Dr. Linda, my newborn has red dots in her diaper

area.What are they? Should I worry?

The most common cause of red dots in your baby’s diaper area is irritant diaper dermatitis (aka diaper rash).

This happens as a result of the diaper rubbing against your baby’s skin which has been softened and irritated by urine or stool. If the rash isn’t treated quickly it can get redder, wetter and more angry looking. Raw areas of skin may appear which are painful, especially when urine or stool touch them. They can also get infected by bacteria in the area which can be a serious issue, especially in newborns because their immature immune system may not be able to prevent the bacteria from crossing into the bloodstream making baby very sick.

If the  diaper rash isn’t treated quickly it may get redder, wetter and more angry looking. Raw areas of skin may appear which are painful, especially when urine or stool touch them. They can also get infected by bacteria which can be a serious issue, especially in newborns.  Their immature immune systems may not be able to prevent the bacteria from crossing into the bloodstream and making baby very sick.

7-35% of all babies may get diaper rash at one time or another. In the US, it is most common in 9-12-month-olds.

Which babies are more likely to get diaper rash?

Babies whose skin is irritated:

  • Babies who don’t get their diapers changed frequently enough.
  • Babies with diarrhea.
  • Babies who wear cloth diapers washed in detergents that contain chemicals, colors or fragrances that irritate their skin.
  • Babies with an intolerance to the chemicals and/or fragrances in baby wipes. My son kept breaking out in rashes until I figured this one out! I finally had to resort to paper towels and water alone.

Babies with altered gut flora, the normal bacteria colonizing their intestinal tract:

    • Babies who have gotten antibiotic treatments recently.
    • Bottle fed babies.
    • Babies born by C/S may have altered gut flora.

How to prevent diaper rash:

  • Keep your baby’s diaper area as clean and dry as possible.

    Sitting in poop or pee for too long can irritate baby’s delicate skin and make baby more prone to diaper rash. Ask whoever is taking care of your baby to change your baby’s diapers frequently,  especially after meals and whenever baby has peed or pooped.

  • Avoid using chemicals that can irritate your baby’s skin:
    • Clean baby’s diaper area with warm water and a soft cloth or paper towel. If you use commercially produced wipes, use fragrance-free, alcohol-free baby wipes.
    • Avoid wipes that contain the chemical methylisothiazolinone. It can cause an allergic reaction.
    • If you notice the baby wipes cause skin irritation,  you may want to change the brand you’re using or maybe switch to using soft paper towels and water. If you are comfortable with it, you can always rinse baby’s bottom in the sink or tub. If you do this, always make sure you test the water first with your elbow to make sure it is not too hot or too cold.
    • If you want to use soap to clean the area, use only one or two drops of liquid fragrance-free, chemical free soap to minimize baby’s exposure to chemicals that may irritate the skin.
  • Be gentle as you handle baby’s diaper area.

    Wipe baby’s diaper area clean very gently. Pat the area dry (instead of rubbing it because rubbing the skin may irritate it.)

  • Use pastes or ointments to prevent and/or treat rashes.

    They are thicker than creams or lotions and protect the skin better.

     

Treatment:

  • Keep the area as clean and dry as possible.
  • Give your baby diaper free times during the day.

    This exposes the area to air and lets it dry naturally. Try to do this right after you have cleaned up a poopy or wet diaper so there’s less of a chance baby will poop or pee again soon.

    Invest in some Chux (disposable pads ) to protect any surface you air your baby out on just in case!

  • Apply an ointment or paste to the diaper area with every diaper change.

    Zinc oxide, Vaseline, Desitin, triple paste, A&D or Balmex are good barrier creams to protect baby’s skin from irritation.  If you change baby’s diaper and the barrier layer is still clean and intact you don’t need to remove all of it,  just take a cotton ball soaked in mineral oil to dab off the dirty spots.

  • If your baby has altered gut flora (see above):

Talk to your doctor about using Probiotics. Culturelle is easily available over the counter in powder form. Studies are showing that normal/healthy bacteria in your baby’s intestinal tract is protective against diarrhea and against yeast infections which can also cause diaper rash. Most experts recommend giving Probiotics by mouth, some, however, recommend making a paste of the powder with water and placing it on the rash area.

When to take your baby to the doctor:

Take baby to the doctor immediately:

  • If the red bumps look like blisters or a cold sore.
  • If the red bumps have pus inside them.
  • If baby has a temperature of 100.4F or 38.2 C or higher.
  • If baby has frequent diarrhea.
  • If baby is refusing to eat or is acting sick

Take baby to the doctor :

  •  If the rash hasn’t cleared up after 3 days. Any diaper rash that lasts longer than three days should be looked at by your doctor. It may have become infected with a yeast or a bacteria which is preventing it from healing.
  • The rash is getting worse.
  • Your baby is acting fussy.

 

As always I hope that you find this blog helpful.  Please share it with anyone you think might need it.

I would love to hear your comments and questions, please post them below.

To your holistic health:

Ask Dr. Linda

 

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