My Baby Has a Rash—Should I Be Worried?

Why do babies get rashes so easily?

From heat rash and diaper rash to baby acne, drool rash, and allergic reactions, skin problems are one of the most common reasons parents worry about their children.

In this episode of Healthy Beginnings, Dr. Edgar Kalimba explains why baby skin is different from adult skin, why rashes happen so often, and how parents can tell the difference between a harmless rash and one that needs medical attention.

In this episode we discuss:

• Why newborn skin is more sensitive than adult skin
 • Heat rash (prickly heat) and how to prevent it
 • Diaper rash and common causes
 • Baby acne and milk rash—what parents should know
 • Drool rash and skin irritation around the mouth
 • Allergic reactions and common triggers
 • Soaps, lotions, fabrics, and other causes of skin irritation
 • Weather-related rashes and seasonal skin problems
 • When a rash requires medical attention

We also tackle common myths, including:

❌ "Babies shouldn't bathe often"
 ❌ "Powder cures every rash"
 ❌ "Herbs are always safe"
 ❌ "Every rash means allergy"

If you've ever looked at a rash and wondered whether to worry, this episode is for you.

Healthy Beginnings offers clear and evidence-based conversations about children’s health, family wellbeing, and the systems that shape our lives. 

New episodes every Monday 

Have a question? Email: healthybeginningspodcast@gmail.com

Produced by LF Media

Transcript

SPEAKER_01 0:00

Welcome back to Healthy Beginnings Podcast. It's really a pleasure for me to continue these conversations. I'm also very grateful that we continue getting more and more feedback from listeners, from parents. We know you're listening, and this is very encouraging, and I really hope that as we go along, these conversations will continually help to shed light on very common topics and concerns and really, really empower parents to continue raising healthy children. So the most recent conversations we had were focusing on an important topic of antibiotics. And often antibiotics are associated with skin rushes, as I discussed before, whether it's side effects, whether it's a rush from the infection itself, particularly viral infections, or whether it's really something completely different. And today and really the next couple of conversations, I would like to focus on a topic that almost every parent, all of us, have encountered, especially within the first few months of life for our babies. And the topic today is really skin rushes. Skin rushes in babies. Now, many parents become worried when they notice small bumps on the face, you know, redness around the neck, maybe a rush in the darker area, or spots appearing suddenly on your baby's skin. As most of the listeners know, the good news is that most of the newborn and infant rushes are completely harmless and really do disappear without needing much in terms of treatment. So, first and foremost, you know, many parents wonder often saying my baby's skin looked perfect when they were born. Why do I all of a sudden have to deal with all these rushes, all these different kinds of rushes appearing on my baby's skin? And really the answer lies in the fact that newborn skin is very different from adult skin or from older children's skin. The baby's skin is much thinner, it is obviously more sensitive, and it is still adapting and growing really to learn to regulate body temperature. And so, because of that, it is more easily irritated and is more likely to lose moisture. So you'd think of the newborn skin as a newly planted seedling. It is healthy, it is still developing and adapting to the outside world. Remember that when babies are born and really the first couple of weeks and months, your baby is adjusting to weather, whether it's heat or cold temperatures, because these are usually very nicely regulated before they are born, intrauterine, things like sweating for the first time, then obviously uh interacting or adapting to clothing, different clothing material, diapers, um, saliva, they are being fed with breast milk or formula, and then all the different things that they get exposed to for the first time, the sops and the lotions. So all of these can trigger temporary skin reactions. The important message here is that uh a rush does not necessarily mean that your baby is sick. So I'll start with a heat rush because this is very common, especially because whether it's Rwanda or East Africa or Africa in general, uh most of the months are warm, the climate is warm, and that can be uh a reason or a trigger for the so-called heat rush. And this happens really because the sweat ducts in your baby's skin become blocked, and then you start to notice tiny red