Diaper rash in newborns and infants is a very widespread problem, and it's not just about hygiene. With all the variety of cosmetics for the care of children's skin, with all the efforts of parents to maintain dryness and cleanliness of diaper rash are not excluded. It is important to know how to distinguish them from dermatological diseases and what to do if the baby suddenly has diaper rash.
What it is?
Diaper rash is called local localized inflammation of the skin against the background of long skin contact with urine, feces, sweat, sebum, as well as against the background of irritation from contact with wet surfaces.
The skin is formed in utero, and only in the second half of pregnancy does the skin in children become four-layered, therefore it is considered one of the weakest, vulnerable places in boys and girls in the first year of their life. The outer layer of the skin (epidermis) in children is much thinner than in adults, it is quite loose, and therefore any infection can penetrate through it into the deeper layers of the skin... The epidermis of newborns and infants cannot be considered complete protection.
The skin of a newborn is very easy to damage, injure, break its integrity mechanically, even during normal infant procedures such as swaddling or massage. And the statements of manufacturers of children's cosmetics that "Baby's skin needs special care" is not a publicity stunt, but the truth itself... The slightest adverse effect can lead to severe diaper rash.
Weeping deep diaper rash, severe prickly heat often lead first to pyoderma - a bacterial inflammation of the skin. The broken integrity of the skin is an excellent prerequisite for the attachment of bacterial microflora. In the most severe form, the bacterial infection becomes generalized, and sepsis develops.
Why and how is it developing?
The water-lipid balance of the skin of children of the first year of life is imperfect, and therefore it can be disturbed at any time. It is the excess moisture on the skin that is considered the main cause of the development of diaper rash. Long-term contact of the baby's skin with urine and feces is the most common prerequisite for an inflammatory process. The inflammation itself occurs in this case due to the effect on the epidermis of urea, ammonia and salts contained in the urine. In feces, the main danger is posed by two enzymes - lipase and protease.
If for some reason the baby has loose stools, diarrhea, everything becomes even worse - such feces are dangerous for the skin not only by its enzyme component, but also by the presence of an acidic environment. With diarrhea, even short-term skin contact with feces causes severe irritation in newborns and infants.
Most often, diaper rash also develops from overfilled diapers, if parents rarely change this baby's hygiene item. The skin of children easily absorbs moisture and is oversaturated with it, and therefore insufficient drying of the skin after bathing can become the cause of diaper rash.
Salts that are harmful to the skin are also found in sweat... Sweat glands in children work very actively, this is a feature of the first year of life. If the parents are unfamiliar with her, then they may mistakenly try with all their might to better heat the nursery, put a couple of heaters, dress the child warmly. The work of the sweat glands becomes excessive, as the child's body tries to get rid of excess heat, to give it out. The saline environment of sweat affects the skin in much the same way as urine.
A real revelation for parents is the situation when the air temperature in the room is normal, and the child is not wrapped up, and diapers are changed often, but diaper rash still appears. In this case, the matter is most likely in mechanical friction - can rub the diaper in the groin area, the undershirt under the armpits, the diaper on the neck of babiesand. Deep folds of skin can also rub against each other - this is how local localized inflammation occurs in the groin, under the knees, under the armpits, between the legs and even between the toes.
The development of diaper rash can be facilitated by a new complementary food that has just been introduced in the baby's menu, and in this case the prerequisites will be allergic. A favorable background for the development of diaper rash is the period of illness - high temperature increases sweating, as well as periods of treatment, in particular, with antibacterial drugs.
Even if the baby is not taking antibiotics, but his breastfeeding mother, the baby is more likely to have skin problems, since antibacterial agents easily penetrate into breast milk.
Doctors have long noticed that children with genetically fair skin and blond hair suffer from diaper rash most often. Swarthy babies are less likely to suffer from prickly heat, dermatological forms of allergies and diaper rash.
