Diaper dermatitis--an overview

Traditional practices in the treatment of children with diaper dermatitis

AIM

Traditions are cultural heritages, habits, knowledge, customs and behaviors that are passed from generation to generation and from society to society. In all societies, children are seen as the future of society. Knowledge from traditions is used in raising children. Traditional practices are often used for children in cases such as breastfeeding, salting, diaper rash, diarrhea and jaundice. The aim of this study is to determine traditional practices used in the treatment of children with diaper dermatitis.

MATERIALS AND METHODS

The research was conducted descriptively between June and August 2023. 81 children with diaper dermatitis were included in the sample. In the study conducted in a single stage, data were collected with a personal information form and Assessing the Severity of Uncomplicated Diaper Dermatitis in Infants Scale.

RESULTS

The age of the children was 16.12 ± 0.97 months and the average score of the Assessing the Severity of Uncomplicated Diaper Dermatitis in Infants Scale was 2.55 ± 0.14. It was determined that approximately half of the mothers received training on diaper dermatitis. It was determined that during diaper dermatitis, mothers used barrier cream containing zinc oxide at most 38.3% as a modern method, and olive oil at most 35.8% as a traditional method.

CONCLUSION

It was determined that traditional methods that do not harm health are generally used in children with diaper dermatitis. It is important to inform mothers and healthcare professionals about traditional practices for children and to support practices that do not negatively affect health.

End-of-life management of single-use baby diapers: Analysis of technical, health and environment aspects

Single-use baby diapers belongs to an important group of products used in the parenting journey because of their high performance and convenience. Single-use baby diapers are normally thrown away after one-time use, resulting in a waste management problem. The goal of this paper was to better understand main environmental concerns of different types of diapers and address how to reduce them, with a special consideration of waste management strategies and user behaviour practices. Furthermore, health and environmental hazards potentially associated with materials included in diapers, or substances formed from diapers during the waste treatment stage, are also analysed (e.g., phthalates, pesticides, dioxins, pesticides). Three main types of baby diapers have been analysed: single-use baby diapers, reusable baby diapers, and biodegradable single-use diapers. Each type of diaper comes with technical characteristics and environmental concerns and challenges, which are discussed in this paper to support the development of measures for the safe(r) and sustainable design, use and end of life management of baby diapers.

Diaper Dermatitis: Prevalence and Associated Factors in 2 University Daycare Centers

Purpose: Diaper dermatitis is uncommon in children older than 2 years because the majority of these children are diaper independent. However, diaper dermatitis still occurs, especially in children in daycare settings. This study attempted to determine the prevalence of diaper dermatitis and its associated factors among children aged 2 to 4 years attending daycare centers. Cross-sectional analysis and tests for correlation were conducted to determine the factors associated with diaper dermatitis among the study population. Results: The prevalence of diaper dermatitis during the study period was 17.2%. Factors significantly correlated with the occurrence of diaper dermatitis were beginning toilet training later than 2 years of age (odds ratio [OR] = 2.84, 95% CI = 1.17-6.86, P = .02) and the use of oral antibiotics (OR = 15.92, 95%CI = 3.57-70.94, P < .001). Conclusion: Two major adjustable factors for preventing diaper dermatitis in the study population were toilet training before 2 years of age and avoiding the use of unnecessary oral antibiotics. These results may help in devising a preventive protocol for diaper dermatitis among this age group in the future.

The evolution of wetness perception: A comparison of arachnid, insect and human models

Hygroreceptors are a type of humidity sensor that have been identified in several invertebrate classes including Insecta and Arachnida. While their structure has been well researched, the nature of the mechanisms behind their function is debated as being either mechanical, evaporative, or psychrometric in insects and potentially also olfactory in arachnids. There is evidence that can be used to support or oppose each of these concepts, which also invites the possibility of multiple unified mechanisms occurring together. The integration of multiple sensory modalities has also formed the foundation of wetness perception in humans, led by thermal and tactile cues with supplementary information from vision and sound. These inputs are integrated by a vast neural network in the brain, which also occurs on a smaller scale in insects and arachnids. It is possible that as cerebral capacity increased throughout human evolution, this facilitated a preferable system of wetness perception via multisensory integration and rendered hygroreceptors obsolete. While this cerebral development hypothesis is only speculative, it gives a framework for further investigation. Additional research needs to be conducted to correctly classify hygroreceptor types in invertebrates and their relative prevalence before evolutionary associations can be made with vertebrate species. This integratory premise also applies to the human system, as knowing the relative contribution and compounding effects of each sensory modality on wetness perception will aid the overall understanding of the system and help to uncover the evolutionary development pathways underpinning each sense.

Diaper dermatitis: a survey of risk factors in Thai children aged under 24 months

BACKGROUND

To identify the prevalence and risk factors associated with diaper dermatitis in Thai children aged 1-24 months.

METHODS

This was a cross-sectional study of 1153 participants using structural questionnaires, which was conducted at Khon Kaen University Faculty of Medicine Pediatric department in Thailand. Univariate and multivariate logistic regression analyses were used to test the association between diaper dermatitis and its possible risk factors.

RESULTS

The prevalence of diaper dermatitis among the study population was 36.1%, a rate which significantly decreased with age. The highest prevalence was found in subjects who were one to six months old. Risk factors that had a statistically significant association with diaper dermatitis in both univariate and multivariate analysis were i) diaper changing fewer than three times/night, ii) previous episodes of diaper rash, iii) using cloth diapers, and iv) topical application of baby talcum powder to the diaper area.

