Understanding Newborn Diaper Rash (Pedcast)


Anyone who has been around a new baby and tasked with changing diapers knows about common phenomena, diaper rash in the first few weeks of life. It is so common as to be almost normal. But why? Why does this happen and more importantly, how can it be avoided? Well, today I am going to try and explain the biology and chemistry behind this phenomena, and maybe even save some babies from having a very sore bum, and you from having to console a very distraught newborn. That’s a big task but I think we can do it.

To get started, we are going to take a quick jaunt down what I call “science drive”, and address where we will review some key ideas you need to understand today’s topic. You may remember the concept of pH, the amount of acid or base in a substance, from your study of chemistry. The stronger the acidity of a substance, the LOWER it’s pH and the more alkaline a substance, the HIGHER it’s pH. The scale spans from 0-14, 7 being neutral. A neutral substance has no properties of acids or bases. Water happens to be one of those substances that are neither acidic nor basic. Now here is a fact you didn’t know, the pH of poop is usually neutral, having a pH very close to 7 and therefore not causing burns of your baby’s skin, even though a baby’s surface skin is very thin! I said usually, didn’t I? One of the times that babies frequently have acidic poop is a few days after birth. Why you ask? Well, there are a number of reasons.

1. Babies at birth, lack bacteria that help the digestive process and balance the pH of your baby’s stool. Remember when your child is first born, they are sterile on the inside. They need to acquire the normal germs we all have in our intestines but this process can take many months to complete so the bacteria just aren’t there to help early on.
2. Secondly, babies often malabsorbsion all sorts of nutrients…especially sugars in milk and these unabsorbed sugars add a lot of acid to their poop.
3. And thirdly, the excretion of stored up BILE, you know that jaundice thing that so man newborns have trouble with, can be very irritating to your baby’s tender skin. Check a discussion of jaundice in a very popular pedcast I have previously posted:


Combine all this with pooping 8-12 times a day, and you can get one nasty rash, as so many babies seem to. Breastfed, bottle-fed, it doesn’t matter in my experience. That first week of life is tough on a baby’s bum. The end result… a terrible chemical burn around the rectum, sometimes with complete skin breakdown and bleeding. Ouch!

What can you do to avoid this?

-Don’t use baby wipes, convenient but… not so good. Too many chemicals.
-During the cleaning process, remember to rinse, rinse, and then rinse some more—and keep the water cool. Hot water is damaging to your baby’s skin.
-And don’t use soaps unless you absolutely have to. Soap removes some of the natural oil that protects your baby’s skin
-Make sure the cloth you use is very soft and clean, free of chemicals and not abrasive. A cut up diaper works well. Be very gentle when you wipe.
-Apply a protective barrier cream BEFORE the burn occurs. You know it’s coming… stop it before it gets started!
-Keep your baby as dry as possible. Far fewer germs on dry than wet skin.
-Here’s a trick a lot of parents use, blow-dry your babies bottom with low heat from a hair dryer before you put a new diaper on.
-I don’t recommend that you use powder to keep them dry, however. For the reasoning behind this, checkout my pedcast on the subject:


So that’s your dose of Doc Smo this week. I hope you got some portable, practical, pediatric knowledge out of this installment. If you enjoyed this method of learning and find it useful, subscribe on iTunes or my website and you won’t ever miss an episode. My docsmo library of pedcasts is getting quite extensive, now pushing on 300 episodes. You are free to explore all of them, for free, at www.docsmo.com. And I have something exciting to announce to my blog audience, the publication of my first book that I expect will hit the bookshelves of Amazon, Barnes and Noble, iBooks, and many many bookstores by February 2015. I have written a book full of information I know every parent will benefit from, an informed discussion about many of the thorniest topics they face every day… providing optimal nutrition, limiting screens, dealing with money and children, balancing your child’s time, and teaching your children to be responsible family members. I hope you will check it out when it is available. This is Dr. Paul Smolen, broadcasting from studio 1E, hoping you will thank me tons, for helping protect your baby’s buns. Until next time.