bumps or small clear blisters, and it's typically on the face, on the neck, can extend to the chest of the trunk, and also in the skin folds because these uh get warm um and they get wet as well. So a heat rush is very, very common in babies, and I must also say that more often than not, we overdress our babies, they are overdressed. You know, sometimes parents come to consult and uh it's a regular day, the temperature is maybe 25-27 degrees, so it's it's pretty warm, sometimes even hot. But this baby is dressed in um a vest, and then they have this nice thick cotton overall covering the whole body, including the feet, sometimes even with uh something on the head, then they are wrapped up in a warm cotton wrapper, and then they have like this thick big blanket on top, so multiple layers. This is something I see frequently, and when I'm undressing the baby to examine them, I have to peel off layers and layers. And then I often tell parents, I'm like, okay, your baby was born at the right time, they are not premature, they were born at full term, the right time. So you don't need to overdress them. When you're feeling hot, your baby's also feeling hot. When you're feeling cold, your baby's also feeling cold. So we often as parents are guilty of overdressing our babies, and that's a frequent trigger for the heat rush. Um, so even just uh dressing your baby reasonably based on the weather is often sufficient enough to help uh relieve or reduce the frequency of the heat rushes. So light clothing, keeping the room cool, avoiding excessive wrapping, and uh gentle bathing, especially when it's very hot. And usually that's all you need. Uh, the heat rush disappears within a couple of days. The other common rush that we see and deal with is a diaper rush, very, very common. And a diaper rush is really um related to um the diaper area being wrapped up, obviously, and this builds moisture, and then the urine, the stool, the friction, all these elements uh often can lead to irritation and some form of skin inflammation, and that's why um frequently parents have to deal with a diaper rush. And really, the simple way to deal with it is to make sure that you change the diapers frequently, and also have episodes of allowing the skin to air dry, you know, so that it's not always wet and moist and covered up. The other thing that helps is um barrier creams. There's all kinds of over-the-counter barrier creams, and the good ones are the ones that have zinc oxide. So usually, if you see like a dapper cream uh or so-called uh creme change, typically they have zinc oxide, which is a very good skin barrier and helps to reduce skin irritation around the dapper area. And of course, dental cleaning also helps. So, really, the time, the only time that you need to seek uh some medical help or advice with regard to DAPA rush is if it becomes very severe and very extensive, because often that is associated with signs of skin breaking down. Or if you see white patches begin to appear. When you see white patches, then that could sometimes mean that your baby is starting to develop a yeast infection around the darper area. Understandably, when the skin has been inflamed and has broken down, um, it creates an environment where other things can develop. And most often than not, that would be a yeast infection or other kind of infections. And generally, if the rush does not improve, and it's it that would be reasonable to consult and get some help. The other common uh rush is uh what is frequently referred to as a milk rush, um, as well as baby acne. So most babies develop small pimples on the face during the first weeks of life, and uh depending on their aspect, it could be baby acne, it could be a milk rush, and parents really start to worry: is it because, you know, is it because of my my breast milk? Is it because of something that I ate in my diet? Um, and usually the answer is no. The fact is that baby acne is thought to be related to maternal hormones, which uh as can still circulate in your baby's system, particularly the first couple of days and weeks. And this coupled with the fact that the oil glands in the skin are still developing, uh, can be a trigger for your baby to develop baby acne. And this sometimes can be scary, it can be very raw and very uh, you know, concerning just looking at the aspect of it, especially because it's typically on the face, on the cheeks, on the nose, on the forehead. Uh, and again, baby acne usually disappears without treatment. Um, a very strong advocate of not being aggressive with these kinds of newborn rushes. And really, what parents should avoid is scrubbing or trying to use strong sops or trying to use all kinds of home remedies because there's all