Midwife reveals common mistakes during nappy changing that cause nappy rash

Midwife reveals common mistakes during nappy changing that cause nappy rash

Post provided by Heather Morris, sponsored by Metanium.

Midwife Heather Morris, along with leading nappy rash brand, Metanium, reveals common mistakes during nappy changing that cause nappy rash.

“Most babies will get nappy rash at some point. Although it is common and mild cases are easily treatable, it can be a cause for concern. At any one time around one in three nappy-wearing infants will have nappy rash, with girls and boys equally affected*. It is less common in new-borns, however, may occur in preterm babies due to the reduced barrier functions of immature skin.

There are some simple changes any parent can make to lessen the chances of their baby getting nappy rash. Below are some common mistakes often made during a nappy change, with easy tips to fix them and prevent your baby’s chances of getting nappy rash!” says Heather.

The nappy you are using

  • “Nappies with a higher absorbency are more effective at preventing nappy rash, as they are better at keeping excessive moisture away from your baby’s skin. Make sure your baby’s nappy is well-fitting, as an ill-fitting nappy will increase friction and therefore chances of irritation. Your baby’s nappy should be snug, but not too tight,” says Heather.

A spokesperson from Metanium added: “Disposable nappies sometimes contain chemicals which may further irritate you baby or they may prove allergic to, which will also heighten their risk of nappy rash. Usually shopping around for different varieties or trying reusable nappies can help solve any problems. As your baby grows, make sure to use nappies which stretch as they move around, being sure to stay snug to their bum to prevent chafing. Look out for plus signs (+) on certain nappies- this means they are super absorbent, and are effective for use at night time or when your baby may need to go for longer without being changed.”

Always having your baby in a nappy

  • “Leaving your baby with no nappy on for a while can also help prevent nappy rash, as it lets their skin breathe, helping to prevent nappy rash which can be caused by excess moisture on the skin. As often as you can after a nappy change, let your baby lie on a towel with no nappy, this will help air circulate around their bum. After doing this for a while, apply a barrier ointment which will help to prevent excess moisture damaging your baby’s skin. If you can give your baby nappy-free time daily for as long as is practical, nappy rash is much less likely to occur and the skin on your baby’s bottom will be healthier,” says Heather.

The use of baby soap/lotion

  • “Potential irritants such as soaps and bubble baths should be avoided when your baby has nappy rash, and use them minimally to prevent it. Such toiletries can remove lipids from the skin, making your baby’s sensitive skin more vulnerable to irritants and microorganisms, enhancing the risk of nappy rash.  Always try to use fragrance-free toiletries on your baby’s skin,” says Heather.
  • A spokesperson from Metanium added “Ingredients such as perfumes and colourants can cause damage to your baby’s delicate skin, especially if they have skin problems such as eczema.”
  • “It is ideal to not bathe your baby too regularly, as it can dry out their skin by washing away natural oils, which may worsen nappy rash. It has been recommended to wash a baby in its early months using only water, then move onto a gentle liquid baby wash. Avoid using talcum powder”, said Heather.

Which baby wipes you’re using

  • “Nappy rash can be prevented by using water based or fragrance- and alcohol-free baby wipes which are more sensitive to your baby’s skin. Heavily fragranced or alcohol-based wipes are potential irritants for baby’s skin and can worsen nappy rash.”
  • A spokesperson from Metanium added, “Water-based baby wipes are unlikely to cause any irritations on your baby’s skin and won’t cause allergic reactions. Using fragrance or alcohol-based baby wipes on skin that is already damaged from nappy rash will only serve to irritate it further. If you don’t have water-based baby wipes, use cotton wool and warm water to clean your baby’s bum which will be gentle on nappy rash.”

