Learning module

Protecting babies from the causes of nappy rash

Nappy rash is the most common skin condition among infants1 and frequently causes behavioural changes, such as increased crying, agitation, and altered eating and sleeping patterns. Indeed, nappy rash can disrupt family life and leave parents feeling stressed, worried and guilty.

Bayer recently has developed a complimentary CPD module, reviewed by a leading academic midwife, from the Mum & Baby Academy that examines the aetiology and diagnosis of nappy rash against the background of recent advances in understanding of skin maturation.

Protecting delicate skin

As the CPD module explains, infant skin forms less of a barrier than adult skin: full-term infant skin is only between 40% and 60% of the thickness of an adult’s skin, for example. This structural and functional immaturity means that an infant’s skin lacks adequate defences against damage. As a result, prolonged exposure of the skin to risk factors for nappy rash undermines barrier function and results in the distressing clinical signs and symptoms2.

Several factors contribute to nappy rash, including moisture, friction, contact with urine and faeces, and, occasionally, microorganisms1. Night time can be the longest uninterrupted period that the skin is exposed to over-hydration and irritation caused by urine and faeces, and friction.

Appreciating the differences between infant and adult skin helps midwives, health visitors and nurses advise parents about the most appropriate way to protect their children from this unpleasant and distressing problem.

Bepanthen: The only leading nappy care product that meets all nine standards4 of an ideal barrier product

In recent years, nappy rash management shifted from treatment to protection4. In recognition of this, an international expert panel of dermatologists and paediatricians agreed nine standards for the ideal nappy care preparation that is suitable for repeated application on the delicate skin of infants (Table 1)4. Bepanthen is the only leading nappy care product that meets all nine standards.

Bepanthen is formulated as a water in oil emulsion containing 5% dexpanthenol (pro-vitamin B5) and gently aids natural skin recovery, while keeping the skin soft and moisturised. Bepanthen forms a breathable, transparent layer of protection and is suitable for even the highly sensitive skin of premature babies. By making Bepanthen Nappy Care Ointment part of the last nappy change of the day, caregivers help to provide protection against nappy rash triggers at night.

Table 1. The nine standards of an ideal nappy care preparation

The ideal topical preparation for nappy care products should:

  • Offer proven clinical efficacy and safety in babies
  • Enhance natural skin protection
  • Maintain optimum moisture levels
  • Contain ingredients with documented safety and benefit
  • Contain no unnecessary ingredients
  • Contain no potentially toxic ingredients
  • Contain no potential sensitizers, such as fragrances
  • Contain no antiseptics or preservatives
  • Be pleasant to use

Adapted from table 1 in Atherton D. et al1;

Trial data

Effect of Bepanthen on protection from the causes of nappy rash in premature and full-term babies.

Bepanthen's effect on the protection from the causes of nappy rash on full-term and premature newborns has been demonstrated in a clinical trial of 54 newborn babies.


Under the conditions of the study, Bepanthen was shown to significantly protect against the harmful effects of urine and faeces helping to keep the skin healthy, when applied to the buttocks of newborn babies.

Full details of the study are noted in Realites Pediatriques, 2001; 63:33-38.


1 Bikowski J. Update on prevention and treatment of diaper dermatitis. Practical Dermatology for Pediatrics. 2011: July/August 16-9.

2 Stamatas GN, Tierney NK. Diaper dermatitis: etiology, manifestations, prevention, and management. Pediatric Dermatology. 2014;31:1-7.

3 Jackson A. Time to review newborn skincare Infant. 2008;4:168-71.

4 Atherton D, Proksch E, Schauber J, et al. Irritant diaper dermatitis: Best practice management. SelfCare. 2015;6(S1):1-11.