Diaper Dermatitis in Preemies

July 13, 2020
diaper dermatitis, diaper change in the NICU

One of the most common skin disorders for infants is diaper dermatitis, normally referred to as diaper rash. NICU babies are even more at risk for this condition since their skin is often not fully developed at the time of birth. It’s a condition to take seriously since it can lead to increased medical costs for caregivers, risk for infection, and distress for NICU babies.

We spoke with Dr. Media Esser, a neonatal nurse practitioner in Milwaukee, WI, about diaper dermatitis, how NICUs practice prevention, and how parents can get involved in the diaper-changing process as a way of taking charge of their baby’s care, making the transition to home much smoother.

Learn more on NICU Now Episode 29: Preemies and Diaper Dermatitis

What is diaper dermatitis?

In short, diaper dermatitis is another term for diaper rash. It’s an irritation of the skin resulting from contact with certain substances, most often urine and feces. The inflammation is the skin’s response to a change in pH levels within the diapered areas. “When we change the pH of the skin, it makes it more susceptible to injury,” says Esser. Despite the fact that we have very absorbent diapers, the diaper area is still relatively closed-off, humid, and hydrated, creating the environment for irritation.

For NICU babies, anything that breaks the skin could be an opportunity for bacteria to enter and cause an infection.

How do you treat or prevent diaper dermatitis?

Many NICUs will practice prevention by applying some sort of clear ointment, such as petroleum jelly on the bottom. This prevents sticky meconium from sticking in the first days after birth. Once the baby starts having regular stools , if any redness appears, Esser suggests moving to something a little stronger, such as a zinc product (products may vary from NICU to NICU).

What can parents do?

Esser recommends that parents get involved in every diaper change they can to help promote practices that may aid in the prevention of diaper dermatitis. “A diaper change is something parents can totally own in the NICU,” she says.

Listen to NICU Now Episode 29: Preemies and Diaper Dermatitis to learn more from guest Media Esser about her research on skin care in the NICU, how NICUs work to prevent diaper dermatitis, and how parents can own the diaper-changing process.