Wednesday, July 24, 2013

Cloth Diapering a Baby with Eczema

Cloth diapers are great for babies with sensitive skin, but what about babies with really sensitive skin such as those who have eczema?  Eczema is a skin condition that affects about 10-20% of babies and it can become severe.  Eczema is more than just dry skin: it is an allergic reaction to something in the environment (food, detergents, baby wipes) and can be exacerbated by hot weather, restrictive clothing, and itching. In babies, systemic eczema may be most severe on the cheeks where drool can irritate already thin and sensitive skin.  In flair-ups, skin becomes rough, cracks, and weeps, which starts a cycle that often leads to infection. Eczema can also strike in the diaper area where heat and friction may irritate skin.  Cloth diapers can help to prevent worsening of eczema, but one must use care to select cloth diapers that are best for babies with extremely sensitive skin.
The fleece on this fitted diaper is the perfect softness for a baby with eczema.  However, beware of serged fabric edging: it could cause irritating if it is slightly rough.

1. Select soft fabrics

The first rule of preventing eczema flair ups is to avoid scratching and be gentle on the skin.  I recommend selecting cloth diaper fabrics that are extremely soft (fleece, bamboo charcoal) and avoiding fabrics that could potentially be scratchy (cotton, wool).  While there are some very soft cotton and wool fabrics out there, even something like a surged edge of fabric could potentially cause irritation.  

2. Change diapers frequently

Wet diapers are more likely to cause chaffing and irritation.  Select a style of diaper with a stay-dry feature (like with pocket diapers) so that moisture will be wicked away and into the absorbent layers of the diaper. 

3. Get a good-fitting diaper

Be sure to invest in a style of diaper that fits your child well.  Babies with chunky legs may have trouble with irritation around the leg openings of cloth diapers.  Invest in a trim-fitting style of diaper that is not bulky and doesn't fit too tightly. 

4. Provide diaper-free time

It is especially important to provide time for baby's skin to breathe.  Allow for diaper free time, but use care with what other surfaces baby is coming into contact with (no scratchy towels should be placed under baby- only soft surfaces).  Use caution to prevent your baby from itching his bottom and use baby mittens or watch your child closely. 

5. Beware of build-up

Babies with eczema are even more susceptible to irritation from ammonia or detergent build-up in cloth diapers.  If you notice irritation, check your rinse cycle to see if you are removing all the detergent bubbles from your cloth diapers during laundering.  It may be helpful to add an extra rinse cycle when washing clothing to remove residual detergent and switch all your clothing to a non-fragranced and all-natural detergent. 

6. Be careful with rash creams

Eczema flair up in the diaper area may resemble a diaper rash.  Use caution when reaching for diaper ointment and start with ointments that are moisturizing and non-drying. Talk with your doctor about your concerns. A red patch of skin could be infected and not respond to a regular course of rash cream treatments.  If your baby is only getting eczema in the diaper area you should be suspicious of disposable wipes, detergents, or creams used in that location. 

7. Work with your physician 

Severe cases of eczema can not be easily handled without the help of a trained professional.  Baby may need antibiotics, diet changes, behavior modification, or steroid creams to help control eczema flairs. You can continue to use cloth diapers on babies that have eczema and cloth diapers may be very beneficial to babies who are experiencing irritation in the diaper area.

This information is not intended to diagnose, treat, or prevent a medical condition.  Consult your doctor about the best course of action to reduce eczema symptoms. 


  1. Thankfully my daughter does not seem to have the skin problems that I have. But one reason that we did choose cloth was because of the potential. Cloth just feels better on the skin.

  2. My middle son (the first son we CDd) had a terrible time with eczema. The 2 things that helped him most were very frequent diaper changes (he was basically allergic to his pee) and naked time.
    Thanks for the great list! I don't think this subject is discussed very often.

  3. My son does have eczema, but fortunately, it's never been in the diaper area. He's prone to a couple of patches on his back. We have a cream that helps.

  4. I wish I had seen this earlier in my cloth diapering experience. I unnecessarily put my son through yeast treatments for what ended up being eczema, and he ended up with chemical burns on his diaper area. Unfortunately his is very sensitive to fabrics and has chunky legs, so I can't use my wonderfully cute Simplex diapers because the birdseye cotton makes his eczema flair up on his thighs every time :(

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