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The Bottom Line on Nappy Rash

'Soft as a baby's bottom' is a popular description of how anything smooth and peachy feels.

But no matter how carefully you look after your baby's skin, they are still likely to get nappy rash at some time. In fact, it's so common that around a third of nappy wearing infants have nappy rash at any one time. [1] In most cases, however nappy rash is a mild condition which can easily be treated.

What causes nappy rash?

The main cause of nappy rash is the exposure of a baby's delicate skin to external irritants such as urine (wee) and faeces (poo). [2]

Sometimes the friction of the nappy against a baby's sensitive skin or even traces of detergent left in washable nappies can be enough to lead to nappy rash.

Given that babies' bottoms spend an average of two, or more, years, encased in nappies it's no wonder that nappy rash is such a common problem.
Nappy Rash Causes

What does nappy rash look like?

The nappy area is a perfect place for a rash to develop. It's moist, dark and there's a constant supply of urine and faeces. There are different types of nappy rash:
The most common sort of nappy rash is a simple irritation. The moisture and ammonia in the urine and stools, together with rubbing against the nappy can irritate your baby's skin. Simple nappy rash may look pink or even very red, but not bright red. There may be red patches on the baby's bottom, or the whole area may be red. The baby is generally well and the redness doesn't reach into the folds of the skin. It usually disappears in a few days.

Yeast/fungal infection (Candida)

Yeast can thrive in the moist, enclosed nappy area and can cause a bright red rash, often with small red pimples. A yeast infection usually causes redness in the folds and creases of a baby's skin.

Bacterial infection

There may be yellowish, fluid-filled bumps (“pustules”) and possibly crusty areas. A bacterial infection is likely to need treatment with antibiotics.

Infantile eczema

Sometimes a nappy rash is part of a more generalised rash. In the nappy area, the skin looks red, inflamed and flaky. The skin scales in this area are small and white and may rub off easily. The red area often extends beyond the nappy to the top of the legs, genitals and between the buttocks.

If you think your baby might have a yeast/fungal infection, a bacterial infection or infantile eczema, ask for advice from your pharmacist, Health visitor, practice nurse or GP.

7 nappy rash trigger times

Recent research has identified seven key trigger times when a baby may be more likely to develop nappy rash. Being aware of these key times means that steps can be taken to help prevent an outbreak and if the tell- tale pink or red spots do appear, they can usually be quickly treated. [1]
Nappy Rash Triggers

Looking out for these key trigger times, means you can take steps to help prevent nappy rash or treat it at the very first signs of your baby's skin becoming irritated.


The best way to deal with nappy rash is to try to prevent your baby getting it in the first place. These simple steps will help: [2]
Bullet  Change wet or soiled nappies as soon as possible. Young babies may need changing as many as 10 or 12 times a day; older babies at least six to eight times.
Bullet  Leave the nappy off for a long as possible. Lie your baby on a towel without a nappy for as long and as often as you can to let fresh air get to the skin.
Bullet  Clean the whole nappy area thoroughly, wiping from front to back. Use plain water or alcohol-free /fragrance-free baby wipes.
Bullet  Try to avoid using soap, bubble baths, lotions or talcum powder.
Bullet  Pat rather than rub your baby's bottom dry.
Bullet  Use a suitable barrier cream at each nappy change before putting on a clean nappy. Metanium Everyday Barrier Ointment is gentle enough to use at each nappy change.
Bullet  In mild cases of simple nappy rash, follow the skincare routine above and ask your pharmacist for advice about the most appropriate nappy rash ointment for your baby. Metanium Nappy Rash Ointment* is formulated specifically to soothe and treat nappy rash. When nappy rash has cleared a barrier cream or ointment like Metanium Everyday Barrier Ointment or Metanium Everyday Easy Spray can be used at each nappy change to help protect the skin. It's now also available in a handy Spray - new double-action Metanium Everyday Easy Spray Barrier Lotion protects and moisturises the skin to help prevent nappy rash.
*Metanium Nappy Rash Ointment is a medicine. Always read the label.

When to seek medical advice

Always seek medical advice from your pharmacist, health visitor, practice nurse or GP if:
Bullet  The rash doesn't clear up within a couple of days.
Bullet  Your baby develops a persistent bright red, moist rash with white or red pimples, which spreads to the folds of the skin or the rash has yellow fluid-filled bumps (pustules)
Bullet  The rash is getting worse rather than better after using an ointment and the skincare routine outlined above.
Bullet  Your baby has a fever and a raised temperature.
Metanium Range

Metanium Everyday Barrier Ointment RRP £3.25 for 40g and Metanium Nappy Rash Ointment 30g RRP £3.99 are available from selected Asda, Boots, Morrisons, Savers, Sainsbury's and Tesco stores and leading pharmacies. Metanium Everyday Easy Spray Barrier Lotion is available in selected Boots, Morrisons and Tesco stores. RRP £5.49 for 60ml Spray (sufficient for one month's use, based on six nappy changes a day and two sprays at each change).
Visit www.metanium.co.uk for more information about the treatment and prevention of nappy rash.

1. Morris H, The bottom line on nappy rash, British Journal of Midwifery, September 2012, Vol 20, No 9, pages 540-543
2. http://www.nhs.uk/conditions/pregnancy-and-baby/pages/nappies.aspx, accessed 22nd January 2015

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