Many babies, no matter what type of diaper they wear, will get a mild diaper rash at some point. The warm, wet conditions in a diaper, combined with friction and a high-bacteria environment, make diaper rashes fairly common. Changing your baby frequently — every two hours with wet diapers, or as soon as the baby makes a dirty diaper — can help prevent diaper rashes. Most minor diaper rashes will clear up on their own after a day or so with minimal intervention. Adding diaper cream can help prevent rashes or speed up the healing process. Our page on diaper creams gives an overview of which products are safe for cloth diaper use, and how to use liners to prevent stains from non cloth diaper safe creams.
The information below outlines some common and less common causes of diaper rash.
*PLEASE NOTE*, we are not doctors. If your baby has a serious or persistent diaper rash or if your gut is telling you that your baby needs medical attention, please check in with your pediatrician.
Common causes of diaper rashes in cloth diapered babies:
Ammonia/bacteria — An insufficient wash routine can leave behind ammonia and bacteria from feces and urine in the diapers. On our forum, we see this most frequently amongst parents using small amounts of weaker “cloth safe” detergent or homemade detergent, but this can also occur in seemingly solid wash routines. If the diaper rash is caused by the wash routine, the best solution is to do at minimum a bleach soak, or in many cases, a mineral strip followed by a bleach soak. Afterwards, you may need to tweak your wash routine to prevent problems from recurring in the future. You can check out our page on how to wash cloth diapers for more info.
Yeast — Yeast, or candida, is a common cause of persistent diaper rashes. A yeast rash will often show up as small bumps, but can also be solid red and warm to the touch. Yeast can be treated with antifungal creams like Clotrimazole or Nystatin (prescription). A pediatrician can culture the rash to test for yeast. For more information, see our page on dealing with yeast in diapers.
Teething, acidic foods, food allergy, or food sensitivity — It’s common for teething or food to cause diaper rashes. Frequently, these will present as a red patch inside the baby’s bottom, but can also show up where the skin comes in contact with the urine. It can be difficult to pinpoint the cause of food-related diaper rashes, but acidic foods such as oranges are often the culprit.
Less common causes of diaper rashes in cloth diapered babies:
Detergent sensitivity — Detergent sensitivity is not common, but it does occur. Babies may be sensitive to scents, enzymes, or other ingredients of laundry detergents. A rash from detergent sensitivity often shows up immediately. A detergent sensitivity will often present all over the body, although it may appear most serious in the diaper area because of the contact with moisture. Many people use different detergents for baby clothing and diaper laundry, so to test for detergent sensitivity, you can either wash an article of baby clothing in the diaper detergent and see if that causes irritation, or you can switch to a different detergent. A baby might be sensitive to Tide but be fine with another mainstream detergent like Gain. Other babies may require a free and clear product. Detergent such as Charlie’s are known to cause rashes; these rashes may appear suddenly after being used for months or years. For this reason, we don’t recommend their use.
Fabric sensitivity — Some babies are sensitive to certain synthetic fabric such as suede cloth, which is commonly used in pocket diapers. An easy way to check for this sensitivity is to line the diaper with a natural fiber such as cotton, or switch to natural fiber diapers. You can line diapers with fabric from cut up tee shirts, flour sack towels, etc.
Wetness sensitivity — Some babies are sensitive to contact with moisture. If you’re using natural fiber diapers such as prefolds, try lining the diaper with a rectangle of fleece. This will keep the baby feeling dry.
Wipes sensitivity — Though uncommon, some babies are highly allergic to the ingredients in disposable wipes. Try using cloth wipes, such as baby wash cloths, moistened with water or with a solution of water, coconut or olive oil, and baby soap.
Other dermatological conditions — There are several other rare conditions that can cause rashes in the diaper area. If you suspect this is the case, make an appointment with your pediatrician or pediatric dermatologist.