When baby has a rash

The doctor looks up from examining your baby and tells you solemnly, “Your baby has transient neonatal pustular melanosis.”

You stop breathing. You’d been worried the blistery rash was chicken pox — a serious thing in a tiny new baby. But this! It sounds terrifying. Then your doctor smiles. “It’s one of the more common newborn rashes. Not pretty, but harmless. It will get better on its own.”

It’s not surprising that the delicacy that makes infant skin so soft also makes it prone to all kinds of rashes. Here are some of the most common baby skin worries:

Newborn

There are a few rashes that most often appear in the early days of baby’s life, says paediatrician Henry Ukpeh, of Trail, BC.

Transient neonatal pustular melanosis, as previously mentioned, consists of little raised blisters that peel open to reveal a small “freckle” inside. The blisters last only a few days, but the freckles can take up to three months to fade away.

Erythema toxicum is a more common newborn rash, usually appearing in the first two weeks of life. It’s a splotchy red rash, sometimes with yellow or white bumps in the middle of the red flares that come and go over the baby’s body. Again, it will clear up within a couple of weeks.

Milia is a scattering of pearly white bumps that look like tiny whiteheads. Milia primarily appears on the nose, chin, cheeks and forehead, and up to 50 percent of newborns have it. While it usually clears up within a few weeks, it can take up to three months to go away. Other common rashes can appear in older babies, says Janet Stosky, a clinical educator for Postpartum Community Services with Calgary Health Region.

Diaper rash is the best-known baby skin condition, and few parents have any trouble identifying it. While it often clears up easily, Stosky adds that a severe diaper rash lasting longer than 48 hours, or one that has a burn-like or blistered appearance, could be a yeast infection or other infection that requires prescription medication. If those symptoms are present, make an appointment to see your baby’s doctor.

Baby acne is a harmless rash that can nevertheless be upsetting to parents when it strikes on photo day, says Ukpeh. Baby acne appears around four to six weeks postpartum, says Stosky. It may look like acne — but don’t put Clearasil on it! The rash will clear up on its own, though Ukpeh says he sometimes prescribes a cream to speed the process along if it’s really bothersome.

Cradle cap is not exactly a rash, but close enough. Those thick, flaky scales on your baby’s scalp and maybe eyebrows aren’t harmful, says Stosky, but they aren’t nice either. To treat, gently massage a small amount of olive oil into the baby’s scalp and allow it to soak for several hours. Then gently rub with a very soft toothbrush, brush the scalp with a baby hairbrush, and then wash with a mild shampoo. But don’t overdo the shampooing, cautions Stosky: “You’re more likely to see cradle crap if you shampoo every day.”

Contact dermatitis is one rash you can do something about. Because a baby’s skin is so sensitive, fragrances or other ingredients in laundry products may cause a reaction. Typically the rash is worse in places where clothing presses on the skin — for example, on the baby’s back after a nap or where cuffs are snug around wrists and ankles. To prevent this rash, suggests Stosky, switch to non-perfumed laundry and bath products and add half a cup of vinegar to the laundry rinse water.

While many baby rashes are harmless or easily treated at home, Ukpeh cautions that others, such as impetigo and yeast, require medical treatment; still others are symptoms of infectious diseases like rubella, herpes or chicken pox. So you should never feel hesitant about having a rash checked out. If your baby has any symptoms of illness along with the rash, such as fever, irritability or lethargy, or if a rash persists longer than two or three days, see the doctor.

Diaper rash drill

Nearly every parent encounters diaper rash at least once. Here’s the basic home treatment, from health educator Janet Stosky:

• Change diapers often. • Avoid perfumed wipes, soaps and fabric softeners. • Expose the diaper area to air for 10 to 15 minutes, three or four times a day. • After diaper changes, dry the skin well and then apply a thin layer of diaper cream containing zinc oxide. • For recurrent rashes, try changing diaper brands (if using disposables).