Nappy rash fungal infection (candidal nappy rash)

Which child hasn't had a bout of red bottom at some point? This common irritation, known as nappy rash, is caused by prolonged contact with soiled nappies. It is generally easy to treat with a suitable cream and a few basic hygiene measures. However, it shouldn't be taken lightly. If not treated promptly, the affected skin can become infected with a fungus — this is known as candidal nappy rash.

What is candidal nappy rash?

Candidal nappy rash, also called candidosis, is a common fungal condition that affects babies. Very common in the first months of life, it mainly affects the skin folds but can spread across the entire nappy area, with the appearance of small pustules.

Nappy rash or fungal skin infection?

Candidal nappy rash should be distinguished from ordinary nappy rash. It is a complication of nappy rash, caused by fungi present in the intestinal flora.

The skin becomes an even brighter red, pustules appear, and a whitish coating covers the infected area. Candidal nappy rash is also often accompanied by oral thrush (which is the same fungal infection affecting the mouth).

Whilst ordinary nappy rash can be treated easily with creams and hygiene measures, candidal nappy rash requires appropriate antifungal treatment.

How is candidal nappy rash treated?

If your child's redness persists, you should consult your paediatrician.

The creams used to treat ordinary nappy rash are ineffective against fungal infections. If your child has candidosis, your paediatrician will prescribe an antifungal cream to be applied for around a fortnight.

In addition to applying the treatment, it is recommended to change baby's nappy more frequently, to let their bottom air as much as possible, and to dry them very carefully after bath time.

Candidal nappy rash is highly contagious. It is therefore important to disinfect any linen that may come into contact with your child's nappy area, such as the cover of their changing mat, as well as flannels and towels.

If you are breastfeeding, the candidosis may also affect your breasts — known as mammary candidosis. It is therefore recommended to treat the mother as well if the baby has oral thrush, to prevent the risk of reinfection.

What causes candidal nappy rash?

Nappy rash due to dampness and heat is the most common cause of candidal nappy rash. The combination of warmth and moisture is particularly conducive to the growth of fungi.

The acidity of stools — especially when the child has diarrhoea — is also a frequent cause of nappy area irritation, as is the ammonia found in urine.

However, other factors can also contribute to fungal infections, including antibiotic treatments, clothing that is too tight, synthetic fabrics, poor hygiene, the use of occlusive greasy products such as liniment, irritating skincare products, or inflammatory conditions such as psoriasis.

All these factors can cause nappy rash, and by extension, fungal infections.

How to prevent your baby from getting a fungal skin infection?

To prevent fungal skin infections in babies, it is very important to prevent nappy rash in the first place and to treat it quickly when it does occur. Changing nappies regularly is therefore essential. If your child is awake, they should be changed as soon as you notice they have urinated — nappies should contain no more than one wetting.

If you use liniment, we recommend first cleaning your baby's skin with a gentle cleansing product. When your child has redness, it is best not to use liniment at all.

A few simple hygiene measures also help reduce the risk of fungal infections. Make sure you wash your hands thoroughly, especially after nappy changes. Your baby's finger and toenails should be filed or cut short to prevent scratching. Finally, wash your child's hooded towel regularly, as well as their changing mat cover, at 60°C.

Candidal nappy rash and Pocket diapers

As the temperature inside a Pocket diaper is generally lower than inside a disposable diaper, the risk of fungal infection is reduced when using Pocket diapers. Natural fabrics also help limit the proliferation of fungi — bamboo viscose in particular has antifungal properties.

That said, fungal infections can still occur even when using Pocket diapers.

What should I do if my baby using Pocket diapers gets a fungal infection?

The first thing to do is to switch to disposable diapers for the duration of the antifungal treatment. Use this time to disinfect all the Pocket diapers.

When a child has a fungal infection, the fungus will infect their reusable diapers. If the diapers are not disinfected, they risk reinfecting your baby.

To disinfect your diapers, simply wash the diapers and inserts at 60°C with a textile disinfectant such as Sanytol.

Please note: Although bicarbonate of soda has fungiostatic properties, it is not a fungicide, so it will not be effective at disinfecting your Pocket diapers. At best, it will limit fungal growth, but will not eliminate it entirely.

How to prevent fungal infections when using Pocket diapers?

As with babies in disposable diapers, the aim is to minimise the risk of nappy rash.

First and foremost, change your child regularly, as soon as they have urinated.

If your child is prone to nappy rash, we recommend never placing microfibre directly against your baby's bottom. Microfibre can be irritating for babies with very sensitive skin. Using inserts in natural materials, such as bamboo or cotton, is preferable as they reduce maceration. Much softer against the skin, they are also more breathable and absorbent. Bamboo viscose also has antifungal properties.

Pocket diapers with a microfleece lining help reduce the feeling of dampness. We therefore recommend opting for Pocket diapers or all-in-one diapers if your child is prone to nappy rash.

If you use Cover diapers, you can also add washable liner covers, particularly at night, to reduce the feeling of dampness.