Nappy rash

This is for anyone looking after a baby with nappy rash.

What is nappy rash?

Nappy rash is skin reaction in your baby’s nappy area. Doctors sometimes call it ‘napkin dermatitis’.

It is common in babies.  About 25% of babies who wear disposable nappies get it.  About 50% of babies who wear traditional cloth nappies get it.

What causes it?

Nappy rash is often caused by lots of skin contact with the baby’s wee and poo, soaps and skincare products. Detergents and fabric softeners can also irritate a baby’s skin.

A nappy’s enclosed, warm environment can make the condition worse.

What does it look like?

Mild nappy rash causes pink or red skin around the nappy area. In severe cases, the skin can break down or small ulcers can appear.

Is it uncomfortable?

Nappy rash can be itchy, uncomfortable and painful. It can distress your baby and make them agitated.  This is upsetting for the baby and their parent(s).

How can I help my baby at home?

You can do the following to help your baby at home:

• change your baby’s nappy often
• when cleaning your baby’s nappy area, use water and cotton wool or fragrance-free, alcohol-free baby wipes. Pat the area dry gently afterwards using clean muslin.
• use olive oil (not water) to remove nappy rash ointment (such as Metanium)
• avoid over-washing your baby. They have delicate skin that can dry out easily.
• avoid potential irritants such as soaps and bubble bath
• try to use disposable nappies during an episode of nappy rash. They have absorbent gelling materials which help keep your baby dry and comfortable.
• if your baby needs pain relief you can use paracetamol (for example Calpol). Paracetamol can only be given to babies aged 2 months or older. Always follow the instructions on the medication packaging.

How long does it usually last?

If your baby has mild to moderate nappy rash and you have followed the suggested actions listed above, they usually start to heal within 3 to 4 days. Severe nappy rash can take up to 7 days to start healing. 

Does it need medication?

Mild to moderate nappy rash does not usually need medication. Make sure you give your baby nappy-free time. This will help their skin to breathe.  Apply regular barrier cream or ointment such as Sudocrem or Metanium. 

If your baby’s rash continues for more than a week or gets worse, seek advice from your health visitor or GP. If they think your baby’s skin is infected, they may take a skin swab and start antibiotics or anti-fungal cream to help clear it up.

Make an urgent GP appointment or go to your nearest Emergency Department (A&E) if your baby:

• is under 3 months of age and has a fever over 38 degrees C
• is 3 to 6 months of age and has a fever above 39 degrees C
• is taking less than half of their usual feeds
• is passing less urine than usual (fewer than 3 wet nappies in 24 hours)
• seems irritable and is not comforted by feeds or paracetamol (such as Calpol).  Paracetamol can only be given to babies aged 2 months or older.  Always follow the instructions on the medication packaging.

More information

NHS information on nappy rash www.nhs.uk/conditions/baby/caring-for-a-newborn/nappy-rash/

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Contacts

Paediatrics Admin Team, Monday to Friday, 9 am to 5 pm

020 8934 6403 khft@paediatricadmin@nhs.net