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Thursday, 29 August 2013

Child skin care- focus diaper area

As I look back to last three years of raising my kid; each stage brings in new challenge from struggling through sleepless nights in first year to super active thrilling days now.
Infants (medical term used for the baby in first year of life)  pass urine and feaces so frequently that most of the time mother is busy changing nappies or diapers during the first year. So, here I am highlighting some important points on how to take care of diaper area of your little one.

Why the diaper area requires special care?
An infant soils diaper area very frequently and  urine and feaces tend to macerate and irritate the tender skin of your child, so keeping this area dry and clean is extremely important.
Also, incorrect use of diaper like fastening too tight (suffocate this area futher) and delay in nappy or diaper change can leave your kid’s bottom eventually bathed in urine. The problem might increase when solid foods are introduced as this further increases the irritant effect of urine and feaces. For obvious reasons episodes of diarrhea can trigger diaper dermatitis, as can a course of antibiotics that kills the good bacteria in the gut of your child.

How do I recognise my child has diaper rash?
The diaper rash affects the convex surface of the diaper area and spares the folds, so to begin with you might notice redness in the genitals and area of thigh that comes in contact with diaper. If precaution are not taken the redness increases and skin appears moist and macerated and in worst case may develop bumps and blisters. Rarely, the rash may spread beyond diaper area and involvement of fold can occur which indicates super added fungal or bacterial infection.
You might notice your child trying to touch or scratch the diaper area and he/she might cry when you touch this area. The older ones might resist putting diapers.

How do I take care of Diaper area of my child?
The general principle is to keep this area dry, free from irritants and moisturised. So here are steps to follow when your child wets the diaper with urine or stool-
Mother should be aware of time of last nappy change, what is the time the kid usually paases feaces and if the child is crying, please look for nappy area before feeding. 
Please remove the diaper/ nappy gently with out rubbing the skin of your baby. Clean remaining urine or stool soiling the skin with a soft cloth soaked in warm water especially the folds.  After this pat dry the area with soft towel. 
Let the diaper area especially folds further air dry for few minutes, followed by application of bland moisturiser like diaper area creams, white petrolatum jelly or coconut oil.  Apply the emollient generously over the diaper area including the fold. This will help in conserving the natural moisturising factors of skin of your baby and also works as barrier that delays the irritant effect of stool and urine.

What should I do once diaper rash develops?
Diaper rash which manifest as mild redness can be taken care by above mentioned steps, except for more frequent change of diaper or giving diaper breaks to your kid at least when you are free.
If the diaper rash is severe then stop diaper altogether. Use a plastic sheet to save your mattresses and lay the child over a soft cloth with diaper area undressed. You can wrap your baby with cotton sheet or a blanket depending on the weather. It is important to change the wrapping sheet as soon as it gets wet and follow the steps as highlighted above while cleaning the bottom of your child.
You might now need a Zinc oxide based diaper rash cream instead of bland cream. There lots of brands of diaper cream available in the market and unfortunately few of them might actually worsen the rash. A general guideline is the diaper cream should be free from fragrance & lot of preservative and do not buy menthol containing brands though they may give a coolong senstaion but menthol can further irritate skin. It would be better to ask from your peadatrician well in advance which diaper rash cream you should use if required and how frequently it can be used.

When should I visit the doctor?
Diaper rash if tackled in early stage should heal in 2-3 days. However if the rash is severe, not responding to over the counter available diaper rash creams in 2-3 days and if it is spreading beyond diaper area or involving folds; you should consult your doctor. It is important not to ignore such cases as the diaper area may be involved various skin disorders like atopic dermatitis,  seborrhoeic dermatitis, Zinc or Biotin deficiency etc.

Disclaimer- The content of this page is meant for information pupose only and not not meant for medical use. As everybody skin behaves differently so the author is not responsible for any damage or losses or side effects arising from the use or following the information provided on this page. Also certain topics in this page are still controversial so the author is sharing her views based on her experience and knowledge. Any wrong content or discrepancies in thought are invited for discussions and if needed can be corrected based on the facts. The results expected with skin care products are not universally applicable as each individuals skin behaves differently. The author is not responsible for any adverse event that arises out of following my opinion, however such negative and positive feedback will help me improve. Kindly seek dermatologist advice for skin care, acne, redness, irritation, dark patches or any other skin problem. Kindly note for medico-legal reasons I have not listed prescribed skin care products which are specially formulated according to skin types and are cost effective too. Also, the author has no monetary association with above listed brands, there are thousands of skin care products in the market I have chosen few of them to start with. All the pictures in this blog are taken from Google images.

 Your invaluable comments, queries and Facebook likes will help me in my effort of Dermato-awareness- working towards healthy, radiant and flawless skin. 

 Dr Surbhi, MD (Skin)

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