Dear Parents,

If you are wondering what to use to prevent or heal your baby’s diaper rash, you aren’t alone! In my experience, I have seen how difficult it is to choose the right product based on your goal. Should you use a cream, ointment, lotion, salve or paste? All these products can be useful, but it depends on what you want to do with it. Is it to hydrate your baby’s skin? To protect it from an irritant? Is it to provide a protective screen for redness?

Whatever the product, it has to be made for babies with ingredients that follow current standards – alcohol-free, fragrance-free, colourant-free, hypoallergenic and not irritating for a baby’s skin and eyes. Don’t forget to consider fragrance: the product should be fragrance-free or only slightly fragrant using natural ingredients approved by the International Fragrance Association (IFRA).

Why is diaper rash so frequent?

Diaper dermatitis affects more than half of all babies, and is caused by a group of factors:

• A damp environment in the diaper
• Exposure to irritants such as urine and stool
• Pre-existing seborrheic dermatitis
• Friction between diaper and skin folds
• Chemical products in diapers, creams and wipes

A baby’s urine is very alkaline (alkaline PH, non-acidic) and this alkaline environment leads to the activation of bacteria found in a baby’s stool. These bacteria produce enzymes that irritate the skin, leading to diaper rash which breaks down the skin barrier. This alkaline environment can also lead to a fungal infection called Candida albicans.

To help you make your choice, I will present each product, how it’s made and the effect it can have when used.  

1. CREAMS:

Cream is a product that is often used for local topical treatment (of the skin) and can be applied to the whole body.

Cream is a combination of two phases – hydrophile and lipophile (referring to water and lipids, which are fats). Creams are often made from palm, sunflower calendula oil (fat) with beeswax or glycerine added, which makes it easy to apply, helps penetrate and hydrate the skin.  

You can apply a light layer of cream to prevent redness or irritation after the bath, when their skin is dry, even when very young. Apply it during the day to maintain hydration.

Cream on your baby’s bottom absorbs quickly and will not leave traces when changing the diaper after their next feeding.

There are also creams for very young babies for their face and hands to protect from cold and wind (ex: Outdoor Cream by Pois de Senteur).

2. SALVES:

Ointments are different from creams as they contain the lipophile phase (fat) but little water. This makes ointments semi-solid and protects rather than hydrates their skin.

3. OINTMENTS:

Ointments are pastier than salves and creams. They don’t contain water and applies easier when in contact with body heat.

Ointments also contain lipids, wax, fats and natural oils that may or may not smell like myrtle, spices, saffron or cinnamon.

The fatty substances found in ointments can be used to protect the skin by creating a barrier, but it won’t hydrate the skin.

4. MILK OR LOTIONS:

Baby soft milk or lotions are more liquid and can easily be absorbed by the skin. They provide ample hydration.

5. PASTES:

Zinc paste, zinc oxide or Ihle paste are terms used to describe a fragrance-free product that is drying, absorbent by providing a screen from irritants such as urine, stool and repeated diaper rubbing.

Many ingredients can be found in these pastes, such as white zinc powder, cholesterol, white bee’s wax, wool grease, purified water, calcium hydroxide and ricin oil, lanolin and vitamin E.

Zinc powder can’t be applied to a baby’s skin without first being combined with a fatty substance (cholesterol, bee’s wax, grease) because the powder doesn’t dissolve in water or oil.

Zinc oxide (creamy paste) is thicker on application. It needs to be applied to very dry skin and has a hydrophile effect (retains water), and it also has absorbent and lipophile effects which retain fats. Zinc paste is also considered as a natural antibacterial substance because it provides a strong protective layer on the skin. It can protect the skin when exposed to irritants such as urine and stool. This makes zinc paste an excellent option when your baby’s bottom seems irritated or red.

Zinc oxide can also be used to protect your baby’s skin from UV rays (see my article about sunscreen) and for its soothing characteristics.  

6. CREAM AND PASTE:

Yes, you can find creams that include a percentage of zinc powder to increase their protective capacity. The rate correlates to its protective power, from 20-40% zinc. This cream will be thicker, harder to apply, but will also hydrate and protect the baby’s skin at the same time.

RECOMMENDATIONS:

Basic recommendations to prevent diaper rash:

• Hydrate the baby’s skin with hypoallergenic cream during the bath to maintain the cutaneous barrier
• Change diapers frequently to avoid a damp environment
• Don’t wash the baby’s bottom each time you change diapers. If there is little urine, sponge the site to maintain the skin’s natural hydration
• When redness is present, dry the area, then apply a very thick cream or paste (zinc, Ihle, Vaseline) to limit contact between the skin and the baby’s urine and stool
• Take a diaper break and let your baby run around naked 😊

Don’t forget to evaluate the possible causes of the redness or irritation on your baby’s bottom:

• Is it a reaction to the diaper? If yes, the redness will be in the shape of the diaper. Switch brands to see if the situation improves.
• Is it a reaction to the wipes? It will happen almost every time you use them.
• Is it a reaction to the soap you use to wash your baby? In this case, they will have redness on other parts of their body.
• Is there a fungal infection? There will be white or red spots around the anus, in addition to redness. These won’t disappear with paste. Please read my article about fungi for treatment options.

If the redness isn’t reduced or even aggravates after three days of using paste, you should go see a professional to be sure you are treating the right thing. You may be advised to use a cortisone cream. Don’t be scared of cortisone cream. While never a first option, it is effective as needed if the rash persists or comes back. It’s better to use cortisone cream on a small area of skin for a couple of days than waiting for the patches to spread elsewhere, requiring more cortisone cream for more extended periods.     

I hope this article will help guide you when choosing the best ways to treat your baby’s diaper rash.

Talk soon,

Marie
The Baby Expert