When baby goes red in the buttocks

By Dr. Sharmila Samaranayake

Nappy rash is a red rash or a sore area that affects the skin under or around a baby’s nappy (diaper). Most babies get nappy rash at sometime.

The main cause of nappy rash is wetness. The chemical ammonia in urine irritates baby’s skin causing the rash. Sometimes on top of it infections like Candida which is a fungus or bacteria can set in to make the condition worse.

The skin being wet along with the chemical irritation of ammonia, produced by stale urine has the effect of breaking down the protective barrier normally formed by the skin, causing redness and rawness (inflammation) and allowing germs of various types to attack.

The longer the wet or soiled nappies are left in contact with the baby’s skin, the more likely it is that nappy rash will develop. Some babies’ skin is more sensitive than others and they tend to develop diaper dermatitis earlier.

Symptoms and signs

The early signs can be a little redness, but the area can become very sore and red, with red spots, blisters and sometimes broken skin. The baby may become irritable and cry.


The most common infection to complicate the ammonia-like irritation is thrush (Candida). Here, the rash often has clusters or red spots around the margins of the main red area. Other germs (bacteria) can also infect the area.


When possible, leave the baby without a nappy, allowing air to get to the skin. Use a barrier cream at nappy changes. Some barrier creams have antiseptic properties, which can help to deal with any germs.

Visit the nearest hospital or a qualified medical practitioner who will prescribe a cream for the dermatitis especially if the rash is not settling after a few days, or the area is very raw and the skin broken.


Change nappies when wet or soiled. Modern disposable nappies (pampers) are better at keeping the fluid away from the skin, but in Sri Lanka’s warm and humid climate it is better to use nappies which are made from bandage cloth which absorb the urine well.

If the nappy is soiled with baby’s stool use the nappy to wipe most of it, and then wash with warm water using cotton wool. Baby wipes can be used alternatively if needed. Keep your baby clean and dry. If soap is used make sure you carefully rinse it off because it can overdry the baby’s skin and cause irritation.

After removing a wet nappy allow baby to lie without a nappy for sometime whenever possible to allow the baby’s skin to get some fresh air. Sometimes baby’s skin may become sensitive to soap, fabric conditioners or detergents so make sure nappies are washed and rinsed well.

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