Tuesday, September 28, 2010

Tell-it Tuesday: How to resolve [cloth] diaper rash

Rashes with cloth diapers are less common than rashes with disposables but on occasion you may find yourself battling a rash. Though not a complete or extensive list I'll discuss the more common types of diaper rashes and somethings that may help you to resolve them:
-Sensitivity rash
-Heat rash
-Yeast rash
-[Urine] ammonia burn or chemical burn
-Allergy ring (Perianal dermatitis)
-and the less common but still worth mentioning Bacterial rash
In order to treat it properly must first diagnosis it properly. If this is your first time dealing with the rash I suggest having your doctor look at it.

-Sensitivity rash (Contact dermatitis): Contact dermatitis is a rash caused by a sensitivity to something on the skin, it could be sensitivity to material or fabric used, diaper area cleaner (or store bought wipes), soaps, detergents, urine,  poop etc.
The only way to resolve and prevent Contact Dermatitis is to find what is irritating your child's skin and remove it completely. You may also find something like Benadryl or Cortisone cream helps relieve symptoms. Your doctor may also prescribe a cream to apply as well.
If it is irritation from urine change baby more frequently and consider using microfleece liners. *Microfleece works as a stay-dry liner allowing moisture to move through it but not back up and keeps your baby drier. You can find microfleece liners already cut and available for sale at some cloth diaper retailers, or you can buy microfleece (not thicker fleeces as it can  cause repelling issues) and cut them yourself. I have also found that a cup or so of Baking Soda in a bath of warm water, filled just enough to cover the diaper area, can help sensitivity rashes. I would put Kadie in a baking soda bath in the evening and by the next morning the rash would be almost totally gone. Some people also make a paste out of baking soda and water and apply it directly to the rash. Baking soda is completely safe for use with cloth diapers.
Google Health as a very informative article on Contact Dermatitis.
-Heat rash: Is skin irritation caused by excessive sweating during hot weather. It's more common in young children and looks like tiny red pimples or blisters clustered together in certain areas of the body, including the groin.
The best way to treat heat rash is to keep the Baby in a cooler, less humid atmosphere. You may notice symptoms improve when you lower the Baby's core body temperature with things like cool bath or things like Popsicles.
In addition to frequent diaper changes, you may find a sprinkle of cornstarch (which you should not use if you suspect yeast infection) or scorched flour will help keep Baby drier which may help relieve the rash. Trimmer diapers, like an AI2 symptom may also be a better choice than thicker diapers, stay-dry liners (as mentioned above* ) may help, as well as non-PUL covers like wool or fleece (this is when you would want the thicker fleeces) soakers.
-Eczema: I have very little knowledge about Eczema so I'm going to refer you see your doctor and research it on sites like Google Health (here), WebMD (here), and KidsHealth (here).
-Yeast rash: eMedicine health has a very information article on diaper related Yeast Infections but in a nutshell-Yeast loves warm, moist environments, can come on quickly, and be a pain to get rid of. You may find using one type of insert or another contributes to Yeast Rashes, or that your baby gets a yeast rash after going overnight in the same diaper.
Normally an anti-fungal cream is necessary to completely kill the rash, some doctors will also prescribe oral medication. There are prescription medications for yeast, as well as over-the-counter remedies like Monistat but before you begin treatment for Yeast Infection in the diaper area check with your doctor. Some people also swear by natural/home remedies but I have no experience with those so I'll stick to what I know. You may find a a cup or so of Apple Cider Vinegar in warm bath with just enough water to cover the diaper area will help relieve symptoms but you should not do that if the skin is open at all.
We battled recurrent Yeast Rashes with Kadie for a couple months straight because I could not kill the yeast. I cannot stress enough that it order to completely kill the yeast and stop it from re-infection you MUST (absolutely must) kill the yeast completely in the diapers. I've seen all sorts of crazy combinations of things people have washed their diapers and cloth wipes in [trying to] kill the Yeast. My recommendation is Bleach-yes, I said it BLEACH and wash everything-inserts, covers, liners, wipes...
I used regular chlorine Bleach on everything white including inserts, and non-chlorine bleach on everything else. I washed in extremely hot water, if your water isn't hot enough add a pot or two of boiling hot water to the water in the washer, at the recommended amount of bleach, then add the cloth diapering stuff, agitate for a little bit, soak and then complete the washing cycle. If the diapers are dirty (meaning you didn't just pull them out of your stash to wash them in the bleach) after the initial bleach cycle wash as you normally would wash dirty diapers and if you don't do an extra rinse add one.  For everything not white I used Walmart's brand of Chlorine-Free Bleach and did the same thing. Bleach was efficient, and effective-I only had to soak/wash everything once in bleach to rid Kadie of the yeast.
Some people also swear by raw silk liners to reduce/prevent diaper related yeast infections.
-[Urine] ammonia burn or chemical burn: [Urine] Ammonia burn can be very common in diapered child. Ammonia burn or chemical burn can vary from mildly red and irritated  to severe including crusty and or/open, bleeding, blisters or worse.
The urine ammonia burn is usually started by infrequent diaper changes, including the Baby sitting too long in a poopy diaper or acidic poop touching Baby's skin. You may notice this rash, in addition to the Allergy Ring rash I'll discuss in a minute or by itself.  You may find the Baking Soda Bath (mentioned above) helps relieve a Urine Ammonia rash as well as more frequent diaper changes, and traditional diaper creams.
According to "A chemical burn occurs when living tissue is exposed to a corrosive substance such as a strong acid or base. Chemical burns follow standard burn classification and may cause extensive tissue damage. The main types of irritant and/or corrosive products are: acids, bases, oxidizers, solvents, reducing agents and alkylants."
You may be familiar with how the term Chemical Burn relates to diapering because of this year's issue with Pampers and their new Dry Max diapers (more info) or the recall of Rockin' Green's Hard Rock version of their detergent in July (see here). Whatever the case, if you suspect chemical burn on your child stop the use of whatever you may think may be causing the burn, rinse with plenty of water and get thee to a doctor for appropriate diagnosis and treatment. You may also want to add an extra rinse cycle at the end of your cloth diaper routine and/or switch detergents if you're using one (like Charlie's Soap with a higher rate of chemical burns). If you're looking to switch I highly recommend Lulu's in the Fluff Glamour Wash. I have been using their Hard Water version for most of the year and have never had an issue with Kadie's very sensitive skin.
-Allergy ring:  According to "a variety of foods can irritate baby's bottom, especially acidic foods such as citrus and tomato-based sauces. Appearance - a red ring around baby's anus. Treatment - discontinue suspected foods. Breastfeeding moms may need to eliminate foods from their diet." Sums it up pretty well.
-Bacterial rash: A bacterial diaper rash is typically a secondary infection that starts after Baby's skin is already compromised. According to "Look for yellowish, fluid-filled bumps ("pustules") and honey-colored, crusty areas, which are symptomatic of a bacterial infection (like staph or strep) and require antibiotic treatment."