Particular attention to the prevention of diaper rash should be paid to parents of babies who are at risk for such a pathology. Pediatricians include:
overweight or obese babies;
children with allergies, especially those suffering from hereditary forms of allergies;
babies diagnosed with intestinal dysbiosis;
children currently suffering from gastroenteritis or intestinal infection;
babies with kidney and urinary system pathologies;
premature babies;
babies who are not breastfed, but artificially fed.
Kinds
Only at first glance, all diaper rash is the same. In fact, in order to quickly cure them, you need to clearly understand what type of skin inflammation belongs to.
The classification of diaper rash implies their separation into separate groups for the root cause.
Diaper (diaper dermatitis) - manifests itself as inflammation and rash of varying intensity in the area of coverage with diapers, where there is contact with urine, feces. It most often manifests itself on the pope, between the buttocks, in the groin area, on the scrotum in boys and the labia in girls, around the anus, in the lower abdomen. There are no rashes on the arms, legs, neck or back of the head.
Allergic (the so-called "allergic ring") - are manifested by the formation of a zone of inflammation in the buttocks and anus. The rashes are bright red, they are small. They usually develop after changes in the diet, if an allergen has been ingested by the baby.
Folding (intertrigo) - only skin folds in the groin, on the thighs, between the buttocks, under the knees, in the armpits, in the neck, on the arms in the elbow bends are affected. Harmful factors are excessive moisture and mechanical rubbing inside the folds.
Seborrheic eczema - a large red spot spreading to the lower abdomen, groin, genitals. The spot has clear boundaries. The skin in the affected area becomes rough and oily, there is a slight swelling.
Fungal (candidiasis) - diaper rash can be based anywhere, but they become such due to the attachment of fungal organisms. The infection appears as medium-sized reddish patches with a whitish tint in the center, most often located in the groin and genitals.
Impetigo - intertrigo, complicated by bacteria, most often streptococci or staphylococci. It looks like pustules, prone to merging with each other, they quickly burst and leave unpleasant-looking dryish crusts of a golden, brownish color. The most common location is the buttocks.
Symptoms and signs, differential diagnosis
Parents usually do not have special difficulties in identifying diaper rash. It is enough to remove clothes, diapers and diaper from the child, and the clinical picture is evident. And here it is important to understand in time what you are dealing with - with impetigo or diaper dermatitis, with seborrheic eczema or an allergic ring.
First of all, the mother should evaluate the nature of the rash and compare them with infectious diseases. An infectious rash is almost always accompanied by a high fever.... If the child is left without clothes for a couple of hours, the diaper rash will begin to decrease, fade, lighten, and the infection will spread further to other parts of the body. In the second case you need to call a doctor at home and determine what kind of infectious disease struck the baby and how to treat it.
The presence of pus and dry crusts always indicates the presence of a bacterial infection in the area of the inflammatory process. A whitish coating is a sign of a fungal infection.
In both cases, you need a doctor's consultation and the appointment of specific treatment (antibiotics, aniline dyes for bacterial damage and antifungal drugs for mycosis). In other cases, the mother may well cope on her own.
Next, you should determine the degree of diaper rash. In modern pediatrics and dermatology, three degrees are distinguished.
The first (she is light). The skin is slightly inflamed, there are no weeping areas, visually there are no damages, cracks, wounds on the skin. The general condition of the child is not changed - appetite, sleep are normal.
Second (middle)... The inflamed areas have a bright red color, there are areas of erosion, the integrity of the epidermis is broken, there are small cracks, and small pustules may be present. The child is restless.
Third (heavy)... The area of the lesion is large, there is swelling of the inflamed areas of the skin, cracks and exfoliation of fragments of the epidermis, ulcers, erosion. Signs of a bacterial or fungal infection may or may not be present. The chance of infection is very high. The child suffers from pain and burning, the sites of inflammation itch. The baby's state of health is disturbed, he cries, does not sleep well or does not sleep, refuses to eat. If the temperature rises, this is a sure sign of infection.
The first degree shouldn't cause much concern. It is treated quickly and easily. In the second and third degree, the child should be shown to a doctor.