CONCLUSIONS

Frequent diaper changings during the daytime do not compensate for fewer changings during the night. Moreover, the use of baby talcum powder on the diaper area significantly increased the risk of diaper dermatitis among the study population. These findings should be applied in future preventive strategies for diaper dermatitis in this age group.

Skin Health Connected to the Use of Absorbent Hygiene Products: A Review

Over the past 50 years, absorbent hygiene products such as baby diapers and incontinence products have become essential features of modern day life. Through innovation and enhanced technology, their design, composition and performance have been dramatically upgraded from their early forms, and they have transformed the lives of millions of people, improving their quality of life. Skin health related to the use of absorbent hygiene products has accordingly also greatly improved. Still, the wearing of absorbent hygiene products will affect the skin, and for some users the changes in microclimate, mechanical interactions and the exposure to urine and faeces may result in irritant contact dermatitis, i.e. diaper dermatitis (DD) or incontinence-associated dermatitis (IAD). Babies with developing skin and the elderly with deteriorating skin functions who are the most frequent users of absorbent hygiene products are more vulnerable to the causal factors. Although irritant reactions are the most common, allergic contact dermatitis should be considered if a DD/IAD fails to improve by recommended actions. There is also a connection between IAD and pressure ulcer development of which it is important to be aware. A holistic approach of using high-quality absorbent hygiene products in combination with appropriate skin care will help maintaining good skin health.

Diaper Dermatitis in Infants Admitted to Social Pediatrics Health Center: Role of Socio-demographic Factors and Infant Care

OBJECTIVE

To determine infant diaper dermatitis (DD) at pediatrics health center; its relation to socio-demographic factors and infant care.

METHODS

The study included 113 infants aged 0-24 mo. Data on infants' age, sex, weight, mothers' education, nutrition, diaper change frequency, cleaning methods and prophylactic cream use were recorded. Infants with minimum one time rash, were accepted to have DD.

RESULTS

Seventy six (67.3 %) infants had DD [32 girls (42.1 %), 44 boys (57 %), mean age: 6.5 mo]. Infants with DD had significantly higher age than those without (p 0.001). DD frequency in infants ≥4.5 mo-old was 5.8(2.4-13.7) times more than in infants ≤4.5 mo. Cleaning material types did not affect DD frequency. No significant difference was observed in DD with diaper change of ≤3 times and ≥4 times. Significant difference in DD increase was observed with supplementary food intake vs. without it (p 0.000). DD frequency in infants with supplementary food intake was 6.4 times (2.4-17.1) more than in those without it. Human milk intake was statistically significant in causing less occurrence of DD as shown in univariate model (p < 0.05). Rash incidence was significantly lower with cream use compared to without its use (p < 0.001). DD prevalence was decreased 0.203 (0.087-0.477) times by cream usage.

CONCLUSIONS

Age, supplementary food intake and lack of cream use seem to be accountable for DD whereas human milk intake lessened the occurrence of DD. Mothers should be informed on dermatitis care and encouraged for breastfeeding.

Guaiazulene: a new treatment option for recalcitrant diaper dermatitis in NICU patients

AIM

Based on a maternal observation, we aimed to evaluate the treatment effectiveness of guaiazulene (GA) containing local pomade in the high-risk neonates with recalcitrant diaper dermatitis (RDD).

METHODS

We included 30 NICU patients of RDD, with level II-III aged between 22 and 67 days. Study group patients (n = 20) were treated with GA containing local pomade (0.05 g/100 g). Control group consisted of patients who had extended antifungal treatment. A visual scale was used to assess the response to treatment at the end of a week. Scoring was done at the beginning of the treatment, on the first, third and seventh days.

RESULTS

Statistically significant differences in visual scores were determined between the two groups at the initial and following days of the treatment. In study group, improvements at the first and third days of the treatment were better than those of control group. Additionally, complete recovery rate in study group was better than that in controls.

CONCLUSION

Having beneficial but no adverse effects, GA containing local pomade provided rapid recovery in risky neonates with RDD, who required rapid improvement.

Diaper dermatitis: a review and brief survey of eruptions of the diaper area

Eruptions in the diaper area are the most common dermatologic problem in infancy. Such eruptions can be subdivided into primary diaper dermatitis, an acute inflammation of the skin in the diaper area with an ill-defined and multifactorial etiology, and secondary diaper dermatitis, a term which encompasses eruptions in the diaper area with defined etiologies. The most important factors in the development of primary diaper dermatitis are: (i) water/moisture, (ii) friction, (iii) urine, (iv) feces, and (v) microorganisms (sometimes). Possible treatments include minimizing diaper use and using disposable diapers, barrier creams, mild topical cortisones, and antifungal agents. A variety of other inflammatory and infectious processes can occur in the diaper area and an awareness of these secondary types of diaper dermatitis aids in the accurate diagnosis and treatment of patients.

Diapers and skin care: merits and demerits

Diapers have been used for care of babies since decades to prevent soiling and for social convenience. However, the use of diaper poses a risk of developing diaper dermatitis. Recent innovations in diaper technology have led to development of superabsobent disposable diapers, emollient delivering diapers and breathable diapers. These newer types of diapers reduce the incidence of diaper dermatitis. The non-biodegradable material used in superabsorbent diapers is, however, a matter of serious concern because of its toxic effects and environmental pollution. The different type of diapers, recent advances in them and their environmental concerns are discussed in this article.