kinds of remedies out there. The skin simply needs time, and that's all uh you should do. The other component that happens frequently is associated with drooling. You know, babies drool frequently, or when they are being fed, uh milk or the feeds often pour around the mouth area. Uh, they could drop down to the neck, to the folds in the neck. And often the drooling rush is you know, this irritation around the mouth, on the chin, on the neck, on the upper chest, etc. So the problem is not the saliva itself, the problem is really the prolonged moisture and irritation. And again, simple measures that help with the drooling associated rush is to keep the skin dry, to gently pat, avoid rubbing, because when you rub, you're actually causing more irritation. And very importantly, is to use protective moisturizers when needed. Um, you know, these nice hydrating moisturizers that are appropriate for babies that do not have a scent that help to relieve the irritation, and there's many, many options available. So drilling rush as as uncomfortable as it appears as it may appear is usually harmless, and sometimes babies uh react to just things touching their skin, whether it's different material or whatever you're using to clean them or rub their skin. And again, there's all kinds of triggers, you know, sops, uh, perfume products, lotions, uh, laundry detergents that you use to wash the clothing or fabrics and clothing that are rough, or really different types of new clothing material. So these can all really trigger the irritation, the inflammation, and cause redness, cause itching, cause dry patches. Um, and that's why, especially for newborns, the first couple of weeks, um, you need to really uh be minimalistic, use very gentle, mild things, whether it's SOP, whether it's lotion, and avoid changing and switching back and forth, because then you get confused in case something is triggering, then you cannot really easily tell. And of course, true allergic reactions can also occur. Um, so for example, if you see swelling, like swelling, um uh things like hives, the appearance of hives, especially on the face and the lips, or if there's any difficulty in breathing or any vomiting, or this sudden breakout of hives, that is something that should uh push you to consult to ensure that your baby is not having an unusual allergic reaction. So, again, going back to the weather changes, baby skins are very sensitive to weather changes compared to older children and adults, understandably. Uh, whether it's heat or hot weather that can lead to heat rush, skin irritation, excessive sweating, or whether it's cold weather, that can also lead to dry skin, cracking, getting rough patches on different parts of the body, or if your baby is prone to eczema, then that can also worsen the eczema or the proper true skin allergy, which is what we call eczema. So, really the goal is to balance uh your baby's temperature. Like I mentioned at the beginning of the conversation, avoid overwrapping and avoid undaddressing them, especially at night or when the weather is a bit cooler. So, again, just to reiterate that most rushes are harmless. However, when should you seek medical care? Definitely, if your baby has a fever and a rush, that could mean something entirely different. We've discussed in our previous conversations the different types of infections. And something to note is that viral infections uh very frequently are associated with a rush. And I can give a couple of examples. For example, measles. You know, measles, it's not as common anymore. We have recently had a mini outbreak actually in Rwanda. A few cases of measles. And that's a virus, gives you a fever and gives you a rash. There's other common viral exanthems or viral associated rashes, especially in the preschool children. So things like chickenpox, where you get fever and you blister all over your body. Uh, very common. That's varicella virus. Um, there is other viruses like hand, foot, and mouth disease, also very common. It's an aggressive virus. Often, you know, your toddler or your preschooler will get a very high fever, and then they'll break out into these um rush rushes around the mouth, the in the hands, in the plantar surfaces of the feet, uh, and sometimes they get sores inside their mouth as well. So all those kinds of rushes that are associated with fever definitely need medical attention. If your baby looks unwell, generally, uh, if they have a rush and they look unwell, I think it should prompt a consultation. If the rush is spreading rapidly, like something appears in the morning, within an hour or two, it's spreading aggressively, that is something that should be checked out. And then other types of rush like uh like