In terms of diaper rashes there are a few things that I have discovered:
(1) Instances of diaper rashes have been far less since we've been using cloth diapers.
(2) Changing baby frequently-no matter if your using disposables or cloth diapers is crucial in preventing most types of diapers rashes. "Nakie" time helps too.
(3) Using creams does NOT mean you HAVE to use disposables! I have used several different creams (including Monistat, prescription yeast cream, as well as supposedly safe and definitely not cloth diaper safe creams) and as long as I've used liners (either Bummis Bio-Soft Flushable Liners or reusable/washable microfleece liners I have not had an issue with repelling.
Read the label-if the cream as ANY proprieties which are water barriers by nature use a liner. I couldn't possibly name all the supposedly diaper safe creams out there but I can tell you from personal experience Grandma Els Diaper Rash Remedy and Prevention is NOT completely cloth diaper safe. Grandma El's had two ingredients-Yellow Petrolatum and  Lanolin- that are water barriers by nature. If you use it (it works great, smells even better), use a liner or two. If you're looking for truly cloth diaper safe cream I recommend trying  Northern Essence. I have used both there Sensitive Diaper Salve and their Better Butt[er] cream without liners and have had no  issues on my cloth diapers. The Diaper Salve has been really great for preventing diaper rashes.
(3) If you use creams and reusable/washing microfleece liners you absolutely must was them separately from all your other cloth diaper laundry or else the barrier ingredients can spread and coat your cloth diaper and accessories and you could have issues with repelling.
(4) Pleasantly Plump babies with "rolls" can have issues with rashes/chafing caused by their skin rubbing together, called Intertrigo. Cornstarch (which you should not use if you suspect yeast) or scorched flour can help with that, the Northern Essence Diaper Salve has been really great for that as well. This isn't necessarily in the diaper area rash which is why I didn't add it to the list but felt is was still worth mentioning since it can be in the thighs which people may think is some sort of diaper rash or irritation (as well as neck, belly, etc).
***Disclaimer: I am not a medical professional of any kind. The information written above was written for informational purposes based on my knowledge and personal experiences. It is not intended to be used for diagnosis or treatment and neither Cow Patties Cloth Diapers or Crunchy Babe with can be held liable for anything related to this article-use at your own risk. Though the things listed above have worked for me/my children they may not work for you/your child and no results are guaranteed.When in doubt, I suggest you contact your child's health care professional about an accurate diagnosis and a treatment plan that will work for his/her specific issue. This article is not meant to be a complete or extensive list of all diaper rashes or all treatments.***


  1. My poor little guy had chemical burns from Charlies. He's in sposies at the moment because of prescription skin cream, but how do you recommend making sure ALL traces of Charlies are gone? We switched a while ago, but they didn't go away until we took him out of cloth. And does it seem likely that RnG would give him similar problems?


    libby dot bloom dot hunt at gmail dot com

  2. Hi Libby~

    I hope you have resolved this by now but in case you haven't what I would suggest doing is an overnight soak in a detergent like Lulu's in the fluff glamour wash or even Ivory Snow Powder. Those are the only two detergents I recommend. After the overnight soak I would wash as you normally would with detergent and very very hot water-boil some on the stove if you have to and rinse, rinse, rinse!

    I can't speak from personal experience about RnG but I will tell you that I've heard of many children getting chemical burns from RnG even before the recall. Her HW detergent was eventually recalled because of the burns and though the accounts of severe chemical burns have died down thankfully I personally would never trust RnG.

    Good luck and if you need anymore helps please feel free to email me at CrunchyBabe @ (take out spaces)

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