Dribble rash, also called teething rash, is common in babies aged from 6 months old. This is when teething generally starts. Babies produce extra saliva when they’re teething as this helps to soften their food so it’s easier for them to chew and swallow. Saliva also contains a digestive enzyme called ptyalin which helps to digest starch in the mouth, but which can be irritating when it comes into contact with the skin.
Extra saliva also helps to protect the new teeth from bacteria and decay. While the mucous membranes in the baby’s mouth are designed to be constantly moist, the skin around their mouth isn’t.
Some babies drool more than others which increases the likelihood of developing dribble rash. Some babies are also more prone to keeping their mouth open, rather than closing their lips. This means their dribble doesn’t stay in their mouth so there is a breakdown in their protective skin barrier.
Dribble rash can look worse when the air is cold or dry, or when it is windy.
What does a dribble rash look like?
Typically, a dribble rash is red, the skin a little inflammed and sometimes pimples are present. Dribble rash tends to obvious in the baby’s cheeks, chin and even onto their neck. Often dribble rash looks worse after the baby has eaten. When food is in contact with already irritated skin, it tends to get worse. Sometimes friction from clothing, bed linen and rubbing also makes dribble rash more obvious.
Should I be worried about my baby’s dribble rash?
Not if your baby is otherwise well and does not have any symptoms of being sick. Generally teething rashes are what is called ‘self-limiting’, meaning the symptoms get better without any specific treatment.
Check inside your baby’s mouth to see if any teeth have erupted. Generally, the first teeth to emerge are the bottom, central incisors.
Fevers are not a typical sign of teething. Take your baby to see a doctor if they have an elevated temperature – above 38°C.
The main issue with dribble rash is that it is uncomfortable. The drier the skin, the more irritated it can feel. As adults we know the tendency with any skin irritation is to want to touch it. Some parents use mittens on their baby’s hands if they’re constantly bringing their hands to their face and causing extra irritation.
The key to managing dribble rash is to protect the skin from getting worse and to treat it carefully when it is present.
What can I do to prevent my baby from having a dribble rash?
The best thing to do is to try and keep your baby’s skin dry. And although prevention can be helpful, it’s not always easy. If you notice your baby is dribbling a lot, try to wipe away the excess drool as quickly as possible. Use a soft, clean cloth and pat, rather than swiping or dragging the cloth against their skin. Some babies are irritated by dribble rash and don’t like the sensation of having their face wiped.
If your baby has a dummy, make sure it has plenty of air vents in the shield. Give your baby some dummy free time so their skin can be exposed to the air.
Other tips to prevent dribble rash:
It’s important to use a good quality barrier cream on your baby’s skin. Small amounts used frequently throughout the day can be better absorbed that less frequent, thicker applications. Warm the cream a little between your fingers before smearing it on.
Dribble rash can be irritating and some babies tolerate more of a ‘dabbing’ application than dragging the cream against their skin. Check the ingredients of any cream you’re applying on your baby’s skin to make sure it’s safe to use, especially on your baby’s face. Low allergenic creams with a pH to match the baby’s skin (5-5.5) can be better tolerated.
- Consider using a sensitive washing detergent or low perfumed option on their clothes and cot linen.
- Use absorbent bibs on your baby and change them frequently. Just remember to remove any bibs before they go down for a sleep.
- Use a soap free, gentle wash when you bath your baby. Chemicals and perfume can irritate a baby’s delicate skin and cause it to become dry.
- Change your baby’s clothing frequently if they’re drooling onto their chest.
- Change your baby’s sheets frequently.
- Clean your baby’s face and hands soon after they’ve eaten. This will help to reduce the risk of further skin irritation from food.
- Try to limit their exposure to dry, cold air and wind.
How can I treat my baby’s dribble rash?
If your baby has a dribble rash, aim to keep their skin as dry as you can. Apply barrier cream frequently, especially after bathing and eating.
It’s important to avoid using any steroid cream on your baby’s face unless this has been prescribed by a doctor. Although these often quickly improve facial irritations, they can lead to more complex skin issues later on.
Written for Sudocrem by Jane Barry, Midwife and Child Health Nurse, November 2024.
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