Both my babies have had nappy rash, and I see a lot of it in the general practice setting. There’s such a huge spectrum of what you might see when you open your baby’s nappy. Nappy rash can vary from just a bit of redness around the baby’s bottom, to severe, weeping, infected skin which may spread into the creases of the baby’s thighs and up towards the genitals.
Current medical guidelines do not support putting cream on your baby’s bottom daily to prevent nappy rash, but there is no harm in applying cream daily if you feel this helps. Some brands of wipes may irritate the skin, so you may want to consider using cotton wool and water or changing brands.
To treat nappy rash medical evidence is supportive of:
- ‘Nappy-free time’ for babies with mild nappy-rash. TIP – put them on a towel or incontinence sheet. However, if this is not helping, there are plenty of creams out there which can:
- Bepanthen or Zinc with castor oil are some of the recommendations. Remember to spread them thinly as the skin won’t be able to breathe if there is a thick layer
- Metanium ointment is good for mild to moderate nappy rash. Watch out this yellow paste really stains clothes!
For anything worse than this it may be worth seeing your GP or Pharmacist who can help guide you. Medical professionals may recommend some mild steroid cream or ointment, or even an antifungal cream as severe nappy rash is often due to thrush. Nappy rash is often worse when babies are unwell or teething. If you are concerned, please speak to a healthcare professional.
Is my baby teething? Could it be teething? Is teething the answer to everything? This is a common topic and most parents are concerned about the effect teething will have on their baby.
Teething is a normal process and babies usually start teething any time between 4-7 months. The bottom two teeth usually come through first. Babies start drooling at about 2-3 months, and this is often misconceived as a sign of teething. In fact, this is because a baby’s salivary glands start working at this stage. Then, when they put everything in their mouths, this is thought to be teething too, when in fact this is more than likely developmental; babies explore everything with their mouths.
So, what are the signs of teething? Medical professional opinion is that teething causes pain only for about 3-4 days before the time a tooth emerges. Signs include:
- Swollen gums, or the gum may turn white over the tooth.
- Cheeks are often flushed, and they may get a mild rise in temperature.
- Increased drooling may cause a rash to their chin/face, and nappy rash sometimes gets worse at this time. They may be more irritable than normal, BUT this could also be a sign they are unwell so please look out for other signs of sickness and, if concerned, seek advice from a health professional.
What can be done? Provide a cool teething ring or a cold clean flannel/muslin for the baby to bite down on. We do not advise teething gels, especially those containing local anaesthetic or salicylate (a product like aspirin which is not allowed for children). Calpol/nurofen can be given if the baby is in distress with signs that a tooth is emerging.
Sticky Eye – Is it conjunctivitis?
New-born babies often have ‘blocked’ tear-ducts (about 1 in 5 babies) and this may cause them to have watery or sticky eyes. This can be both eyes or one. Parents might worry that the baby has an eye infection. In fact, this is normal in many babies and simply wiping sticky eyes with cool boiled water and cotton wool will do the trick. You can also massage the baby’s tear ducts (next to the upper part of the nose) which may help open them up. They usually open in the first few weeks to months of life. If the ducts do not open for more than a year, your GP may refer you to a specialist.
Actual eye infection can happen in new-borns as well as older babies. Signs of eye infection may be:
- Redness in the whites of the eye; swollen eye lids
- Yellow or even slightly green crust on the eye lashes
- It may be hard to get the eye to open and when you do the eye ball usually looks red
- If your baby has signs of infection it is important to go to your GP. This can affect both eyes and is usually contagious. It is important not to share towels and wash your hands regularly. Your GP may prescribe eye drops and may occasionally take a swab.
Dr Laura David works in General Practice in North London and has a wealth of experience in Paediatrics and Obstetrics. With two children of her own she is in the perfect position to help you prepare for your baby’s health journey. Contact firstname.lastname@example.org to book Your Baby’s Health workshop at home or at a venue near you. @yourbabyshealth 07793022475.