Diaper Rash, Non-Infected (Infant/Toddler)

Front and back views of baby showing common areas for daiper rash to form.
Areas where diaper rash can form.

Diaper rash is a common skin problem in infants and toddlers. The rash is often red, with small bumps or scales. It can spread quickly. Areas that have a rash can include the skin folds on the upper and inner legs, the genitals, and the buttocks.

Diaper rash is often caused by urine and feces, especially if diapers are not changed frequently. When urine and feces combine, they make ammonia. Ammonia is a chemical that irritates the skin. Young children’s skin can also be irritated by baby wipes, laundry detergent and softeners, and chemicals in diapers.

The best treatment for diaper rash is to change a wet or soiled diaper as soon as possible. The soiled skin should be gently cleaned with warm water. After the skin is air-dried, put a barrier cream or ointment like zinc oxide on the rash. In most cases, the rash will clear in a few days. If the rash is untreated, the skin can develop a yeast or bacterial infection.

Home care

Follow these tips when caring for your child at home:

  • Always wash your hands well with soap and warm water before and after changing your child’s diaper and applying any cream or ointment on the skin.

  • Check for soiled diapers regularly. Change your child’s diaper as soon as you notice it is soiled. Gently pat the area clean with a warm, wet soft cloth. If you use soap, it should be gentle and scent-free. 

  • Apply a thick layer of barrier cream or ointment on the rash. The cream can be left on the skin between diaper changes. New layers of cream can be safely applied on top of previous, clean layers. A layer of petroleum jelly can be put on top of the barrier cream. This will prevent the skin from sticking to the diaper.

  • Don’t over clean the affected skin areas. Also don’t apply powders such as talc or cornstarch to the affected skin areas.

  • Change your child’s diaper at least once at night. Put the diaper on loosely. 

  • Allow your child to go without a diaper for periods of time. Exposing the skin to air will help it to heal.

  • Use a breathable cover for cloth diapers instead of rubber pants. Slit the elastic legs or cover of a disposable diaper in a few places. This will allow air to reach your child’s skin.

Follow-up care

Follow up with your child’s healthcare provider, or as directed.

When to seek medical advice

Unless your child's healthcare provider advises otherwise, call the provider right away if:

  • Your child has a fever (see Fever and children, below).

  • Your child is fussier than normal or keeps crying and can't be soothed.

  • Your child’s rash doesn’t get better, or gets worse after several days of treatment.

  • Your child appears uncomfortable or complains of too much itching.

  • Your child develops new symptoms such as blisters, open sores, raw skin, or bleeding.

  • Your child has signs of infection such as warmth, redness, swelling, or unusual or foul-smelling drainage in the affected skin areas.

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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