“Im wondering if you can advise me. My son is 17 months old and I have noticed a rash /small spots on his scrotum, some spots on his bum, I am treating as nappy rash, as he is teething and drooling. But earlier I noticed they’re on his penis now. He’s not in any distress, nappies are changed regularly, sudocream is used on his bum, sensitive wipes are used. I’m just wondering if it’s anything to be concerned about or could it be just nappy rash. Any advice will be appreciated.”
Pop into your GP or practice nurse and let him/her have a look. Could be many things, but one of the commoner causes of a spots appearance can be candida or thrush. There are a few other things, and since it’s hard to tell without looking at it, you will have to get someone to have a look.
For everyone else, what should you know about nappy rash?
What causes nappy rash?
● The combination of moisture, friction, and poo contents.
●Infants with diarrheoa or frequent poos have an increased risk due to continuous skin irritation.
●Diet: Breast-fed infants have a lower (but not zero) incidence of nappy rash than formula-fed infants, possibly because breast-fed infants have lower stool pH … but this doesn’t matter as much after weaning starts.
●Recent antibiotics: the risk of developing diarrheoa or yeast infections
●Other skin irritants, such as sensitivity to a type of baby wipe [hypoallergenic or sensitive products are good, but not perfect for every baby, more below]
In this case, why is it really important to get on top of this especially in toilet training toddlers? If it is giving child discomfort doing poos, it can make long-term success with toilet training difficult. There is always a risk of “holding in” poos in early toilet training due to fear, lack of confidence, sense of control, etc. leading to constipation and pain and then a vicious cycle.
What can you do to prevent it or treat early, mild cases?
Frequent nappy changes (do not allow child to sit in wet or dirty nappies). Nappy free time to allow skin to breathe is helpful.
Cleaning is usually the root of many cases: either too much, too little, or wrong product. Enthusiastic cleansing actually cause irritation. Warm water and a soft cloth/cotton usually is sufficient in young infants. If the skin is very red and/or broken,use warm water from a plastic squeeze bottle or by squeezing a facecloth soaked in water. Dried poos can be gently removed with baby or other oil and cotton.You don’t need to wipe off barrier paste completely every time. Dry skin gently, patting – not rubbing – with a towel.
Fragrance-free and alcohol-free baby wipes can be used as an alternative to water and cloth, but should be discontinued if the skin becomes irritated or broken down. Infant wipes are widely used for practical reasons. There is some evidence from studies that they are gentler than water for cleaning, but official recommendations still suggest cotton wool and water for neonates. Baby wipes containing the preservative “methylisothiazolinone” should be avoided.
In the case of this toddlers, consider if bum got red after changed to a “flushable” toddler toilet wipe? If so, might be worth considering changing temporarily back to the normal baby wipes you used for his nappies.
So mild cases: pay attention to cleaning and use a paste such as Sudocrem, Bepanthen, etc. Apply thickly and at EVERY nappy change. Pro-tip: cover that layer with Vaseline/petroleum jelly to keep it from sticking/absorbing into nappy.
Note to the organic/all-natural mammy: I love coconut oil. Great treatment for many things, including cradle cap. Not the best choice for nappy area. Petroleum jelly and preparations including a mineral-based oil do work better here.
No, do not put yogurt down there. I don’t care what Karen’s natural-mammy blog said or what Dr. Google said. Just no. (If you missed it, that same advice goes for putting it other places for yeast infections.)
So into GP. S/he might consider whether or not baby/toddler has yeast infection and might need antifungal, like canestan, cream 2-3 times a day under barrier cream. However, worth touching base with GP because occasionally, these areas become infected with bacterial and require topical antibiotics, or if very severe, oral antibiotics. Some types of severe rash need a prescribed steroid, applied under barrier cream.
In the very, very rare cases that it is not settling after that, then your GP might consider specialist opinion.
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