Rashes

By Sr Teresa Hayward (RN, RM, Lactation consultant, Infant & Paediatric Nutritionist, Baby Sleep Consultant)

It's normal for babies to develop rashes from as early as a few days old, as their sensitive skin adapts to a different environment. Most rashes are harmless and go away on their own.

But if your baby has developed a rash and seems unwell, or if you're worried, see your Paediatrician to find out the cause and receive any necessary treatment.

Baby acne (neonatal acne)

Pimples sometimes develop on a baby's cheeks, nose and forehead within a month of their birth.

These tend to get worse before clearing up completely after a few weeks or months.

Pimples or blackheads that develop after three months of age (infantile acne) tend to be more severe and often need medical treatment.

Cradle cap

Cradle Cap is where yellowish, greasy, scaly patches develop on a baby's scalp.

Occasionally, the face, ears and neck are also affected.

Cradle cap isn't itchy and shouldn't bother your baby. If your baby is scratching or upset, they may have eczema (see below).

Cradle cap is a common condition that tends to develop within two or three months after birth. It usually gets better without treatment in a few weeks or months.

Gently washing your baby's hair and scalp with baby shampoo may help to prevent further patches developing.

Eczema

Eczema is a long-term condition that causes the skin to become itchy, red, dry and cracked.

The most common form is atopic eczema, which mainly affects babies and children but can continue into adulthood.

Eczema in babies under six months is sometimes associated with allergies to milk and egg.

Atopic eczema often starts in young babies as a red, itchy rash on the face, scalp and body. As the child gets older, it usually starts to develop in areas with folds of skin, such as behind the knees or on the front of the elbows.

Creams and ointments can often relieve the symptoms.

Erythema toxicum

Half of all newborns develop a blotchy red skin reaction called erythema toxicum, usually at two or three days old.

It's a normal newborn rash that won't bother your baby and clears after a few days.

Hand, foot and mouth disease

Hand, foot and mouth disease is a common, viral illness that causes a blistery rash on the palms of the hands and soles of the feet, as well as ulcers in the mouth.

Your baby may also feel unwell and have a fever.

Treatment isn't usually needed, as the baby's immune system clears the virus, and symptoms go away after about 7 to 10 days. If you're worried, see your paediatrician, especially if baby is struggling to drink.

Hand, foot and mouth is contagious so baby needs to be isolated from other children. It is contagious for 5 days from start of symptoms

Hives (urticaria)

Hives (also known as urticaria) is a raised, red itchy rash that appears on the skin.

It happens when a trigger (such as a food that your baby is allergic to) causes a substance called histamine to be released into their skin.

If your baby gets urticaria during feeding, the condition may be triggered by something they've had to eat or drink. The most common foods are egg and milk, but many other foods can sometimes be the cause.

The urticaria rash is usually short-lived and can be controlled with antihistamines.

Childhood illnesses

· Chicken pox

Where it appears: Often on the scalp, face, or torso first, then spreading to the entire body.

What it looks like: Small red bumps at first, which quickly become clear, fluid-filled blisters on a pink base; these eventually become dry brown crusts or scabs. New waves of itchy blisters often emerge as the illness progresses. Children usually get between 250 and 500 blisters, although it's possible to have just a few, especially if the child has had the chicken pox vaccine. Child may have a slight fever. Uncommon before the first birthday.

Chicken pox is very contagious.

· Measles

Where it appears: Throughout entire body.

What it looks like: Red bumps with tiny white dots on the inside of cheeks a few days after a fever and runny eyes and nose. Next, a rash appears on the face and progresses down the back and torso to the arms and hands, and finally to the legs and feet. The rash starts as flat red patches but eventually develops bumps and may be itchy. Lasts about five days then fades to a brownish color, leaving skin dry and flaky. Rare due to vaccinations; most likely to occur in unvaccinated children.

Measles is very contagious.

· Roseola (Baby measles)

Where it appears: On the torso and neck; may spread to arms, legs, and face.

What it looks like: A pink rash on torso and neck usually following three to five days of a sudden, relatively high fever that's often greater than 103 degrees Fahrenheit. May spread to the arms, legs, and face. Child may be irritable and have diarrhea or vomiting. Most common in children between 6 months and 3 years old.

Roseola is contagious.

· Rubella (German measles)

Where it appears: Starts on the face; spreads all over the body.

What it looks like: Pink-red rash lasting two to three days; may accompany a mild fever, swollen lymph nodes behind the ears, runny or stuffy nose, headache, and sore throat. Rare due to vaccinations; most likely to occur in unvaccinated children.

Rubella is contagious.

Sweat rash/heat rash

A heat rash, sometimes called miliaria, may flare up when your baby sweats – for example, because they're dressed in too many clothes or the environment is hot and humid.

It's a sign your baby's sweat glands have become blocked. They may develop tiny red bumps or blisters on their skin, but these will soon clear without treatment.

A good rule of thumb with rashes is, if no other symptoms other than a rash then it is generally a Heat rash.

Babies can also get this rash about 48hrs after having a fever, due their body overheating during the fever.

With any rash, when in doubt, rather isolate baby until you have been able to chat to a Health professional