Guidance on the use of nappy rash barrier preparations in ECE services

The Ministry does not consider that nappy rash barrier preparations are medicines, so they do not need to be authorised or acknowledged in the same way that medicines are (HS28 Appendix 3).

Prevention of nappy rash is key. Prolonged contact with moisture and soiling causes nappy rash, so reducing the time tamariki are in a wet or soiled nappy is very important.

But, if a child has a nappy rash, or parents want to help prevent nappy rash occurring, nappy rash barrier preparations may be used in an early learning service.

Nappy rash barrier preparations need to be carefully managed to minimise the potential risk of cross-contamination. One way to mitigate this risk is for parents to provide their preferred nappy rash preparations for their child (named) with the service adhering to careful hygiene practices.

There may be times when a child needs nappy rash barrier preparation applied and doesn’t have their own. In this case, the service can supply nappy rash barrier preparations ensuring particular attention is given to hygienic practices.

Nappy change practices and procedures that would mitigate and prevent infection/cross-infection:

  • Staff are recommended to use gloves when changing nappies and to change gloves in-between each child.
  • Always wash your hands for at least 20 seconds before and after changing nappies and changing gloves. Dry your hands thoroughly.
  • Use individual containers of nappy rash cream/barrier cream for tamariki when administering the cream. If using a shared container of nappy rash cream, use a disposable wooden stirrer/stick for each child to minimise cross-contamination, and dispose of it after each use.
  • If a child has nappy rash, trying a disposable nappy may help.

Early learning services should work with their communities about how to manage nappy rash barrier preparations. If service supplied nappy rash barrier preparations are used the service provider should have a process of informed consent for its use, including brand names, much in the same way that they do for sunscreen. 

Being SunSmart

When supplying nappy rash barrier preparations, services need to ensure hygienic practices are followed to manage the risk of potential cross-contamination and the spread of illness and potential allergic reactions. Services should have clear procedures and practices in place to ensure these potential risks are effectively mitigated and managed.

If a child needs a prescribed medication to treat a condition eg. thrush or infected nappy rash, this medication must be treated as a category (ii) medicine.

Ask whānau to share any special advice/information with staff if a child is diagnosed with these conditions.

Health NZ

In consultation with Te Whatu Ora, National Public Health Service, Greater Wellington Region.

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