Skin Conditions. Illness and Infections. Vaccinations. Nappy Rash.

Vaccinations

Cloth nappies can be used during and after vaccinations, without the need for any specific laundering or treatment.

The oral rotavirus vaccine is live and a small amount may be excreted in poo. Thorough hand washing is the only precaution needed to prevent accidental cross-contamination. People with immune conditions should be extra diligent with hand washing, consult your medical professional for more advice.

Hand, foot and mouth disease

Hand, foot and mouth disease is a viral illness. There is no need to sanitise nappies, and cloth nappies can be used during the illness. Change nappies frequently use a zinc-based rash cream to prevent irritation to blisters and alleviate discomfort.

If sores worsen seek medical advice from a GP, as secondary bacterial/fungal infections can occur.[5]

Acidic Urine and Alkaline Degradation

Some members of the cloth community attribute nappy insert degradation to ‘acidic urine’. The pH of a healthy person’s urine ranges from 6.5 to 8.0 – neither acidic nor alkaline. Degradation is far more likely to be from other causes, specifically the development of ammonia in the fabrics, physical damage or the age of the fabrics.

Although acidic urine is completely possible due to medical conditions (as is alkaline urine) it is rare.

Urine is nitrogen-rich as it contains urea CO(NH2)2. The urea cycle produces urea from ammonia NH3 in the body, catalysed by enzymes. Once urine leaves the body, even without the enzyme urease as a catalyst (which is found in a variety of things including bacteria), it will rearrange to form ammonia and carbon dioxide, it will just take longer. The pH of the environment becomes alkaline because ammonia is alkaline.

CO(NH2)2 urea + H2O water + urease = 2NH3 ammonia + CO2 carbon dioxide ((+H3)

With repeat exposure ammonia is highly irritating to the skin, it will cause redness in the nappy area and is corrosive to fabrics.

Nappy Rash

Nappy rash can be caused by a combination of the following;

  • prolonged exposure to moisture
  • friction
  • bacteria
  • yeast
  • ammonia
  • enzymes from poo
  • reactions to disposable wipes (for example an allergic reaction to the preservative Methylisothiazolinone)[4]
  • detergent (in the majority of cases all areas of skin in contact with clothing will have a rash)

See your GP for a diagnosis. If the rash is a fungal infection the nappies will need to be sanitised.

Stains, smells, a smelly dry pail, and ammonia in night nappies indicate that the nappies are not being cleaned thoroughly. Ask for troubleshooting help if you experience any of these issues.

Treating nappy rash

  • Wash nappies with a good detergent and warm/ hot water.
  • Use a zinc based nappy rash cream at each nappy change
  • Change nappies regularly
  • See your GP again if the rash persists

Fungal Infections

Often fungal nappy rashes are secondary infections that follow an initial rash. If your child has been diagnosed with a fungal nappy rash infection you will need to sanitise all cloth nappies, wipes and other fabrics (e.g. towels) that can recontaminate the area. Fungal infections are often caused by the Candida species.

Either use disposables for the duration of the rash or add chlorine bleach to each main wash.

Ensure that the treatment cream is an over-the-counter product specifically for fungal infections. Either dispose of any opened creams that might recontaminate, or wipe the cream off the contaminated area.

Oral thrush infections can be passed back and forth between a breastfeeding mother and baby. If this occurs sanitise bras, nursing pads, towels and sleepwear if needed. There is no need to sanitise nappies if only oral thrush is present in children.

References and further reading

  1. Donald V Belsito, Anthony F Fransway, Joseph F Fowler Jr, Elizabeth F Sherertz, Howard I Maibach, James G Mark Jr, C G Toby Mathias, Robert L Rietschel, Frances J Storrs, James R Nethercott, Allergic contact dermatitis to detergents: a multicenter study to assess prevalence (May 25, 2021) <https://pubmed.ncbi.nlm.nih.gov/11807430/>.
  2. D.A. Basketter; J.S.C. English; S.H. Wakelin; I.R. White, Enzymes, Detergents and Skin: Facts and Fantasies (May 25, 2021) <http://www.medscape.com/viewarticle/575890>.
  3. National Eczema Association, Eczema and Bathing (May 25, 2021) <https://nationaleczema.org/eczema/treatment/bathing/>.
  4. Dr Lynne Gordon, Dermatologist, Adelaide, South Australia; Chief Editor: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, 31 January 2016, Methylisothiazolinone allergy (May 25, 2021) <https://dermnetnz.org/topics/methylisothiazolinone-allergy/>.
  5. Government of South Australia, Hand, foot and mouth disease - including symptoms, treatment and prevention (May 25, 2021) <https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/hand+foot+and+mouth+disease/hand+foot+and+mouth+disease+-+including+symptoms+treatment+and+prevention>.