Nappy rash is very common and occurs with the use of both cloth and disposable nappies.

I get customers contacting me who are concerned about a persistent nappy rash on their baby and are looking for help with finding causes and cures. Here’s a comprehensive article to help anyone who is also struggling with nappy rash on their baby.

Firstly, if your little one has a severe, persistent rash the first place to seek advice is from your doctor.

The most likely cause of nappy rash is simply:

1.    Skin irritants. In other words – poo and wee.

When in repeated contact with the skin along with the combination of friction from the nappy, plus a reduction in air circulation around the skin, it can cause a rash. So in this instance, more frequent changes, nappy free time everyday, and a nappy balm or cream* will help immensely and is likely to clear the rash.

*Please note that using petroleum or zinc based nappy rash creams and balms with cloth nappies leaves a residue on the fabric that decreases absorbency and is difficult to remove. Cloth nappy friendly balms and creams are available here. If you use cloth nappy friendly balms and creams with every change it is recommended that a liner (fabric, disposable or flushable) be used to protect the fabric.

Here are some other possible causes of nappy rash:

2.    Reaction to washing detergent residue on the fabric of the nappies.

3.    Reaction to disposable wipes. My second son had sensitive skin so I made the switch to cloth wipes with plain water and the rashes disappeared.

4.    Reaction to certain foods (or allergic dermatitis).

5.   There are claims that teething is linked to rashes. The overproduction of saliva goes into the gut and can cause diarrhea which then irritates the nappy area.

6.    Recovering from a vaccination.

7.    Generally unwell including stomach bugs.

8.    A bacterial or fungal infection diagnosed by a medical professional.

Ways to clear nappy rash and reduce the likelihood of it returning:

• Watching out for those poo’s and changing as soon as possible. Cloth nappies are notorious for hiding any poo smells!
• Including a rinse cycle after washing your nappies to ensure detergents are completely washed out.
• Once again, nappy free time every day. This is not always practical, especially in winter, but is important – I often think about how babies have their skin constantly covered by a nappy day and night for 2 or so years! Lie or sit baby on a  Waterproof change mat or play mat to catch any wee’s or poo’s and then pop it in the wash.
• Using a barrier between baby’s skin and the nappy such as a fabric nappy liner.  Microfleece or polar fleece will wick moisture away from baby’s skin, keeping it dryer.
• Using a cloth nappy friendly balm or cream with each change to protect the skin. Use a liner (fabric, disposable or flushable) to protect the nappy from a build up of these products on the fabric.
• Fasten the nappies loosely for more air circulation to the skin.

For diagnosed bacterial, viral and fungal infections:

As these infections can live on fabrics is usually recommended to switch to disposable nappies during treatment and for a period of 5 days after the rash has disappeared.

You may wish to disinfect your cloth nappies. The recommendation (from the NHS) to disinfect fabrics is to wash at 60 degrees Celsius with a bleach based laundry product.

Please note that disinfecting your nappies at this temperature with bleach based products may void your nappy warranty. Warranty periods are usually 6 months to 1 year. If you are concerned it is best to contact the nappy brand, or ask me to, so that they can give you their recommendations.

If you would like to go ahead with disinfecting with bleach then use chlorine bleach (not oxygen bleach). This is actually recommended by cloth nappy brands Grovia and Bumgenius for fungal or bacterial infections.

Grovia’s advice (current at September 2015): To bleach your diapers, add 1/8 cup (for an High Efficiency machine) to 1/4 cup (for a standard top-loading machine) disinfecting chlorine bleach to a warm wash cycle after washing with your regular detergent. Do not mix with other laundry additives.

Further instructions are available here: http://www.gro-via.com/disinfecting-cloth-diapers.html or  http://www.cottonbabies.com/blog/2014/05/cloth-101-how-to-sanitize-your-cloth-diapers.html.

Please note it is really important for baby’s skin to rinse, rinse AND rinse after using bleach to disinfect  your cloth nappies.

If you are concerned about using bleach, and would like to try a gentler approach on your nappies, you could consider:

• Using natural options include using Grapefruit Seed Extract and Tea Tree Oil in your wash cycle. Studies have shown that these need to be used in large amounts to see significant results.
• One recommendation I’ve found is scrubbing the inserts directly with laundry detergent before putting through the wash. I would recommend rinsing very thoroughly a number of times if you do this.
• Use an antibacterial, sanitizing laundry rinse available in the washing aisle of supermarkets.
• Boiling your inserts/soaker pads and reusable liners. Given most cloth nappy brands don’t recommend washing their nappies above 60 degrees Celsius, this suggestion is a risk for the longevity of the fabric of your soaker pads. Also, nappy shells will also need to be disinfected and the elastics and waterproof fabrics are likely to be damaged by the high temperatures required for boiling.

I would suggest that no parent has escaped seeing a sore rash on their precious little one’s toosh at one stage or another. I hope this article has helped you identify the causes and been helpful for tackling nappy rash on your little one.