I enjoyed reading the article "Diaper Dermatitis" in your June issue.1 To the many treatments discussed, I would offer 2 additional management points. First, persistent and/or recurrent diaper rash is more common when children older than 12 months continue to drink from the bottle. Excess fluid intake leads to soppy diapers and often, sloppy stools. When the cup replaces the bottle, diapers and firmer stools ensue--and accompanying rashes disappear.
Second, even at the risk of waking their infant (regardless of his or her age), parents achieve much better diaper hygiene when diapers are checked--and, if need be, changed--once or twice during the night as well as frequently during the day.
In over 32 years of office practice, I've seen many otherwise refractory diaper rashes clear, with or without topical therapy, when only these 2 strategies are employed.