving your baby a daily bath with a little added mineral oil, which helps moisturize their skin. A thin layer of barrier cream like zinc oxide should be used after cleaning the diaper area, especially if your baby is prone to diaper rash. If you see some slight redness, consider rubbing in a little breast milk as soon as possible, which may help prevent the development of more severe diaper rash.