B5 panthenol nappy ointment: how should you use it?

What should a nappy ointment do?

The practical goal is a protective barrier, rather than choosing an ointment by its B5 ingredient name. Barrier preparations help keep poo away from skin and reduce moisture damage and water loss from the skin. A barrier ointment's main job is keeping skin and nappy contents apart, which is less glamorous than the packaging but considerably more useful.1

Prolonged contact with wee and poo, moisture and friction can damage the skin's protective barrier. Ointment is only one part of care: frequent changes and gentle cleaning reduce that contact. Do not leave a baby in a soiled nappy, even when they are sleeping.1

How do you apply nappy ointment?

1. 1Wash your hands and put the clean nappy, water, cotton wool or suitable wipes, drying cloth and ointment within reach.
2. 2Remove the wet or dirty nappy promptly. Clean the whole nappy area gently, including the skin folds, using plain warm water and cotton wool. If using wipes, choose ones without fragrance or alcohol.
3. 3Clean girls from front to back. Clean boys around the penis and testicles without pulling back the foreskin.
4. 4Pat the skin dry rather than rubbing it. Allow some time without a nappy when possible.
5. 5Apply a thin layer of a suitable barrier cream at each change, following the exact ointment's directions. Ask a pharmacist for help if the product's suitability or application instructions are unclear.
6. 6Put on a clean nappy that fits properly without being too tight, then wash your hands.

Keep water and cream off disposable nappy tabs because they will not stick properly, and the fastening system has only one job.3

What else helps, and what should you avoid?

Choose absorbent nappies and give the skin time without a nappy. For reusable cloth nappies, use dry liners and change them often. Avoid fabric conditioner when washing cloth nappies because it reduces absorbency. A daily bath is enough; bathing more than twice a day can dry the skin. Avoid soap, bubble bath, baby lotion, talcum powder and antiseptic creams or lotions on nappy rash.234

How quickly should nappy rash improve?

Ordinary nappy rash usually clears within a few days with gentle cleaning, time without a nappy and nappy rash cream at each change. Medication is not normally needed. Mild rash often does not feel sore, while severe rash can make a baby uncomfortable or distressed. If the rash does not settle, a pharmacist or health visitor can help decide whether a different cream is needed.45

When is ointment not enough?

Contact a GP or health visitor if the rash persists, worsens or spreads, or your baby has a high temperature or seems very uncomfortable. Bleeding, red skin folds or red spots also need assessment; redness in the folds can indicate thrush, a fungal infection. For broken skin, seek advice rather than repeatedly switching ointments. If an infection is suspected, a GP can prescribe an antifungal or antibiotic treatment; they can also prescribe a steroid cream for redness and soreness.124