Treatment
Diaper rash in newborns and infants should be treated after the type and degree of the disease has been accurately established. Recommendations to show the child to the doctor with pronounced weeping diaper rash exist not in order to complicate the life of mom and dad, but in order for the treatment to be correct, accurate.
Sometimes it is necessary to identify the type of bacteria or fungus in order to prescribe the most effective remedy., and in this case, a microscopic examination of scraping from the epidermis for fungi, bacterial culture and other microflora is carried out. And for allergic diaper rash above the second degree, consultation of an allergist and a breastfeeding specialist is needed if the child has not received complementary foods.
How to treat a precious child depends on the degree of diaper rash found in him.
First degree - easy
At the first degree, nothing special from the mother is required. Changing the approach to hygiene and the baby's lifestyle will help quickly get rid of the trouble. First of all, you need to check if the room is hot. If the air temperature is above 21 degrees, you need to bring it to values of 19-21 degrees... Adults may not find this temperature comfortable enough, but for a child it is ideal due to the peculiarities of thermoregulation.
Baby diapers need to be changed every 3-4 hours, that is, before each feeding, be sure to wash the child with warm water without soap, if there was no fact of defecation. After each bowel movement, the diaper is changed out of schedule without delay.
The baby needs air baths - staying without a diaper and diaper... Prickly heat and diaper rash do not like the flow of fresh air, and this should be actively used. For baby skin, when the inflammation disappears, especially in the perineal area, you need to use a protective baby cream - it will help create a film on the skin that will repel excess moisture.
Prickly heat and diaper rash cannot be cured with baby cream. It is always greasy, it moisturizes, and does not dry out, and therefore it is categorically contraindicated to deal with already existing diaper rash with its help.
Means based on panthenol - "Panthenol", "Dexpanthenol", "Dexpan plus", "Bepanten", "D-Panthenol", "Panthenol-spray", "Heppiederm" will help to remove the manifestations of diaper rash on the skin and so on. You can use folk remedies for bathing and care, they will be discussed separately. The use of baby powder is acceptable.
Second degree - medium
For diaper rash of the second degree it is also important to bring the air temperature in accordance with the norms, not to wrap up the child, to exclude all possible allergens from his diet, air baths and frequent diaper changes will also be an integral part of therapy.
In addition, parents must to treat the affected skin areas with special drying preparations based on zinc oxide. These include special "talkers", which are prepared according to a doctor's prescription in any pharmacy with its own prescription department. Of the ready-made preparations, one should pay attention to Desitin, Zinc paste, Tsindol. It is possible to treat the sites of inflammation with methyluracil and tannin ointments. The effect of sunlight on the affected areas of the epidermis is beneficial.
If small pustules are found, the doctor usually prescribes anti-inflammatory and antimicrobial agents - Levomekol, Baneocin (powder and ointment) in combination with preparations of a drying action based on zinc oxide. After the foci of inflammation have passed, prophylactic use of a protective ointment or cream "Purelan" is recommended.
If diaper rash has developed against a background of food allergies, antihistamines are recommended in an age-specific dose (Loratadin, Suprastin), in severe cases, an ointment based on hydrocortisone.
Third degree (severe)
The most difficult to treat at home is diaper rash of the third degree. Such lesions require careful care and special medications. Medical lotions with solutions of tannin, silver nitrate are recommended... This is necessary to stop eczema and ulcers from getting wet. After this process is stopped, zinc paste, antibiotic ointments are prescribed.
At the same time, parents need to strictly follow the processing technique and the algorithm of actions:
the sore spot is treated with an antiseptic (Miramistin, Chlorhexidine, hydrogen peroxide 3%);
after waiting a couple of minutes, they are treated with aniline dyes ("Fukortsin", brilliant green, methylene blue);
having allowed the surface to dry, apply the ointment recommended by the doctor with an antibiotic or zinc oxide (the best thing is to alternate: use the drug with zinc in one treatment, and an antibacterial agent in the other).