blistering, you know, a blister is a little rush that has some fluid inside, or if the skin begins to peel aggressively, or if a rush is purple or bruised, bruised looking, or your baby is not feeding poorly. And generally, in babies and infants who are below let's say six months, the first six months of life, if they have a significant rush that really is puzzling to you, it's always reasonable to consult. So a couple of myths that I would like to tackle, common myths. First one is about how often should babies bathe. And um the truth is that again, more often than not we overdo it. Um, babies do not need to bathe multiple times every day, completely unnecessary. A regular bath is good and healthy, of course, helps to remove the sweat and the saliva and all the irritants. But bathing your baby two, three times a day is definitely not necessary, especially the first couple of days and weeks. In fact, you know, in some countries where it tends to be a bit cooler or colder in some seasons, some people would even argue that uh the first couple of weeks, all you need to do is to wipe your baby gently and then give them a bath every other day. Um in our context within Eastern Africa and Africa in general, because we tend to have a warmer, sometimes a hot weather, it probably makes sense to have one birth every day. So do not overdo it. I know many families that have a bath in the morning, maybe another one in the afternoon, and another one at night. Uh and that sometimes can be excessive, especially for the newborn period or the first one month of life. The second thing is about uh powder. I don't know how frequently this is now at the moment, but not so long ago, powder was very common, and you would see babies patched up with powder uh in the neck, in the folds, um, with the thinking that it actually helps to keep the skin dry and reduce the risk for rushes. The truth is that powder does not necessarily help, and it's definitely not a cure for every rush. Uh, in fact, my observation is that it may even worsen the irritation and create uh even breathing risks if inheld. You know, if you put too much uh powder around the face or neck, it's really not safe and it's not a useful, it's not a useful practice at all. The other common thing is, you know, people using home remedies or herbs or different strong products. And again, uh something being natural or organic does not automatically mean that it is safe. And this is what I meant when I said that with newborns, with more small babies, um we like to say that less. Is more. Keep it simple. Keep it really, really simple. Avoid exploring and adventuring with all kinds of things, whether they are humble or traditional, because typically you run a risk of irritating the skin, causing burns, and potentially triggering allergic reactions. So you always need to be cautious with all those products out there. The other myth is every rush equals allergy. The truth is that most rushes are actually not allergic at all. They're not related to anything allergic, it's just all the adaptation, all the environmental triggers, and everything else that I just discussed. So most of these frequent rushes that we see are either triggered or worsened by heat, same thing with moisture, or just simply normal newborn skin changes adapting. And of course, I gave an example, I gave some examples of viral infections. We call these rushes triggered by viruses, we call them viral exanthems. And those are very frequent, particularly in babies that are exposed to siblings who go to preschool or who go to school and can potentially bring home all the different common viruses that we see in children. So not every rush means your baby is allergic to food or milk or medication. So as I close this conversation today and before I move on to responding to your questions, just remember that your baby's skin is naturally sensitive, particularly at the beginning, just after birth. Most newborn rushes are really harmless. They are self-limiting, and you don't need to do much about them. And the common ones, a heat rush, a diaper rush, whether it's baby acne, a drool rush, are extremely common. Most parents are going to deal with them. And you need to be clear and empowered on how to handle them and not to worry too much. What I'll do is that in our next episode in this series, uh, I'll focus a little bit more on eczema or what we call atopic dermatitis, which is uh pure allergy or allergic allergic skin condition. Uh, and then we will also delve into a bit more details to try and clear up the nuances and help um make this topic much, much clearer to the listeners. Before we leave, I would like to answer some of the questions that were sent to us by the listeners.

