What Causes Nappy Rash, and How Can I Cure It? Lots of parents worry that using cloth nappies might give their children nappy rash, but this simply isn't the case. A study by the Avon Longitudinal Study of Parents and Children into the causes of nappy rash concluded that the type of nappy worn isn't a significant factor and that disposable nappies offer no benefit. (The abstract can be seen here http://www.alspac.bris.ac.uk/abstracts/p29.shtml) In fact, anecdotal evidence suggests that using cloth nappies can reduce nappy rash problems. Frequent nappy changing is one of the best ways to relieve nappy rash, and parents using cloth nappies seem to be inclined to change their child more often, because there is no cost implication and we tend to be more aware that a child's nappy is wet or dirty. The super-absorbers and chemicals in disposable nappies can make a dirty or wet nappy smell or feel clean. So What Really Causes Nappy Rash? True nappy rash, results from the chemical effect when stale urine interacts with the bacteria from faeces to create ammonia, which effectively burns baby's bottom. Urine is sterile when it first comes out (unless your baby has an infection) so whilst your child's nappy is just wet there is no real risk of nappy rash developing. Once they have had a poo, the bacteria in the faeces reacts with stale urine on the skin to produce ammonia. It is the release of ammonia which irritates the skin and causes the rash to develop. It is in order to avoid stale urine on the skin that you are advised to change nappies frequently, so that when they do poo, there should be less for the bacteria to react with. You should also be careful to clean baby's whole nappy area thoroughly to ensure there is no stale urine on the skin. A child can safely sleep all night in the same nappy because they tend not to poo in their sleep - but it is essential to change them first thing in the morning and clean their skin particularly thoroughly at this change. There are also lots of other things which can cause redness or a rash, and it is a case of eliminating possible causes. Sweat rashes or heat rashes can often occur in babies, and often indicated by redness around the waistband of nappies or clothes and also in other areas such as armpits or neck creases. Thrush in young children and babies is common and is indicated by tiny red spots around the nappy area; if you suspect your baby's rash might be thrush consult your GP. If you are using cloth nappies, make sure you wash at 60 degrees until the thrush has completely cleared up. If you currently use cloth nappies, it could be your detergent which is causing the problem. Always use a mild non-biological detergent, and experiment with different brands to find one which doesn't irritate your baby's skin. The gentlest I have found is Ecover. Use only half the recommended amount of detergent in your machine, as it can easily build up in the fibres and cause skin irritation. If you find that your cloth nappies have a strong smell of ammonia when wet, it may well be that your nappies have a detergent build up. To remove the build up, simply wash your nappies at 60 degrees without detergent a couple of times. White vinegar in the fabric conditioner section of your machine will also help prevent build up. Some foods can trigger a rash, and many babies are particularly susceptible to dietary factors when teething. Common culprits are tomatoes, citrus fruit, and avocadoes - try avoiding these and see if it helps. Some children can get a rash when they first switch from disposables to cotton nappies. Their skin has have been used to being kept artificially dry, and there may be an initial sensitivity as they adjust. Children who use cotton nappies tend to react very badly if they have to use disposables, this is probably a reaction to chemicals against the skin. It is important to keep an eye on it for a few days and it will almost certainly resolve itself. This kind of "transition" rash tends to be fairly mild, and if there are any sores or a very strong rash you should investigate other causes. How to Prevent or Cure Nappy Rash As nappy rash is caused when the baby's urine comes into contact with the bacteria in faeces, causing ammonia to be released. Frequent nappy changing means there is less chance for the ammonia to affect your baby's skin. Nappies should be changed every couple of hours, and straight away if baby has done a poo. Keeping baby's bottom scrupulously clean is essential, and you need to ensure that the entire nappy area is cleaned thoroughly at every nappy change. Plain water or a simple homemade solution such as camomile tea is the best thing for cleaning baby's bottom. Use cotton wool, or washable wipes (you can make your own by chopping up flannels or old towels). Many rashes are not actually a true "nappy rash" and can be caused by a reaction to fragranced baby wipes or toiletries. Midwives and other health professionals recommend using water and cotton wool or terry wipes to clean your baby's bottom. Some baby wipe manufacturers have "sensitive" ranges, which beggars the question "aren't all newborn babies' skins sensitive?" Try avoiding wipes for a while and see if it helps. Using water and washable wipes/cotton wool will also save you a fortune! Fresh air will help to ensure your baby's bottom is thoroughly dry, and will help clear any existing rash. Keep your baby's nappy off for a while whenever it's practical, but don't leave them lying on your favourite rug - accidents will happen! You can also try drying baby's bottom with a hairdryer on its coolest setting; it gets the area thoroughly dry and most babies love the sensation. Cooled camomile tea used to clean baby's bottom will help clear up nappy rash quickly. This has almost miraculous properties in mild cases, and will help even a severe rash, especially if you add a little honey to the tea. The healing powers of camomile are well known and many commercial creams contain it, but this is a much cheaper and more effective solution. A single drop of Tea Tree Oil can also be added which will help skin heal more quickly, especially if there are blisters or sores; this is a natural antiseptic but exercise caution as it's quite powerful stuff. In fact, tea tree oil can in some children be the cause of a rash if used to soak cloth nappies. There are lots of different lotions and potions on the market, some more effective than others. Again, Tea Tree Oil can be mixed into a commercial cream, to such as Chamillosan; personally I found this to be a very effective combination. When used at the first sign of redness creams such as Sudocrem or Bepanthen can be effective, but beware of using a barrier cream if your baby already has an existing rash, as it will prevent air getting to baby's skin which is essential if the rash is to heal. Fleece or Biodegradeable Liners used inside cloth nappies will keep baby's skin nice and dry. Silk Liners are also available which can help to alleviate or cure nappy rash. Silk has natural healing properties, and the raw threads against baby's skin can improve healing quite quickly. There is no reason why silk liners couldn't be equally effective inside a disposable nappy. Some people may tell you that nappy rash is inevitable when using cloth nappies; this isn't the case and in many ways, cloth nappies can reduce or prevent problems. If you're using cloth nappies and having a particular problem with rashes, please feel free to e-mail me and I'll see if I have any useful suggestions.