What to do when your baby has heat rash

Does your baby have a fine red rash on certain parts of their body that’s causing them to scratch the area? This could be a heat rash (or miliaria) caused by blocked sweat ducts – if it is, there’s no cause for concern and there are ways you can make your baby more comfortable. 

Sister Doriska Posthumus, a registered nurse and midwife in Cape Town, notes that so many health and skin conditions can cause rashes. “It is very difficult to differentiate between types of rashes. You have to look at the complete clinical picture, other symptoms and history before just saying it is a ‘heat rash’,” she says. 

Common signs of heat rash

A heat rash will likely form where there’s friction or around skin folds – inner thighs, elbow and knee creases, neck, armpits, or the groin area. Signs include:

- Inflamed, swollen skin.
- Itchiness and discomfort. 
- Not spreading or worsening. 
- Disappearing within a few days. 
- Accompanying symptoms, such as fever. 

How can I make my baby more comfortable?

Sister Doriska says that the rash will likely disappear on its own when making the child comfortable. You can do this by keeping the skin dry and rinsing baby in a bath of cool water (drop in a rooibos teabag for an extra soothing rinse), or apply breast milk to the area to soothe itchiness. 

“Sometimes a pharmacist will advise an antihistamine or hydrocortisone cream, but any medication for a small child should be used with caution and only by instruction of a health professional,” she says.  

Dr Cora Bopape-Chinyanga, a Johannesburg-based specialist paediatrician, says you should switch to plain skincare products that contain no fragrance, such as aqueous cream or a zinc balm that will calm and heal the skin. 

An effective ingredient for soothing the skin is anhydrous lanolin, which can be found in nipple creams, or you could try calamine lotion.

How to prevent a heat rash in babies

“A major cause of heat rash in a child is overdressing,” says Sister Doriska. She suggests the following:
- Dress baby in thin layers of cotton clothing. 
- Stay out of very warm areas and direct sunlight. 
- Keep them hydrated – nurse on demand for younger babies; frequent sips of water for older ones. 
- Do not keep the baby in a carrier, stroller, or car seat for long periods. This causes sweating, which can lead to rashes. 
- Keep baby’s sleep area well ventilated; dress them in cotton pyjamas.

Conditions that could look like heat rash 

Fine pimples on your baby’s face could be baby acne. “It is so common, especially in the first weeks of life,” says Dr Bopape-Chinyanga.

Another possible cause of a rash is allergies. “Before we would consider testing for allergies, however, there needs to be a family history. And, in most cases, we would only test after the age of three,” she adds. 

Remember that an allergic reaction would only be brought about by a certain allergen, like a particular food. If you notice a rash forming after introducing a new food, it’s likely linked to that and not a heat rash. 

When should you visit your paediatrician? 

If the rash is repetitive, growing, causing scarring, swelling or infection, and/or met with other clinical symptoms, rather have it looked at, advises Dr Bopape-Chinyanga. 

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