SPEAKER_00 25:18

We have our first question from Fatima from Nairobi. Whenever my child sleeps late, the next day becomes chaos, tantrums, mood swings, and crying. Does sleep really affect children's behavior that much?

SPEAKER_01 25:31

So the answer is yes.

SPEAKER_02 25:34

If there's one thing that is really underrated is sleep, uh, prioritizing sleep. And this is not just for children, but also for adults.

SPEAKER_01 25:46

So, particularly for children, sleep disruption is bad for um brain development, first and foremost. Learning, of course, because if your child is tired and they have to go to school the next day, there'll definitely be an impact on their learning capacity.

SPEAKER_02 26:07

But on top of that, it also disrupts mood.

SPEAKER_01 26:11

Mood regulation is affected and can go as bad as even immune function or reducing immune function. So poor sleep in children is linked with daytime sleepiness, worse attention, school performance, negative emotions, behavioral problems, and so on and so forth.

SPEAKER_02 26:35

So I usually say that, you know, it's important to set routines.

SPEAKER_01 26:45

For children, it's it's always important to set routines and really try to abide by them. You know, sometimes uh some parents have a child for whom going to bed is a battle, and you end up giving in, there's all kinds of disruptions, and by in time, uh, they end up going to bed late, and that definitely has a profound effect. So I would say that the answer is yes. Um, insufficient sleep, disrupted sleep all have an impact, and not just on the mood, but on a lot more um other functions of the body that are actually critical, including growth and development. So, yes, you should pay attention to this and ensure that your child gets sufficient sleep and rest.

SPEAKER_00 27:40

Second question from Kevin 32 from Kigali. My baby sometimes gets small rashes or bumps after heat or certain lotions, and older relatives immediately recommend home remedies. How do parents know what's a normal skin reaction versus something serious?

SPEAKER_02 27:56

Okay, so this is a very good question. Um I think the easy way to answer this is to say that it's important to look at your child holistically.

SPEAKER_01 28:10

Look at how they feel overall, and not just how the rush looks.

SPEAKER_02 28:17

So a rush is more likely to be harmless if the child is alert, drinking normally, breathing comfortably, um, acting well, playing, good energy levels, and so on and so forth. So if your child appears well, looks well, um, it is most probable that the rush is mild and will be self-limiting, and that it's nothing to worry about. However, if there's anything additional, your child seems lethargic or sleepy or generally very unwell, or if they have a fever, or if there is other signs, you know, like vomiting or dizziness or um uh anything that is out of the ordinary on top of the rush, then I would suggest that you definitely consult.

SPEAKER_01 29:18

But if your child is otherwise well, it is reasonable to observe, monitor at home, and keep an eye on the general status and for any other additional signs and symptoms. And if there's any red flags, then you definitely need to seek urgent medical attention.

SPEAKER_00 29:40

And now we have our last question from Emmanuel 34 from Kigali. My son gets emotional very quickly, crying over small frustrations or corrections. I'm not sure whether to comfort him or teach him to toughen up. What's the healthy approach?

SPEAKER_02 29:56

Interesting question again. Um, so um, this is the point.

SPEAKER_01 30:06

I think um, first and foremost, as parents, we need to intentionally practice to stay calm. If you have an emotional child who is throwing tantrums, it is important that you don't that you do not get frazzled.

SPEAKER_02 30:24

You stay calm and you validate the feeling, uh, but still set a clear limit on the behavior.

SPEAKER_01 30:34

So um the thing that I would suggest that you avoid is to shame the child for being emotional because that doesn't help. Um, and it is usually more effective to say that the behavior is not okay while the feeling is okay. So they might feel frustrated, they might feel, you know, sad about something, um, they might feel triggered for one reason or the other, and that is fine. It's okay, we all have feelings, but what is not okay is how they respond, how they act out um the emotion that they are feeling at that point in time. So um keep it simple, and an example of a simple script is I see you're upset, I am here, and I'll help you calm down. However, hitting or screaming or shouting or breaking things is not okay. So it's always that balance of trying to separate the feeling and what we do about it. I hope that helps. Thank you for listening to Healthy Beginnings. If you have any questions you'd like answered in the next episode, you can submit them to our email, healthybeginningspodcast at gmail.com. You can also follow us on all social media platforms. You can find us on YouTube as well as the audio platforms of your choice. See you next week.

SPEAKER_00 32:19

This podcast is for general informational and educational purposes only. Do not make health decisions without consulting your doctor. This podcast is brought to you by LF Media, home of Great African podcasts.