Diaper rash is one of the most common skin problems for babies; in the U.S., most babies will suffer mild diaper rash at some point before they are potty trained. If treated quickly, diaper rash usually clears up within a few days. However, a diaper rash that doesn't improve with normal treatment may be caused not by contact but by a yeast fungal infection.
Yeast is a fungus that is normally present in the human body. The population of yeast in the body is usually balanced by good bacteria in the digestive system that prevent yeast overgrowth. However, there are several factors that can cause a baby to develop a yeast infection in the diaper area. A contact diaper rash, caused by the skin being in contact with urine and feces, can make the baby's skin more vulnerable and may develop into a yeast infection. Also, if antibiotics are taken by the baby or the breastfeeding mother, they can kill good bacteria, allowing yeast to multiply and potentially resulting in a yeast infection.
The first way to identify a fungal diaper rash is its lack of response to diaper rash treatment. If using diaper rash cream and leaving the baby's skin exposed to air as much as possible does not clear the rash within a few days, then it's likely that the rash is a fungal infection. As it worsens, a fungal diaper rash will have raised, bumpy skin, clearly defined borders, and satellite red spots surrounding the main rash. If the baby has recently had a thrush infection in the mouth, that makes it more likely that the diaper rash is fungal.
An over-the-counter topical antifungal cream will usually clear a fungal diaper rash. During treatment, leave the baby without a diaper as much as possible; the warm, moist environment inside a diaper is a good environment for fungus, and leaving it open to the air will clear the condition more quickly. If the rash doesn't clear within a few days, see your doctor for a prescription antifungal cream.
Many of the steps that prevent fungal diaper rash are the same as those that prevent any diaper rash. Change your baby's diaper frequently when wet and immediately after a bowel movement. Use wipes with no additives or fragrance, and wash you baby's skin with warm water during diaper changes. Allow time for the baby's skin to air dry between changes, and let the baby spend some time without a diaper every day. When putting a fresh diaper on, fasten it loosely enough that there is room for air to circulate.
In addition, avoid using antibiotics as much as possible. If a breastfeeding mother needs to take antibiotics, it might be helpful for her to take probiotics as well to help prevent yeast overgrowth.
If you are using disposable diapers, make sure your brand has a breathable outer lining as this will help improve air flow and reduce the likelihood of a fungal rash. If you are using cloth diapers, you need to kill fungus in the diapers in addition to clearing the rash on the baby's skin. Wash the diapers using bleach, grapefruit seed extract, tea tree oil or water hotter than 122 degrees F to get rid of yeast in cloth diapers.