Cloth Diaper Tech Support: Persistent Diaper Rash & Not-So-Waterproof Covers

Hi Amy,

I love reading Advice Smackdown, and Amalah. I love reading about your boys, thank you for sharing!

I have two questions. First is I have an eight week old with very sensitive skin. I recently switched to cloth diapers because she had the worst diaper rash. The doctor seemed unconcerned, but this is my third baby and I had never seen a diaper rash so bad. We have been using Charlie Banana, and bumGenius for about a month now. At first the diaper rash seemed to get better, but never completely went away. Now it is back full force, she has been crying a lot, and is having trouble sleeping. I feel horrible every time I change her. I change her about every two hours, except at night, she sleeps about six hours. Plus, sometimes after I wash her diapers smell like pretzels. Weird, right? I hope you can suggest some cures for her bottom troubles.

Second is involving her cloth diapers again. I hold her in a carrier, often. When she is removed from the carrier, the cover of her diaper feels moist. I always expect a huge wet spot on my shirt, but there is none. I always feel bad when someone wants to hold her, and her clothes are slightly moist. I don’t think the cloth diapers are repelling, but since we haven’t been using cloth for a long time, maybe? I feel like I should add that I wash with Rockin Green, and have not used anything else.

Thank you for your time,
Confused with Cloth

*puts on cloth diaper troubleshooting cap, adjusts to a jaunty angle*

Okay! So.

Problem number one: Is it possible that your baby’s diaper rash was/is yeast related? Perhaps an undiagnosed run-in with thrush that manifested bottom-only?  Because that rash sounds AWFULLY familiar to me. Ike developed a yeast infection this past summer (thanks to spending a bit too much time in the swim diapers, methinks) and HOLY NUTBARS, the rash was vicious. And it looked EXACTLY like the rash Noah developed as a newborn, thanks to thrush. I had the nipple discomfort (think itchy burning like athlete’s foot) and got it treated super-quickly, and while my lactation consultant insisted Noah was fine because he never developed the telltale white spots in his mouth…his diapers told a different story. Red, raised, meaty, prone to blister-type lesions and even bleeding. A completely different animal than “regular” ol’ diaper rash.

A fungal infection of some kind would explain why the rash reemerges in cloth, even after you’re confident you’ve cleared it up. The infection is living on in your diapers and you must kill it by disinfecting them. I learned this one the stupid-hard-way because it simply didn’t occur to me that I was basically re-infecting poor Ike every time we switched back to cloth after treating the rash with non-cloth-friendly creams. (Clotrimazole, miconazole or nystatin, topped off with a hardcore barrier cream like Desitin or Triple Paste.)

Technically, washing your diapers on hot *should* be enough to kill the yeast, but it didn’t work that way for us. Probably the fault of our high-efficiency washing machine not getting hot enough. Instead, I had to go nuclear. Anything that could be safely bleached (prefolds, inserts, etc.) was bleached. Anything that couldn’t (pocket diapers, colored fabrics, PUL covers, etc.) was washed with about 20 drops or so of grapefruit seed extract, which you can usually find at health or vitamin stores, or on Amazon. Tea tree oil will also work — just make sure you’re get the 100% pure essential oil. These are natural anti-fungals and will do an effective job while not damaging your diapers, so you can use them multiple times without fear if you want to be extra double mega sure you’ve killed the nastiness.

You’ll also want to do the same to your cloth wipes, if you use them. We also put Ike on a probiotic to kill any yeast in his tummy (since the rash would always flare up after even just the shortest contact with poop as well), AND we got rid of any diaper balm sticks we’d used during the infection window that had direct contact with his bum. (I love love love the cloth-safe GroVia Magic Stick ointment, and while it might have been overkill, I swore the rash would flare up after I used it. So I chucked it and got a fresh one. So far, so good.)

Other possibilities for your daughter’s rash? An allergy to your diaper detergent, or something in her milk/diet. Though if it clears up in disposables that’s less likely. Try disinfecting and/or switching detergents first.

And now! Problem number two! Mysteriously moist pocket diapers. Your cloth diapers are very new (unless you got them secondhand?) and you’re washing them in a good detergent, so this one is kind of a puzzler. The outer shell of Charlie Banana and bumGenius diapers should be reliably waterproof, unless they’ve somehow been damaged via improper laundering, use of non-cloth-safe creams or a manufacturing defect. If you lay the diaper flat and pour a little water on the outside shell, does it pool and bead up? Or does it penetrate the fabric? Now do the same to the inner fleece/suedecloth lining. Is it really the outer shell that feels moist, or is the leakage coming from the edges of the leg holes and waistband? Or is she simply saturating the inner guts of the diapers so much that it’s hitting maximum capacity?  When you change her, is her skin wet or is the inner lining wicking moisture away (like it’s supposed to)?

If you think your diapers are just plain leaking (her skin is wet, the inserts aren’t saturated yet her clothing is damp), then yes, you probably have repelling fleece and need to strip them. (Did you prewash all your inserts on hot with no detergent three or more times before using them? Is it possible they weren’t adequately prepped?) I actually had problems with my pocket diapers when I tried using Rockin Green as my regular detergent, weirdly enough, even though I know tons of people who love it. I do LOVE it for stripping/deep cleaning, but using it all the time caused stink/leakage for us. So we stick with Charlie’s Soap. Maybe try switching and see what happens.

If it’s not leaking, but the inserts are seriously getting overly soaked in just a few hours, then you may just need more absorbency. The outer shell of a pocket diaper isn’t foolproof — I know when the insides of ours get completely soaked through I’ve experienced something similar to what you’re describing, though not usually enough to transfer moisture onto clothing. (More of a feeling/smell of wetness, with perhaps some leakage around the edges.) What are you stuffing the diapers with? The full-size insert or just the smaller newborn doubler? If your baby isn’t big enough for the full-size insert but is soaking through the smaller one, I’d suggest buying some extra doublers and double-stuffing her at all times (and triple at night). GreenMountainDiapers.com sells really nice, inexpensive cotton doublers (Workhorse Doublers) in a variety of sizes. You can also find a ton of newborn-sized doublers on Amazon in just about every fabric imaginable: hemp, velour, fleece, microfiber, etc. I personally prefer the natural fibers like cotton and hemp because they are easy to wash and not prone to build-up and repelling and stink like the microfiber.

Lastly, I would definitely recommend letting your baby have some open-air naked-butt time. The outer shells of pocket diapers are NOT BREATHABLE, so it’s possible that with the rash and all the time bundled up in a carrier her little bottom might just be getting hot and irritated and needs some time out of the PUL-covered diapers. Pile some absorbent blankets on the floor to catch any mess and let her butt get 30 minutes to an hour or so of fresh air every day, if at all possible.

Good luck! I hope you get to the bottom (OH LOOK I MADE A PUN) of the mysterious diaper rash and leakage. And let us know what — if anything — ends up working so we can add it to the endless pile of cloth diaper troubleshooting tips.