How you’re changing your baby

  • “Though simple, the way you change your baby’s nappy can affect its chances of getting nappy rash. Being gentle throughout a nappy change and being cautious not to rub your baby’s bum, but to pat it dry, can stop nappy rash occurring. Rubbing skin dry causes unnecessary friction which can weaken the skin. Make sure to wipe your baby’s bum from front to back, being careful not to drag their skin as this can irritate and damage it. Make sure to clean their skin thoroughly with every nappy change, using water-based baby wipes or cotton wool. Leave their bum to dry naturally or pat dry with a clean towel. Make sure that when changing your baby, you have clean hands in order to prevent the spread of bacteria. After they are clean and dry, apply a thin layer of purple Metanium everyday barrier ointment in order to prevent nappy rash by forming a barrier against external irritants,” says Heather.

How often you’re changing their nappy

  • “Although obvious, changing your baby’s nappy frequently can prevent nappy rash. When your baby first starts to sleep through the night, nappy rash is more likely to occur due to prolonged skin exposure to excess moisture. Change your baby’s nappy before or after every feed and whenever they have done a wee or a poo. Also be sure to change your baby into a fresh nappy right before bedtime when they start to sleep through the night, to ensure the nappy is dry for as long as possible. Keep an eye on your baby’s nappy, checking it regularly to avoid prolonged contact with moisture.  Be sure to dry your baby’s bum thoroughly before applying a new nappy,” says Heather.

Not taking into account your baby’s stage of development

  • “The peak incidence of nappy rash is between the ages of nine to twelve months. ** Despite nappy rash being less common in new-borns, a study in the UK showed that 25% of babies experienced nappy rash in the first 4 weeks. *** There are certain ‘trigger times’ that may exaggerate the risk of nappy rash, including when your baby is teething or weaning, as these stages can cause diarrhoea and frequent, watery poos which increase moisture in your baby’s nappy. If your baby is poorly, such as when it has a cold or is on antibiotics, the chances of it getting nappy rash is likely to be increased. Certain antibiotics including amoxicillin can cause diarrhoea in babies and therefore heighten the risk of nappy rash. By following a good skincare routine, wearing super absorbent nappies, eliminating the use of fragranced or alcohol-based toiletries and baby wipes, and changing nappies frequently and gently, nappy rash should be effectively treated even at times when health and development factors may be the cause,” says Heather.

Using a preventative nappy cream rather than a treatment

  • “There can be some confusion when to use a preventative or treatment ointment. To prevent nappy rash, use an everyday ointment with every nappy change, such as the purple Metanium® barrier ointment or the blue Metanium® everyday easy spray. Ointments are more effective than creams and lotions, as they create a better moisture barrier. ****

In cases where nappy rash has occurred, use a treatment such as the yellow Metanium to quickly soothe and treat the rash. The topical ointment has a thick yellow consistency which should be spread thinly, so the skin can still be seen through it. This creates a barrier from moisture in order to eliminate the rash. Apply at every nappy change to ensure quick treatment. Follow effective treatment of nappy rash by applying barrier ointment and adhering to these top tips to ensure your baby doesn’t get nappy rash again.

If the rash persists despite adhering to treatment via an ointment, you should contact your GP as your baby may have a secondary candida infection.

Most cases of nappy rash are mild and easily treated by parents without the need for referral. Despite being a cause for concern, uncomplicated nappy rash should settle when treated appropriately with good skincare routines and the use of an appropriate barrier ointment. It typically lasts about three days,” says Heather.


* Merrill, L. (2015) Prevention, treatment and parent education for diaper dermatitis. Nursing for Women’s Health19(4), 324-336.

** Cohen, B. (2017) Differential diagnosis of diaper dermatitis. Clinical Pediatrics 56(5S), 16-22

***Phillip, R., Hughes, A. and Golding, J. (1997) Getting to the bottom of nappy rash. British Journal of General Practice 47(421), 493-497

**** Atherton, D.J. (2004) A review of the pathophysiology, prevention and treatment of irritant diaper dermatitis. Current Medical Research and Opinion 20(5), 645.

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