Articles

Key takeaways

• Nappy rash and thrush are common baby conditions.
• Nappy rash can often be treated at home.
• Thrush is a fungal infection needing medical treatment.
• Both conditions are manageable with proper care.

What are nappy rash and thrush?

Nappy rash is a common condition in babies. It can usually be treated at home.

Thrush is also common and can be treated with creams or tablets that kill the fungus (antifungal medicine). This article will explain how to understand, prevent, and treat both conditions.

Understanding nappy rash

Nappy rash is redness or soreness on and around your baby's bottom and genitals. It is quite common in babies.

Symptoms of nappy rash can include:

• Red or raw patches on your baby's bottom or the whole nappy area.
• Skin that looks sore, feels hot to touch, or appears scaly and dry.
• Your baby might seem uncomfortable or distressed.
• Spots, pimples, or blisters may appear. These can be red or brown but are less noticeable on brown and black skin.

What causes nappy rash?

Nappy rash is often caused by your baby's skin being in contact with wee or poo for a long time. It can also happen if a nappy isn't changed straight away, which is easy to do when you're busy with a new baby. The nappy rubbing against your baby's skin can lead to irritation.

Other causes of nappy rash can include:

• An allergic reaction to soap, detergent, or bubble bath.
• Irritation from fragranced baby wipes or wipes containing alcohol.
• Certain medicines, such as antibiotics or laxatives.
• Thrush, which is a fungal infection.

When to seek medical advice for nappy rash

You should see a health visitor or GP if you are worried about your baby's nappy rash.

• The nappy rash does not go away.
• The rash gets worse or spreads to other areas.
• Your baby has a high temperature.
• Your baby seems very uncomfortable.

Preventing and treating nappy rash

Nappy rash can be treated and prevented by following some simple advice.

• Change wet or dirty nappies – do this as soon as possible.
• Keep the skin clean and dry – clean your baby's skin with water or fragrance-free and alcohol-free baby wipes.
• Pat skin dry – gently pat the skin dry and avoid rubbing, as this can cause more irritation.
• Leave nappies off – do this when possible to allow air to circulate.
• Use extra absorbent nappies.
• Make sure your baby's nappies fit properly.
• Bath your baby daily – but not more than twice a day, as too much washing can dry out the skin.

There are also some things you should avoid.

• Do not use soaps, baby lotion, or bubble bath – these can irritate the skin.
• Do not use talcum powder or creams and liquids that kill germs (antiseptics) – avoid these on nappy rash.
• Do not put nappies on too tightly – this can irritate the skin.

Changing your baby's nappy

Babies need frequent nappy changes. Young babies may need changing as many as 10 or 12 times a day. Older babies need to be changed around 6 to 8 times.

Changing your baby's nappy as soon as possible after they have wet or pooed will help prevent nappy rash.

To change your baby's nappy:

1. Wash your hands.
2. Gather your supplies: a clean nappy, a bowl of warm water with cotton wool, and a soft towel.
3. Lay your baby down on their back on a changing mat or towel.
4. Unfasten their clothes from the waist down.
5. Unfasten and take off the dirty nappy.
6. Hold their legs and feet up.
7. Wipe their bottom and genitals clean with cotton wool balls soaked in warm water.
8. Wipe baby girls from front to back to prevent an infection.
9. Pat them dry with a small soft towel.
10. Put on a clean nappy.
11. Throw away the dirty nappy.
12. Wash your hands again.

Treating nappy rash with creams

A pharmacist can help with nappy rash. They can recommend a nappy rash cream or medicine to treat it at home. They may suggest using a thin layer of a barrier cream to protect the skin.

Only use a nappy cream if your baby's skin is red or sore. Put a small amount on and rub it in well.

For pain relief, a pharmacist might suggest giving your baby child's paracetamol. This is only suitable for babies over 2 months old.

Identifying thrush

Thrush is a common yeast infection. It's caused by a type of yeast (Candida) that usually lives harmlessly on our bodies. This fungus is a normal part of our bodies.

Thrush can be a fungal infection in the breasts. If you are breastfeeding, the infection can be passed between you and your baby during feeds.

Oral thrush and breastfeeding

Breastfed babies can also develop thrush in their mouths.

Symptoms of thrush in your baby's mouth (oral thrush) include:

• Creamy white spots or patches – These appear on the tongue and gums, or on the roof of the mouth and inside the cheeks.
• Patches that do not come off – if you gently wipe these patches with a clean cloth, they will not come off.
• Unsettled feeding – your baby may seem fussy or distressed when feeding.
• White film on lips – a noticeable white film may be present on your baby’s lips.
• Persistent nappy rash – a nappy rash that does not clear up with usual treatment.

If you are breastfeeding and experiencing pain in your nipples and breasts, this may be caused by a thrush infection. It can make breastfeeding very painful.

If you suspect you or your baby has a thrush infection, see your health visitor or GP. They can arrange for swabs to be taken from your nipples and your baby's mouth to see if thrush is present.

How to treat thrush

If either you or your baby has thrush, you will both need to be treated at the same time. This is to stop the infection from being passed back and forth between you. You can continue breastfeeding while you and your baby are treated for thrush.

Thrush in your baby's mouth is usually treated with a gel or liquid that kills the fungus (an antifungal medicine). Thrush in breastfeeding women is usually treated with a cream.

You should spread a thin layer of this cream on and around your nipples after feeds. Some women may need to take antifungal tablets to clear the infection. If you do not see any improvement within 5 days, speak to your health visitor or GP.

Medicine safety during breastfeeding

The creams and gels used for thrush often contain an antifungal medicine. These are safe to use while you are breastfeeding. While breastfeeding, it is usually recommended to use creams or gels for thrush instead of taking tablets by mouth. Always follow the advice of your GP or pharmacist, as they can give you the safest treatment for you and your baby.