The Hows and Whys of Diaper Rash
“Although common, diaper rash isn’t normal.” Dr. E
Diaper rash (diaper dermatitis) is common in the USA, with up to 2/3 of diaper-wearing babies having some rash. Diaper rash is a dermatitis or skin irritation and not primarily an infection, so prevention is better than having to treat once it occurs. The rash is caused by contact allergens and irritants, combining with moisture trapped under the diaper, together they act to impair the skin’s healthy acid barrier. These changes to the surface of the sensitive genital and rectal region increase surface pH, inflammation and chaffing. The resulting rash creates a “perpetual breakdown of the skin barrier” and an exacerbated cycle of increasing pH and irritation.
All redness in a baby’s “down under” isn’t necessarily diaper rash, it can also be due to yeast infections and commonly eczema or psoriasis triggered by allergens in products. These skin conditions also result in higher rates of diaper rash, suggesting that babies with recurrent diaper rash should see a healthcare provider to look beyond the diaper rash to other medical issues.
Medical guidelines now suggest preventing diaper rash by supporting the healthy acidic pH of our body surfaces, which improves the barrier function and microbiome (healthy bacteria) health. Keeping the baby’s bottom area at a balanced, low pH by using a cleanser like Wouche Away™, can help reduce enzymes that cause irritation with dirty diapers and suppress bad bacteria that cause diaper rash to progress.
Diaper Wipes and Care Products Differ in pH
Many products used for cleaning dirty diapers don’t meet medical recommendations for acidic pH (<5) or have ingredients that cause dermatitis and irritation.
|Huggies Natural Care
Recent studies suggest that diaper rash isn’t a sign of bad caregiving, in fact, rashes are more common in babies with more day-time diaper changes and wet wipe use.
- To prevent diaper rash, we need to realize how common it is. In a 2020 study, only 1/3 of full-time diapered American babies did not have some rash.
Babies with less diaper rash had healthier skin surfaces, and the following care-giving:
- less frequent use of wet wipes, including not using a wipe for a urine-only diaper
- decreasing overnight diapers from 8-9 hrs to 6 hrs
- spending more undiapered air time
- breast feeding (lowers baby’s diaper area pH)
Things that don’t help prevent diaper rash:
- use of wet wipes for urine-only diapers (Just spritz on Wouche Away when changing urine-only diapers, leave it on and place new diaper!)
- higher number of diaper changes during the day
- frequent bathing
Int J Womens Dermatol 2019 Mar 3;5(4):233-234
Skin Res Technol 2021 Mar;2; 7(2):145-152.
BMC Dermatol 2020 Sep 21;20(1):7 ¼-1/3
J Eur Acad Dermatol Venereol 2020 Jul;34(7):1516-1523.
Am J Perinatol 2018 Apr;35(5):486-493.
Pediatr Dermatol 2020 Jan;37(1):130-136.
Pediatrician 1987;14 Suppl 1:21-6.
Am J Perinatol 2018 Apr;35(5):486-493.
Common Allergens in Wet Wipes & Diaper Care
Up-to-date medical guidelines recommend using acidic, pH-balanced cleansing protocols to prevent diaper rash, such as that found in the patent-pending Wouche Away formulas.
Switching from wet wipes to “not yet wet” wipes at changing (with use of organic reusable or disposable dry wipes), DRAMATICALLY decreases baby’s exposure to preservatives and natural bacterial killers that harm good bacteria. There is NO way to formulate a product that is open to air and stays wet all the time without having ingredients that KILL bacteria, including the healthy ones. Manufacturers get around this inconvenient truth, by using plastic fibers to make wipes (most) or by misbranding their products to say they only contain a “trace” of irritating preservatives such as benzalkonium chloride, when it is actually being used at a normal preservative found to be irritating (:().
Although many wipes and cleansers have the wrong pH for healthy surfaces, almost all are not balanced to the salt levels needed for our cells and health bacteria. This can cause cell rupture and sloughing. Almost all wet wipes also contain ingredients reported in published studies by Dermatologists and groups like the Environmental Working Group (EWG) to be potential contact allergens (some in top 10 allergen lists); and/or harm sensitive cells of the vagina, penis and rectum, causing higher disease rates (increased urinary tract infections, bacterial vaginosis, STDS). Even “natural” type products such as glycerin, aloe vera, citric acid, and Cocamidopropyl betaine associate with significant skin and mucosal irritation.
- When individuals become allergic to these common allergens, dermatitis rates in their genital and rectal region can increase up to 15-fold.
In addition to increased diaper rash rates from frequent use of wet wipes, data is not clear for the benefit of barrier creams to prevent diaper rash (Aquaphor, Desitin etc…). Some studies have found no benefit, small studies have found benefit with poor evidence, and in one study, babies in NICU treated with a diaper cream ended up with 3-times more incidence of rash than babies not exposed to these products.
- Studies of vaginal and rectal tissues from adults found that common ingredients and oils, also used in diaper barrier creams, damaged tissue cells, harmed healthy bacteria and increased vaginal infections (up to 8-fold). Similarly, a recent meta-analysis (study of all study outcomes) found that baby moisturizers don’t prevent skin dryness (eczema), but actually increased the risk of infection and food allergies. Daily use of ointments to prevent diaper rash may carry similar risks.
The Inventors of Wouche Away have created a safer diaper changing system, to help prevent diaper rash before it starts. Because Wouche Away is quick-drying, non-irritating and balanced for healthy surface ecosystems, it can be spritzed on for wiping baby during diaper changes, and then applied again a final rinse-free time for soothing prebiotic care before placing a new diaper. (Waste Management & Wiping)
- Our prebiotic Wouche Away used with organic dry or cloth reusable wipes is a game-changer in mild baby care. It has helped the babies in our family avoid that all too common diaper rash. (See Recent Reviews.) We even know kiddles who ask for “More Wouche Away” with hand signals before they can talk! 🙂