Rashes in Trinidad & Tobago are mainly due to heat, dirt or allergy. Infectious causes such as measles and German measles have almost entirely been eradicated by the Ministry of Health’s immunisation programmes. The only “old-time” rash hanging around is chickenpox. There may or may not be an outbreak of chickenpox starting in T&T if you believe the newspapers and some parents, but if the Ministry of Health knows anything else, they are not saying. There is a vaccine that prevents chickenpox, but it is not offered routinely in T&T.
The important thing to remember when your child gets a rash is that most childhood rashes do not need medication. They do not need doctors. With common sense and knowledge, you can handle most rashes at home or at the beach. The most common rash in babies in T&T is heat rash, known as “prickly heat” up north.
It happens because parents keep their baby covered up too much. Babies in T&T over the age of three months should not wear anything except a nappy. Whilst it is a lovely West Indian custom to dress up the child for a visit to the clinic or doctor, my heart goes out to some of the children who are so obviously uncomfortable with the amount of clothes they have on. Particularly reprehensible are the one-piece sleepers sent down from Brooklyn by a fond auntie. Apart from rashes, these babies cry incessantly. They are hot and uncomfortable. There is an easy way to tell if the baby is too hot: she will sweat. Sweat irritates the skin and will cause a rash, especially on the baby’s head and shoulders, the area where the baby sweats most.
Heat is also implicated in the second most common rash in babies: nappy rash. Nappy rash is a misnomer. It should be called “disposable nappy” rash.
It is caused by so-called disposable nappies that have replaced cloth nappies. They are not really disposable. They predominantly end up in landfills. A single disposable nappy takes up to 500 years to decompose and, as they do so, they release greenhouse gases like methane, which heat up the atmosphere, causing more nappy rash. It also seems that people believe the advertisements which claim that you do not have to change these plastic nappies very often since they “absorb” urine. Maybe they are meant to be used in cooler climates where urination is not as frequent as in T&T.
Our babies, like many Trini men, urinate frequently and publicly. Our mothers change the disposables infrequently and reluctantly. The combination of a urine-soaked nappy, mixed with the last bowel movement, all covered with plastic, in a hot, humid environment, is lethal to a baby’s delicate skin.
Nappy rash is prevented by changing nappies more often. It is treated by not putting a nappy on for two or three days and by keeping the baby’s bottom cool and clean. Changing disposable nappies to prevent rash is expensive, but it must be done, or cloth nappies must be used. The best advice for treatment is to take the baby to the beach for a day of sun, sand and a sea bath.
Take off all her clothes, keep her in the shade, give her lots of breast milk and water to drink, and the occasional dip in salt water, and you will be astonished at how quickly the rash will disappear. If it does not, then she may need some medicated cream. Most nappy rashes will not need this if you act promptly and keep the baby clean, cool and naked.
The third most common type of rash is the rash caused by irritation. Anything that you put on a baby’s skin can cause a rash. This is worsened by heat. Heat rash and irritation rash go hand in hand. Different creams and types of clothing materials are usually implicated. The treatment again is to stop the creaming and keep the child as naked as possible. Sometimes a mild cortisone cream is needed.
Finally, seborrhoeic dermatitis, also known as “cradle cap”.
The name refers to that harmless piece of old-time baby furniture, the cradle, where babies used to spend lots of time, and the head or cap of the baby. It is a form of dandruff and is harmless, but can cause a rash on the body and hair loss. It is difficult to prevent.
No one knows exactly what causes it; overactive oil glands and a certain innocuous fungus are implicated, but it is not caused by poor hygiene and is not contagious. Softening the scales with good coconut oil for 24 hours and then shampooing them off gets rid of it.
