My baby has a rash

It's normal for babies to develop rashes from as early as a few days old. If your baby has a rash but doesn’t show signs of illness, speak to your midwife, health visitor, or your GP. If your baby appears unwell, call your GP or GP out of hours service

Most rashes are harmless and go away on their own
Babies can have ‘non-specific rash’ which means it is often hard to say what caused the rash. As long as they are well and comfortable, continue with normal care
Causes for skin rashes tend to differ in babies compared to older children. Sometimes viruses can cause a rash in addition to other symptoms such as fever and cough
If your baby is unwell and has a rash which does not disappear on pressure (glass test positive), please contact 999

Milia

About half of all newborns develop tiny (1-2mm) white spots on their face. These are called milia.

These are just blocked sweat pores. They usually clear within the first four weeks of life.

Erythema Toxicum

Half of all new-borns develop a blotchy red marks with small bumps and weal’s scattered over face and rest of the body. This is called erythema toxicum. This is usually seen at two or three days old. It's a normal new-born rash that won't bother your baby and clears after a few days.

Please visit

Rashes in babies and children - NHS (www.nhs.uk)

for an image of this Erythema Toxicum

Cradle cap

Cradle cap is where yellowish, greasy, scaly patches develop on a baby's scalp. Occasionally, as well as the scalp, the face, ears and neck are also affected

it isn't itchy and shouldn't bother your baby- if your baby is scratching or upset, they may have eczema.
it is a common condition that tends to develop within two or three months after birth
it usually gets better without treatment in a few weeks or months

Things you can do to try and get rid of cradle cap:

gently washing your baby's hair and scalp regularly with mild, non-perfumed baby shampoo and gently loosen flakes with a soft brush
gently rub on baby oil or vegetable oil to help soften the crusts
use baby oil, vegetable oil or petroleum jelly overnight and wash with baby shampoo in the morning
do not use olive oil or peanut oil as they are not suitable
do not use soap/adult shampoos and do not pick crusts as this can cause infection

CradleCap

CradleCapII

Nappy rash

Nappy rash occurs when the skin around the baby's nappy area becomes irritated. It occurs due to a combination of moist environment, chemical irritants and friction.

is often caused by exposure to wee or poo for a long period of time
it can sometimes be the result of a fungal infection

You can usually reduce nappy rash by taking simple steps to keep your baby's skin clean and dry by frequent nappy changes. If the rash is causing your baby discomfort, your health visitor or pharmacist can recommend a nappy rash cream to treat it.

Antifungal cream may be necessary if the rash is caused by a fungal infection. For futher information see Nappy rash - NHS

Baby acne (neonatal acne)

Baby acne usually develops about two to four weeks after birth. Tiny red or white bumps appear on the baby’s cheeks, nose, and forehead, which may be surrounded by red skin. The cause is unknown. It typically clears up on its own in about three to four months without leaving marks.

Regular home care should be enough to treat baby acne:

Wash your baby’s face with a gentle soap
Don’t scrub hard or pinch the irritated areas
Avoid lotions or oily face products
Do not use over the counter acne products that you would use on yourself-this can damage baby’s delicate skin

If you’re concerned that your baby’s acne isn’t going away, your doctor can recommend or prescribe safe treatments

Eczema

Eczema is a dry skin condition which causes the skin to become itchy, red, dry and cracked.

The most common form is atopic eczema. It mainly affects babies and children but can continue into adulthood.

Creams and ointments can often relieve the symptoms.

Please see our information on eczema in the dedicated webpage

Eczema Rash.jpg

photo used with permission 
from DermNetNZ.org

Sweat rash (miliaria)

A heat rash is sometimes called miliaria or prickly heat. It may flare up when your baby sweats. For example, because they're dressed in too many clothes or the environment is hot and humid.

It's a sign your baby's sweat glands have become blocked.

They may develop tiny red bumps or blisters on their skin, but these will soon clear without treatment.

When should you worry?

If your child has any of the following:

A rash that does not disappear with pressure (see the “Glass Test”)
Becomes extremely agitated (crying inconsolably despite distraction)
Becomes floppy or very lethargic (difficult to wake)
A temperature less than 36^oC or temperature 38^oC or more if baby is less than 3 months
Breathing very fast or breathing that stops or pauses
Working hard to breathe, unable to talk or noisy breathing
Pale, blue, or mottled skin, lips, or tongue and /or cold hands or feet
Difficult to wake up, very sleepy or confused
Weak, high-pitched, continuous cry or extremely agitated
Has a fit (seizure)

You need urgent help

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

A rash that looks like small blisters or fluid filled spots
Broken skin and the surrounding area becomes warm to touch or red. Look out for redness around the base of the umbilicus (belly button) in the first few weeks of life
Nappy rash that isn’t getting better with simple measures such as regular nappy changes or barrier creams
A fever for more than 5 days or shivering with fever (rigors)
Breathing a bit faster than normal or Working a bit harder to breathe
Dry skin, lips, tongue or looking pale,
Not had a wee or wet nappy in last 12 hours
Sleepy or not responding normally
Crying and unsettled
Poor feeding (babies) or not drinking (children)
A temperature 39^oC or above in babies 3-6 months

You need to contact a doctor or nurse today

Please ring your GP surgery or call NHS 111 - dial 111

We recognise that during the current COVID-19 crisis, at peak times, access to a health care professional may be delayed. If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, then consider taking them to your nearest ED

If your child has none of the above

Closely monitor your baby for any signs of deterioration by looking out for any red or amber features

It is common for newborns to develop blotchy red skin at 2 to 3 days old. This is a normal newborn rash and shouldn’t bother your baby. It clears after a few days

Additional advice is also available for families to help cope with crying in otherwise well babies

Self care

Continue providing your child’s care at home. If you are still concerned about your child contact your Health Visitor or call NHS 111 – dial 111

This guidance has been reviewed and adapted by healthcare professionals across North East and North Cumbria with consent from the Hampshire development groups.

Best Beginnings video

Where should you seek help?

If it is non-urgent, speak to your local pharmacist or health visitor.
If your child has any of the above features in amber, urgently see your GP. For an urgent out-of-hours GP appointment, call NHS 111.
You should only call 999 or go your nearest A&E department in critical or life threatening situations or if your child is showing any of the signs in the red section above.

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

Many visits to A&E and calls to 999 could be resolved by any other NHS services.
If your child's condition is not critical, choose another service to get them the best possible treatment.
Help your child to understand – watch this video with them about going to A&E or riding in an ambulance

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Some primary and secondary schools may have an allocated school nurse, however this can vary depending on the area – telephone your child’s school to ask for the contact details of your school nursing team.

There is also a specialist nurse who works with families who choose to educate their children at home.

Redcar and Cleveland

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

encouraging healthier lifestyles
giving information, advice and support to children, young people and their families
supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

Breastfeeding, weaning and healthy eating
Exercise, hygiene and safety
Your child’s growth and development
Emotional health and wellbeing, including postnatal depression
Safety in the home
Stopping smoking
Contraception and sexual health
Sleep and behaviour management (including temper tantrums!)
Toilet training
Minor illnesses

For more information watch the video: What does a health visitor do?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

Visit a pharmacy if your child is ill, but does not need to see a GP.
Remember that if your child's condition gets worse, you should seek further medical advice immediately.
Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?