Here are the most common causes of diaper rash:
Normal Developmental Rashes
Newborns get diaper rash because their skin is new and delicate and they pee and poop a lot. Try to change the baby as soon as he pees or poops, and just use a cloth wipe wet with warm water, and don't rub hard. You can use a very gentle baby balm or rash cream with each change, but make sure it is cloth diaper-safe. (See below for rash creams.)
Teething (two months and up)
When babies teethe, they drool, and they swallow some of this drool, and it can irritate their bums on the way out. This is totally normal, and again, the solution is to change them often and use a protective balm or cream that is cloth diaper-safe. (See below for rash creams.)
Solid foods change the chemistry of the baby's poop, again resulting in diaper area irritation. The most common culprits are acidic foods such as tomatoes and oranges. Our third child could not eat anything with tomatoes for a long time - every poop after eating tomatoes would cause a terrible, burning rash that made her cry and suck her breath in sharply because of the pain. I had to lay down the law - absolutely no tomatoes - and by about 15 months, she could eat tomatoes without pain. Pay attention to which foods irritate the baby more, and be especially vigilant about changing them as soon as possible.
Other Common Rashes
IT IS VERY IMPORTANT THAT YOU SEE YOUR PEDIATRICIAN FOR A RASH THAT DOESN'T GO AWAY WITH EXTRA CHANGING AND A BIT OF DIAPER RASH BALM. I am not a doctor and I cannot give you medical advice. Many times when a baby has a rash that won't go away, a pediatrician can easily diagnose it and prescribe a cream that will quickly heal it. These rashes also don't have a lot to do with using cloth diapers, as babies who wear disposables get them, too.
Yeast rash looks like tiny red bumps that may give a sandpaper-like feel. It can come and go and peel as it heals. Older babies may scratch at it when their diaper is off. It often appears in the creases where it is moist, such as under the fold of the belly and in the leg folds. Yeast lives on our skin and inside us, but given a warm, moist environment, it can grow out of control. Your pediatrician can prescribe an antifungal cream for it which will clear it up quickly. There are also over-the-counter creams which will work well. Please ask the doctor for the cheapest solution - this is very common and can be cured with inexpensive and old medicines. It is important that you use the cream for a week after the rash appears to clear up.
Whether you can continue to use your cloth diapers with the medicine depends on the ingredients and how much you are putting on. Please email me the name of the cream and I can tell you if it is cloth-safe. If it is not cloth-safe, you can use fleece liners to protect the diapers and hand-wash the liners separately.
With most yeast infections, a hot wash with 1 cup white vinegar will freshen up the diapers. This is because yeast lives on us all the time and it is impossible to kill it all, nor would you want to. If you have recurrent yeast infections, you may need to treat the diapers a little more harshly, but it is more important to find the physiological cause of the yeast infection rather than fuss over the diapers. Ongoing yeast infections are a health issue, not a laundry issue - something is not right in the body's chemistry.
Bacterial Rash (Impetigo, etc.)
A rash caused by a bacteria will look like round sores that may blister and ulcerate. Please see your pediatrician for diagnosis and a prescription cream. Whether you can continue to use your cloth diapers with the medicine depends on the ingredients and how much you are putting on. Please email me the name of the cream and I can tell you if it is cloth-safe. If it is not cloth-safe, you can use fleece liners to protect the diapers and hand-wash the liners separately.
To treat the diapers, wash them with 1-2 Tablespoons chlorine bleach and rinse well. Do not bleach covers or anything that really isn't coming into contact with the baby, and be aware that too much bleach will lighten cotton. You can really bleach the heck out of microfiber pocket inserts without hurting them, but too much bleach will weaken or destroy PUL.
Rashes Specifically Caused by Cloth Diapering Issues
Fabric Sensitivity or Allergy
Some babies are sensitive to certain fabrics - the most common culprit is suedecloth (for example, the inner fabric of bumGenius 3.0 and 4.0 diapers.) This is not very common - see your pediatrician if you suspect this. Some babies cannot tolerate diapers that "feel wet" like natural fiber diapers, but they are fine with "stay-dry" diapers with polyester inners.
I know everyone thinks that their baby's rash is the detergent's fault, but it actually usually is not. Here are the issues caused by detergents.
- If you are using way too much detergent, and not rinsing it all, it will irritate the baby's skin. Most people need 1 Tablespoon or less of detergent - yes, you read that right. To give you an idea, I wash 40 diapers at a time in a front-loader and only use 1 Tablespoon of cloth diaper detergent.
- If you are using a detergent with enzymes (Tide is the biggest culprit), the enzymes may not rinse out of the fabric. When the baby pees, it reactivates the enzymes and they go to work digesting the proteins in the baby's skin. This will look like a red sunburn all over in the shape of a diaper. Stop using the detergent with enzymes, and strip the diapers really well. (We can use detergents with enzymes on our clothes because they are not wet against our skin, but if we use them on diapers, it is an instant rash.)
- If your detergent has unnecessary additives, these can irritate the baby. These are optical brighteners, fabric softeners, stain guards, and dyes.
- In general, powder detergents are easier to rinse.
Rash Creams and Balms
You cannot use just any diaper cream with cloth diapers. Creams that have zinc oxide mixed with petrolatum (petroleum jelly) will stick in the diapers and be almost impossible to get out in the laundry. If you feel you must use such a cream, use a large fleece liner and handwash the liner with dish detergent, separate from the diaper laundry. We have several cloth-safe rash creams in our store. Also remember to keep the baby's bum smooth and moisturized - that goes a long way, and small amounts of moisturizer won't hurt the diapers. Make sure to choose one that is free of fragrance, dye, etc.