Baby Peter has made his appearance into the family. He's my niece Maria's first baby, and the family is in a baby blue twitter. For a baby gift, I want to put together a basket that holds all that a mother needs. Ranking near the top in importance is the diaper-rash cream. But I didn't want any old product; I wanted the best. I turned to my trusty veteran super moms."My Bradley instructor said to put breast milk on the rash," offered sister Nancy. "She said the healing properties of the breast milk would help heal the rash. I also heard of putting olive oil on the baby's bottom. But I haven't actually tried these homespun remedies. I use Triple Paste Medicated ointment for diaper rash [$8.00 online at SkinStore.com], which a friend of mine, who is a pediatrician, gave to me. I find that it works right away."
Messy application seemed to be a general complaint among the moms. "Johnson's Diaper Rash Cream [$4.49 for 3 ounces at Longs] is terrible," moaned friend Sarah. "It is globby, hard to spread, and it just doesn't work that well. I prefer the A & D zinc oxide cream [$3.94 for 4 ounces at Target]. You can coat it on thick."
"Aveeno Baby Diaper Rash Cream is my baby bootie cream" [$3.99 for 4 ounces at Target], offered friend Margaret, "because it is not as messy as Desitin and it takes away the rash."
"You know what really nips it in the butt?" quipped friend Jill. "Balmex Ointment [$3.96 for 4 ounces at Wal-Mart]. I like it because it is much easier to put on, just sprinkle it on and your hands don't get all gunky."
So much for the ease-of-application report. Now I wanted the results angle. Friend Bernice offered, "My sister-in-law uses homeopathy which I thought was quackery. But out of frustration one day, I tried a homeopathic remedy called Calendula [$6.19 for 1.5 ounces at Henry's] on my kid's rashes. Ever since, I have never had to buy Desitin or anything else. I just use Calendula. It looks like Vaseline, and it has an interesting marigold smell to it. Not only does it make a nice shield to keep moisture from getting to the skin, but also there is some ingredient that helps heal the rash. I have always used it on the kids at the first sign of any skin irritation. Occasionally they have gotten a bad rash, and calendula has always done the trick. I have even used it on their chapped lips and the sore skin under their noses. The only times it hasn't worked was when the kid had a yeast rash."
I popped down to Henry's and snatched up some Calendula. The saleslady also pointed me toward the Burt's Bees Diaper Ointment ($6.75 for 1 ounce), which I snagged for a second option.
Pleased with the testimonial but wanting a little expert info, I made one more phone call to our family pediatrician, Dr. Jennifer Thompson. "Contact diaper dermatitis, where the bottom gets red and sore, is usually right on the labia for the girls, kind of that thick outer tissue there, or it is right on the prominences of the little buttocks because those are the areas that rub the diaper, the area that is in friction. Sometimes it can even get raw looking, kind of weepy with clear fluid. Occasionally there are blisters, but usually it just gets red and raw. A yeast rash tends to be in the folds, between where the thigh meets the groin area. It is big red patches. Then there are what we call satellite lesions -- bright red dots kind of away from that central area. It is raised a little bit and there might be a bit of dry white scales."
The most common yeast rash is from a fungus called Candida albicans, explained Thompson. "Everyone has Candida on their body, but with an infant it overgrows because of the diaper area. Candida likes to grow in places that are wet, hot, and dark. The diaper is a perfect area for it to grow."
On top of friction and resident fungi, Dr. Thompson said there are other rash-causing factors. "Sometimes the baby has diarrhea," she explained, "so the acidity of the stool, or the bacteria or virus that is in the stool, can be irritating. Sometimes you use a wipe maybe that is scented or has fragrances or something that is irritating and can cause the rash. Or it can come from just sitting in a wet diaper for too long. When you urinate, the urine is sterile, but there is always bacteria around the whole diaper area, so they start to replicate."
What about eczema?
"Eczema looks like dry red patches. Not a huge thing, like the Candida, where the whole diaper area can be red, but maybe the size of a dime, or a quarter. It can be seen anywhere on the body, but in the diaper area not quite as much. Usually we see eczema in the creases where you bend your elbows or you bend your knees. It is dry, very itchy. With the irritant diaper rash, the Candida, they are just sore, and uncomfortable. But with the eczema, it is always itchy.
"Typically," Dr. Thompson continues, "you treat the yeast rashes with a prescription like Nystatin or over the counter with Lotrimin or Monistat. For the diaper dermatitis, use a product with zinc oxide in it like Desitin [$3.99 for 4 ounces at Target] or Balmex or A & D. The zinc oxide not only treats the rash but also helps prevent them. It is just a thick barrier; basically cakes the whole bottom all white. For particularly inflamed red areas, where it looks like it is going to bleed, put 1percent hydrocortisone on it a couple of times a day as well as the zinc oxide product."
Do certain foods cause the diaper rash?
"Some kids are sensitive to certain foods like strawberries. Some babies are allergic to lactose or have wheat intolerance and they can get more of that contact irritation because they have diarrhea. But a food in particular won't make them get a yeast infection."
And what about the breast milk and olive oil remedies?
"I have heard of moms using breast milk. I think breast milk is fine; it does have some healing properties to it, but the zinc oxide definitely works better."