Nappy rash in a 2-week-old baby

Moisture, contact with urine or stool, rubbing, fragranced wipes and soap can inflame newborn skin. Irritant nappy rash often affects the areas touching the nappy while sparing deeper skin folds.

A bright rash involving the folds, sometimes with separate small spots around its edge, can be a presentation of yeast infection. Blisters, open sores, pus, rapidly spreading redness or crusting can point to another problem and need examination rather than trial-and-error treatment.

Change every wet or soiled nappy promptly. Clean from front to back with lukewarm water and soft cotton or a fragrance-free, alcohol-free wipe, then pat dry. Allow brief nappy-free time in a warm, safe room and fasten the fresh nappy without tight rubbing.

A thin barrier ointment suitable for newborns can separate skin from moisture; a pharmacist, midwife or clinician can help select one. Avoid talcum powder, antiseptics, essential oils, perfumed products and vigorous wiping. Do not start an antifungal or steroid preparation unless a professional has identified the likely cause and advised its use.

Contact a clinician promptly if the rash is worsening, spreading, very painful, blistered, bleeding, weeping or crusted, or if it does not begin to settle with gentle care. Seek urgent assessment if this newborn feels hot or cold, feeds less, has fewer wet nappies, is difficult to wake, breathes unusually, or seems unwell in any way.

Tell the clinician whether the folds are affected, when the rash began, which products touch the area, how feeding has changed and whether urine or stools seem different. Ask if the appearance is irritant, fungal or bacterial and request exact instructions for any prescribed cream.