What care does baby skin need in the diaper area?
Even in the first days of life, you notice that your baby's skin is very different from your own or that of older children. It is not only delicate and thin, but also much more sensitive. Redness and small pimples appear quickly – and a sore bottom is not uncommon.
Baby skin is not yet fully developed. The protective horny layer is much thinner and the re-lipidation mechanism does not work properly yet. Colonization with good bacteria and the slightly acidic pH value also only develop in the first months of life. That’s why it’s important to find a good balance in skin care.
After birth, your baby's skin is only used to the moist amniotic fluid and the protective vernix (cheese-like coating). The change to the dry environment after birth is a big adjustment and the skin takes about three years to fully develop.
Why is the skin in the diaper area so sensitive?
While the skin on most parts of the body quickly learns to cope with the new environment, it remains permanently moist in the diaper area. The diaper and contact with urine and stool stress the skin and often lead to redness or small pimples.
That’s why it makes sense to give your baby diaper-free time from the very beginning – even if there is no redness yet. If the changing area is equipped with a heat lamp, parents can calmly extend changing times and let the baby kick without a diaper. A thin muslin cloth gives a bit of boundary. Important: Always stay with your baby and keep a hand on them!
Tip:
If your baby has a sore bottom, you can cut a hole in a woolen tights in the diaper area during this time, so that the tummy and legs stay warm but air can get to the bottom. At home, you can then do without the diaper for a while.
What to do about redness?
If there is slight redness in the diaper area, parents should clean the skin thoroughly, especially after a bowel movement, and apply a wound protection cream. Most creams contain natural oils such as almond, sesame, or coconut oil, lanolin, and zinc oxide. Zinc oxide protects the skin by binding moisture and preventing the skin from softening further.
The cream is applied thinly once or twice a day – especially if the diaper is not changed for a longer period, for example during a nap or at night. For more severe redness, the cream can be used more often. But: more is not better! A thin layer on the affected areas is completely sufficient.
„For mild redness, breast milk can also help. Simply dab a few drops on the sore spots – the substances it contains have anti-inflammatory and antibacterial effects.”
If the bottom is red, parents should change the diaper more frequently, especially after a bowel movement. Sometimes it takes a few days for the treatment to work – be patient and don’t keep trying new creams, as this only irritates the skin more.
For mild redness, breast milk can also help. Simply dab a few drops onto the sore spots – the substances it contains have anti-inflammatory and antibacterial effects. Studies have shown that certain ingredients in breast milk have anti-inflammatory and antibacterial properties, such as lysozymes, immunoglobulin IgA, or bifidus factors. Healing wool (untreated sheep's wool with lanolin) can also help, but only for mild redness and never on open wounds!
Parents should take a close look at the baby once a day during diaper changes and especially check the skin folds – sore spots can quickly develop behind the ears, on the neck, and under the armpits. A drop of oil in the skin folds can help prevent this.
„Even with healthy baby skin, parents should use wet wipes only rarely.”
Gently clean the diaper area daily with lukewarm water. Cotton pads, washcloths, or microfiber pads are ideal for this. If the skin is already red or sore, wet or oil wipes are a bad choice – they often contain many ingredients that can further irritate the skin.
Try different diapering systems
Even with healthy baby skin, parents should use wet wipes only rarely. Many products still contain substances that can make the skin more permeable or trigger allergies.
After cleaning, gently pat the skin dry – do not rub and do not use a hairdryer!
If the skin in the diaper area is repeatedly irritated, it may help to change the diaper brand or system. Maybe your baby tolerates cloth diapers better than disposables – or vice versa.
Longer diaper-free periods often help keep the skin healthy in the long term. Some parents also try what is called 'elimination communication' – you learn to recognize your baby's signals for elimination. Growing up without diapers was common in Europe until the early 20th century, and many babies worldwide are still raised diaper-free today. It's not about potty training, but about communicating with your baby. All babies show when they 'need to go': they kick, seek eye contact, become restless, or cry a little. If parents pay attention to these signs and hold the baby out in time, this can also help prevent skin problems in the diaper area.
What to do with inflamed skin?
Sometimes, despite all care, the baby's bottom does not improve. The skin can become soft and bacteria or fungi can enter. It often looks scaly, raised, or pustular.
If it is a fungal infection (diaper thrush), you need a special cream from the pediatrician. In the case of a bacterial infection (diaper dermatitis), the skin shows small red pimples or pustules, sometimes even open spots.
How can you recognize diaper dermatitis?
Severe soreness in the diaper area is called diaper dermatitis. The skin is swollen and reddish to deep red. The skin often oozes in this moist environment. Small blisters and open skin areas can form. The most important therapy is to keep the diaper area dry. A baby's full diaper should be changed immediately. With proper care and without a fungal infection (see diaper thrush), diaper dermatitis usually heals within a week.
What are the causes of diaper dermatitis?
Soreness in the diaper area can be caused by "acidic stools of the newborn. These occur especially when introducing complementary foods and during teething. Stool that remains in the diaper for a long time and thus on the newborn's bottom can also irritate the skin. This also applies to stool residues that are accidentally left behind after changing the diaper. Antibiotic administration can also promote diaper dermatitis, because it almost always disrupts the natural bacterial flora of the skin. Sometimes the skin also reacts to substances in wet wipes, disposable diapers, or ingredients in baby care products.
What helps quickly with diaper dermatitis?
Parents should change diapers regularly and thoroughly clean the diaper area with water and then with an unscented, high-quality baby care oil.
Affected areas can be dabbed with a little breast milk. The baby should be diaper-free as often as possible so that plenty of air gets to the skin. It may also help to change the diaper brand or switch to cloth diapers, or if using cloth diapers, temporarily switch to disposable diapers.
If you are unsure, contact your midwife, pediatrician, or doctor. Especially in the first weeks and months with a baby, this is completely normal – don't hesitate to seek help.
