What should you know about bad nappy rash from diarrhea?

Loose stool spreads widely under a nappy and contains substances that irritate skin. Frequent bowel movements also lead to repeated wiping, adding friction before the barrier has time to recover. Redness may therefore appear around the anus and buttocks, then extend across areas in direct contact with the nappy.

A persistent moist environment can also allow yeast to overgrow. Redness within the creases and separate small red spots around the main rash can fit that pattern, although a clinician should assess uncertain or severe changes.

Change the nappy as soon as possible after each stool. Use lukewarm water from a squeeze bottle or a very soft wet cloth to lift residue with minimal rubbing, then pat dry. Cover all exposed red skin with a thick fragrance-free barrier ointment. At the next change, remove stool and loose ointment gently, leaving clean barrier in place where possible.

Offer the child's usual milk or fluids according to age and existing medical advice. Avoid anti-diarrhoeal medicines unless a clinician specifically recommends them for that child. Wash hands carefully after changes to reduce spread of infections that may be causing diarrhoea.

Seek medical advice when diarrhoea is persistent, the rash is severe or broken, or the child is not improving with careful skin protection. Urgent assessment is needed for unusual drowsiness, markedly fewer wet nappies, a dry mouth, poor drinking, repeated vomiting, blood in the stool, fever with an unwell appearance, spreading redness, blisters or pus. These signs may reflect dehydration, significant infection or a complication of damaged skin.

Ask whether the child shows dehydration, whether feeding or fluids should change, and whether the rash looks purely irritant or has signs of yeast or bacteria. Confirm which barrier is suitable, whether topical antifungal treatment is needed, and which stool or skin changes should trigger reassessment.