Keeping baby's bottom smooth as, well, a baby's bottom

FROM TOTS TO TEENS

March 03, 1992|By Dr. Modena Wilson and Dr. Alain Joffe | Dr. Modena Wilson and Dr. Alain Joffe,Contributing Writers

Q: My mother told me to clean my baby's bottom with a mild vinegar-water solution to clear up diaper rash. Since vinegar is an acid like urine, won't it just further irritate the rash?

A: As you know, at one time all babies wore cloth diapers. A vinegar rinse for those diapers was sometimes suggested, since diaper rash was blamed on the irritating effect of ammonia. Ammonia is produced in a wet diaper when bacteria act on the urea in urine. Vinegar -- an acid -- was recommended to neutralize the ammonia -- a base. We suspect your mother and, perhaps others, decided to apply the treatment directly to the baby. However, vinegar on your baby's bottom is misplaced therapy.

Diaper rashes are appropriately named, because the diaper does cause the rash. The diaper traps moisture next to the baby's skin. The outer layers swell, like your hands do when they stay in water too long. The swollen skin is easily damaged by the rubbing of the diaper. Damaged skin is not resistant to irritating chemicals and germs. A rash can result. The best treatment (and prevention) for diaper rash is to keep the baby's skin clean and dry.

To avoid or treat a diaper rash, remove your baby's wet or soiled diapers quickly. Gently wash your baby's bottom with a soft, clean cloth, water and mild soap. Rinse the soap off thoroughly. Pat the baby's bottom dry. If a rash is present, apply a zinc oxide ointment to protect the damaged skin. If the rash is not improving after two or three days of careful bottom care, it is usually because Candida, a yeast-like germ, has invaded the damaged skin. A prescription ointment will be needed to help the skin heal.

Dr. Wilson is director of general pediatrics at the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.

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