A Mommybites reader asked:
Should I worry about my baby’s rash and how do I treat it?
Rashes are very common in babies during the 1st and 2nd years of life. Parents can become anxious about rashes and feel uncertain as how to treat the rash, and whether the rash is suggestive of something more serious. The most common rashes are not serious and, depending on the rash, are easily treated. However, rashes can be challenging for both pediatricians and parents.
First, when should you worry about a rash? When your baby has both a fever and a rash. This is not because it’s usually something serious (it usually isn’t) but because when it’s serious it’s really serious. One way to decide is to see how your baby looks. If she is happy and contently playing, she is probably fine. However, if she is lethargic and not moving around along with having a fever and rash then you need to seek medical attention for your baby right away. Here are some guidelines about when to be concerned about a rash:
- Rash associated with high fever.
- Painful rashes.
- Rashes in newborns and young infants.
- Rashes associated with respiratory (breathing) problems.
- Rashes associated with fainting or dizziness or change in personality.
- Rashes that are painful.
- Rashes that happen after taking medications or eating new foods.
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Treating rashes depends upon what the rash is. Here are some common rashes seen in infants and ways to treat these rashes.
Eczema or atopic dermatitis: This rash usually is related to an allergic type of reaction. The rash usually starts on the baby’s cheeks and spreads to other areas such as behind the ears, neck, arms and legs. Small bumps develop and can fill with fluid, ooze and crust over. The severe itching often associated with this rash causes babies to scratch, which can cause an infection. Eczema usually needs to be managed by your pediatrician or pediatric dermatologist. Here are some eczema management ideas:
- Clip your baby’s nails to minimize scratching. You may also want to put mittens or socks over her hands to prevent her from scratching while sleeping.
- Limit bathing baby to once a day or every other day since this causes increased skin dryness. Baths should be no more than 10 to 15 minutes with a mild cleanser such as Cetaphil or Dove that is unscented. After taking baby out of the water do not dry her completely but instead use a moisturizer such as Aquaphor or Vanicream or Cerve’ on her wet skin. The water will act as a seal and seal the moisturizer.
- Moisturize baby’s skin generously with one of the above skin creams.
- Avoid taking baby out in extreme weather as excessive heat; cold or dry air can worsen eczema. Use a humidifier in your baby’s room and do not keep your home too warm or too cold.
- Use 100 percent cotton clothing on your baby.
- Eliminate any food triggers such as dairy or acidic fruits such as peaches or apples.
Diaper rashes: There are many different types of diaper skin conditions. Here are some diaper rash management ideas:
- Decrease the moisture on the diaper area skin by changing the diaper often including at night when your baby is sleeping.
- Avoid giving baby juices, which leads to increased wet diapers and diaper rash.
- Leave the diaper off your baby whenever possible to allow air to the area.
- Use mild cleanser such as Dove or Cetaphil to limit irritants to diaper area skin. Wash the diaper area after bowel movement with warm water and cotton balls instead of wipes, which can irritate the skin. Make sure the diaper area is completely dry after cleaning the area. One dermatologist I know recommends using a blow dryer on the area if the diaper rash persists to completely dry the area.
- Use organic diapers or cotton cloth diapers if your baby has a persistent diaper rash to see what diapers work best. Earth’s best organic diapers are a good choice.
- Always use a barrier ointment such as Vaseline, A&D ointment, Zinc oxide, Butt cream, etc to prevent urine from reaching the diaper area.
- There are diaper rashes such as fungal ones that require a prescription ointment or cream that you need to see your pediatrician.
Heat rash: This rash, which is caused by sweating, is managed by keeping the rash areas cool and dry.
There are many other common rashes, which possibly I can discuss in the future. If you are uncertain about your baby’s rash consult your pediatrician for help.
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Expert: Dr. Gina Lamb – Amato MD
Gina is a general pediatrician and developmental pediatrician who works at Village Pediatrics and Agho Medical practices both in Manhattan, NY. She has a masters in child therapy and works with a child psychologist Rosa Vasquez PhD performing office and home consultation for newborns and parents, office and home developmental assessments, school consultations and parent child playgroups where play and art along with baby massage and other techniques are used to help parents bond and support their child’s development. Formerly, Gina was the Director of Pediatric Special Medical Needs before she went into private practice where she cared for medically fragile infants and children. She is also a Early Intervention Pediatrician for Early Intervention which assesses and treats infants from age zero to 3 years. She has extensive experience in Early Head Start programs which work with infants from prenatal to 3 years of age. She is the mother of a beautiful daughter who is 3 years old and the joy of my life. Her husband is an artist, producer and owns Synchronicity Space, a non-profit arts organization that supports emerging artist in fine art and theatre. Finally, she is also an artist who paints mainly babies and children.
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