Nappy rash

If your baby's skin becomes red and sore in the nappy area, it's probably a rash caused by contact with wet urine and/or poo, both of which are irritating to the skin as they contain ammonia and various bacteria. The rash can cause the skin to crack and weep, which is the time when secondary infections can occur (see Complications, below).

Don't feel guilty if your baby develops nappy rash as most young children suffer from it at some point during their nappy-wearing years, although disposable nappy technology means the incidence has gone down significantly.

Complications

If the skin is very irritated or even broken, it can become infected with bacteria. The yeast candida, which normally lives harmlessly on the skin can multiply and causes problems in warm, damp conditions, such as those found inside nappies. Candida causes thrush - an angry looking rash with scaly edges and possibly small, white spots - which requires an anti-fungal cream from your GP to clear it up.

If the rash shows signs that it might be caused by ezcema - for example, it's weeping or blistering - your GP may give you a mild hydrocortisone cream to use sparingly until the skin has settled down again.

Occasionally, a baby's skin can react to a washing powder so, if you've opted for reusable nappies and your baby develops a rash, try switching to a milder detergent and make sure it's non-biological.

What to do

• Use a soothing medicated nappy cream, such as Sudocrem, to ease any redness and clean your baby's nappy area thoroughly at every change.
• Let your baby or toddler to kick around without their nappy for a few minutes at each change to let the air circulate around the affected skin.
• If using re-usable nappies, apply a barrier cream (containing zinc and castor oil) to the skin in the nappy area until the infection clears up. This isn't usually necessary with disposables as they are so efficient at locking away the moisture inside the nappy.
• Change your child's nappies frequently - at least every two-three hours for newborns and as soon as they do a poo.
• Ask your GP or health visitor's advice about the rash if it doesn't heal up using the above measures.