Development of diaper rash in the newborn

Diaper rash is a common infant malady. This study documents the earliest st ages of rash in a cohort of 31 healthy term newborns over the first 28 days of life. The diaper area was evaluated using a standardized diaper rash gr ading scale. The anal, buttock, genital, intertriginous, waistband, and leg areas were assessed separately. At birth the average grade was 0.1 and non e of the infants had specific features of advanced rash. Nineteen percent h ad dryness and/or slight redness, By day 7, 71% of infants had some feature s of skin compromise, giving rise to an overall grade of 0.6, Both the freq uency and overall grade increased during postnatal weeks 2 and 3, Overall s cores for days 21 and 28 were the same (1.1), The perianal area had the hig hest overall regional rash grade, Gender differences were present for the g enital area only, These findings indicate that epidermal barrier breakdown is an uncommon finding at birth, Clinical signs of irritated skin in the di aper area develop progressively over the first postnatal month, A better un derstanding of the mechanisms conferring epidermal barrier protection at bi rth may be important for developing skin care products and practices to ext end this protection later into life.