Leather should be processed at least 3 times a day. Additionally, you need to comply with all the above requirements for hygiene, air temperature, air baths, and so on.
For wounds on the skin, ulcers and eczema, do not use powder and baby cream.
Folk remedies
For the treatment of mild diaper rash, as already mentioned, you can resort to folk remedies. They are approved by pediatricians. There are many tips on how to easily and quickly get rid of diaper rash at home on the Internet, but not all of them are reasonable and rational, and some are even dangerous for babies. Therefore, we divided them into acceptable and unacceptable.
What can you do?
With any degree of pathology, parents can arrange for the baby to bathe in a bath with the addition of a decoction of oak bark. A glass of oak bark is brewed with two liters of boiling water, insisted well and then add the broth (after straining) to the bathing water. It is not worth doing such a healing bath daily. It will be quite enough to take it every 2-3 days..
With the same success, you can make baths with a series, pharmacy chamomile.
It is allowed to wet diaper rash with a decoction of eucalyptus leaves. Two large spoons of plant materials are brewed with boiling water in a volume of 200 ml. Ready warm broth (not hot!) With a cotton pad is gently applied to the site of inflammation and lubricated with skin folds.
What is not allowed?
Some of the recommendations of traditional healers can seriously harm a child. First of all, this should include advice to remove diaper rash with iodine solution. Attempts to treat the inflamed skin with iodine can lead to burns and an overdose of this remedyas it can accumulate in the body. This is fraught with the most dire consequences.
Also advice to lubricate the affected skin with honey should be considered dangerous - This is the strongest allergen that can harm a child under 3 years of age more than good.
Do not lubricate in the folds of the skin, behind the ears and in the groin with vaseline and sunflower oilas it creates a strong waterproof film on the skin, which makes it difficult for the damaged epidermis to heal. Of the oils, sea buckthorn is permissible, but only for mild forms of pathology.
It is forbidden to use starch and tooth powder instead of dusting. It is strictly forbidden to use any recipes with alcoholic tinctures.
The opinion of Dr. Komarovsky
The well-known pediatrician and TV presenter Yevgeny Komarovsky claims that a child with healthy skin does not need advertised skin care products at all, but if the skin is unhealthy, then you need a clear understanding:
with diaper rash, high humidity, you need to dry it (drying creams, powder);
for dry skin, peeling, cracks, you need to moisturize (baby cream, oils, etc.).
And in no case should you break these rules. Prophylactically treating the skin, according to Komarovsky, makes sense only in those places where contact of children's skin with urine and feces is implied.
Oddly enough, but Disposable diapers can help parents in the prevention of diaper rash, if they are of high quality, having a layer that quickly turns liquid into gel. At the same time, the skin suffers much less. It is clear that the diaper will not protect against feces, but it is the combination of feces and urine that Komarovsky considers the most dangerous and traumatic for the delicate children's skin.
Dr. Komarovsky considers diaper rash treatment to be "work on mistakes" - parents should try to make the skin feel good and comfortable, the air humidity in the room was at the level of 50-70%, and the air temperature did not exceed 21 degreesso that the child is dressed for the climate and weather and does not sweat. If a walk in the winter in a thick and warm overalls still led to the fact that the child was sweating, it is important to immediately rinse the child with warm water without soap, change into dry clothes.
And, of course, all fabrics that baby's skin comes into contact with must be natural, with a minimum amount of textile dye.
Reviews
According to mothers, diaper rash is treated rather quickly, but there are isolated cases when parents have been unable to defeat skin rashes for a long time. Usually we are talking about inflammation in places that are technically difficult to "ventilate" - the anus, the intergluteal fold.
Experienced mothers warn young parents against a common mistake - abandoning the already familiar "diapers" in favor of gauze diapers.
This decision is made by many, but in vain - wet gauze only intensifies the inflammatory process and causes a mechanical effect on already diseased skin areas.
You will learn even more about the causes of diaper rash in a baby and how to deal with them in the next video.
