Little Green Angels
It is a common misconception that babies who wear washable nappies are more prone to nappy rash. This is not true. Research done by Professor J Golding at Bristol University shows that children in real nappies are no more likely to have nappy rash than children in disposables.
The term "nappy rash" is often used incorrectly to indicate any kind of redness on baby's bottom. However, it is a very specific term, and relates to the chemical effect when stale urine interacts with the bacteria from faeces to create ammonia, which effectively burns baby's bottom. Bad nappy rash results in open sores. There are many other sorts of rashes which are not nappy rash, and are dealt with differently - it is a case of eliminating possible causes.
Other possible causes of redness might be:
• Sweat rash - a classic sign is a red mark around the waistband, where sweat has gathered as baby sleeps
• Heat rash - similar to a sweat rash, but you may also find baby is prone to this in other parts of the body as well, not just in the nappy area (maybe hairline, neck, elbows or armpits?)
• Reaction to detergent - if you are using a brand that has not been a problem before, check to see if it has a new formulation or call their customer care line. Try switching brands for a few days to something known to be mild (eg Surecare or Filetti) and see if this makes a difference. If it is a reaction to the washing powder, you may well also find new rashing on the face, if your child sleeps with their face to the sheets.
• Dietary effect - see comments below about keeping a food diary
• Nappies are not clean enough - if you wash nappies at 40, this is an indication that you need to wash them at 60.
• Thrush - little red spots are the classic sign. See your doctor for how to clear this up, and make sure you wash nappies at 60 until it is sorted out
• Reaction to a sanitising agent used in the nappy bin.
So what is Nappy Rash?
When it first comes out, urine is sterile (unless your child has an infection). Whilst your child has a wet nappy only, there is no real risk of nappy rash developing. However, as soon as they have had a poo, the bacteria in the faeces reacts with stale urine on the skin to produce ammonia. It is this that irritates the skin and causes nappy rash to develop. Once baby has got any redness, you might wish to change nappies more frequently than you would normally do, until the irritation settles down.
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 latch onto. Also, you should be careful to clean baby's whole nappy area thoroughly. A child can safely sleep all night in the same real nappy because they do not usually poo in their sleep - but it is important to change them first thing in the morning and cleanse particularly thoroughly at this change, before the stale urine has had a chance to react with any bacteria from faeces.
Sometimes you will find a child goes red as soon as they have a poo, regardless of how long their nappy has been on, and sometimes you will find that they have no redness at all. This is where dietary factors may come in, changing the composition of the faeces. If you find a pattern of rashing develops, try keeping a food diary to see if you can identify what might cause it. If you are breast feeding, this means a food diary of your own consumption. One product which is known to have quite an irritant effect for many people is fresh orange juice. Tomatoes and avocados are other common culprits.
Avoid chemical wipes, as these can often be an irritant for your baby, which will make it harder for you to clean him/her. Switch to something particularly soothing such as a natural wash recipe or use plain water.
Information courtesy of the Isle of Wight Real Nappy Network