Q: Good Evening Doc, Pls am a bit worried. My daughter of a week and six days is having rashes on her vagina wall. I don’t know if is the diaper that caused it. Please assist on what to do.

A: Congratulations on your new baby and don’t worry, motherhood just looks/feels harder than it really is. In a few months now, you’ll be dispensing motherly advice to other new mums 😀

Diaper rashes are common in babies and they could happen on the butt or anywhere around the area including the lips of the vagina as you have observed. The causes include
• Prolonged contact with urine or stool
• Diapers that are too tight
• Harsh detergents, soaps
• Baby wipes.
• Sensitivity

Prevention essentially focuses on the causes. So,
• Change your baby’s diaper as soon as you realize it’s wet or soiled
• Be sure to buy the right size of diapers and avoid harsh soaps and detergents.
• Keep baby’s butt open to air dry as long as practicable 😀 I hear some of you mums groaning…I know, you’re taking a huge fat risk that he or she will do their business while you’re trying to air dry them 😀
• Ensure that baby’s butt is dry before closing up the diaper after a change
• Pat baby’s butt dry especially if he/she already has a diaper rash to prevent irritation
• Always have a diaper rash cream handy. Creams that contain zinc like Sudocrem or Desitin are good examples. I used the latter for my babies and it always worked like a charm.
Diaper rash that does not ‘sneak’ away after a couple of days (about a week) may be due to a yeast (candida) infection. And before you raise your eyebrows, yes this can in babies and may be due to yeast overgrowth in babies taking antibiotics or breastfeeding babies whose mothers are on antibiotics, poor hygiene when cleaning baby up after a poo (such that baby is cleaned from the back to the front), the moist and warm environment provided by unchanged diapers etc These rashes are usually well defined with raised borders.

If the rashes develop some pus like fluid, then this is the sign of a bacterial infection (impetigo) and needs to be treated with antibiotics.

So rule of thumb is change your baby often to prevent prolonged contact with poo or urine and keep the area clean. Use barrier (nappy rash cream) at the first sign of a rash and if this does not improve after a few days, she should be ideally seen by her doctor to confirm whether this is a fungal infection. Note that other rare causes of rashes are eczema, psoriasis etc

In the case above, I assume that you had used a barrier cream initially (or maybe not) before using the antifungal cream. Since the rashes are not getting any better, please take your baby to see her paediatrician.

For more on diaper-related issues, please click on the links below:
https://chatwithdrketch.com/2014/06/30/daily-health-tips-my-baby-is-having-a-reaction-to-her-diapers/
https://chatwithdrketch.com/2014/01/07/daily-health-tips-more-diaper-tips/
https://chatwithdrketch.com/2014/01/03/daily-health-tips-diaper-bag-essentials/
https://chatwithdrketch.com/2013/12/19/daily-health-tips-diapering-your-baby/

Have a good night, y’all 😀