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Mothers' Experiences of Babies’ Diaper Dermatitis After Discharge from Neonatal Intensive Care Unit

Year 2026, Volume: 19 Issue: 2 , 282 - 296 , 14.04.2026
https://doi.org/10.46483/jnef.1625854
https://izlik.org/JA95EL97WD

Abstract

Background: Diaper dermatitis (DD) is a prevalent issue among neonates discharged from neonatal intensive care units (NICU) due to their sensitive skin and high vulnerability.
Objectives: This study aimed to investigate the experiences and contributing factors of DD as reported by the mothers of NICU graduates.
Methods: The retrospective, comparative, and correlational study included 180 mothers. Data were collected using the “Sociodemographic and Clinical Characteristics of Newborns Data Form” and the “Sociodemographic Characteristics of Mothers and Diaper Care Practices Form.” Descriptive statistics and chi-square analysis were applied for data interpretation.
Results: The findings revealed that 78.3% of neonates developed DD post-discharge. A significant reduction in DD incidence was observed in infants whose diaper care involved wipes containing pure water. Conversely, a notable increase in DD was linked to infections and diarrhea (p<0.05).
Conclusion: The incidence of DD was high among infants discharged from the NICU. While the use of wipes containing pure water for diaper care was associated with lower DD rates, post-discharge infections and diarrhea were associated with higher DD rates. During the discharge process of high-risk neonates, it is recommended to provide mothers with information regarding diaper care and DD. In the post-discharge period, follow-up with mothers through phone calls or home visits by nurses, regular monitoring of the infants, and repetition of education when necessary are also advised.

References

  • Adalat, S., Wall, D., & Goodyear, H. (2007). Diaper dermatitis‐frequency and contributory factors in hospital attending children. Pediatric dermatology, 24(5), 483-488.
  • Aker, M. N., & Gönenç, İ. M. (2019). Diaper Dermatitte Anne Sütü Kullanımı. Pediatric Practice and Research, 7, 588-591.
  • Akpinar, F., & Göçmen, İ. (2014). Yenidoğanlarda Deri Bakimi. Maltepe Tıp Dergisi, 6(2), 1-3.
  • Atherton, D. J. (2016). Understanding irritant napkin dermatitis. Int J Dermatol, 55 Suppl 1, 7-9. doi:10.1111/ijd.13334
  • Blume‐Peytavi, U., Hauser, M., Lünnemann, L., Stamatas, G. N., Kottner, J., & Garcia Bartels, N. (2014). Prevention of diaper dermatitis in infants—a literature review. Pediatric dermatology, 31(4), 413-429.
  • Capone, K. A., Dowd, S. E., Stamatas, G. N., & Nikolovski, J. (2011). Diversity of the human skin microbiome early in life. J Invest Dermatol, 131(10), 2026-2032. doi:10.1038/jid.2011.168
  • Chiabi, A., Kamdem, J. C. N., Nkoro, A. G., Siyou, H., Mah, E., Nguefack, F. D., . . . Angwafo III, F. (2018). Epidemiological and Clinical Features of Diaper Dermatitis in Infants at the Yaounde Gynaeco-Obstetric and Pediatric Hospital, Cameroon. Journal of Child Science, 8(01), e46-e49.
  • Cohen, B. (2017). Differential diagnosis of diaper dermatitis. Clinical pediatrics, 56(5suppl), 16-22.
  • Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Routledge. https://doi.org/10.4324/9780203771587.
  • Çavuşoğlu, H. (2011). Çocuk Sağlığı Hemşireliği (9 ed.). Ankara: Sistem Ofset Basımevi. Delgado, B. S., Costa, R., Dal Vesco, S. N. P., Santos, F. A., & Santos, S. V. (2019). Newborn skin care strategies in neonatal unit. Estima–Brazilian Journal of Enterostomal Therapy, 17, 1-9.
  • Ersoy‐Evans, S., Akıncı, H., Doğan, S., & Atakan, N. (2016). Diaper dermatitis: a review of 63 children. Pediatric Dermatology, 33(3), 332-336.
  • Esmaeilzadeh, H., Qolizadeh, A., Hosseini, S., Norouzi, K., Mafi, M., & Rafiei, H. (2020). Incidence and Risk Factors of Diaper Dermatitis in Hospitalised Children Aged 0-24 Months: An Epidemiological Descriptive Study in Iran. Journal of Clinical & Diagnostic Research, 14(4), 1-4.
  • Esser, M. (2016). Diaper Dermatitis: What Do We Do Next? Advances in neonatal care: official journal of the National Association of Neonatal Nurses, 16(5), 21-25.
  • Esser, M. S., & Johnson, T. S. (2020). An integrative review of clinical characteristics of infants with diaper dermatitis. Advances in Neonatal Care, 20(4), 276-285.
  • Esser, M. S., Ngui, E. M., & Johnson, T. S. (2021). Contributing factors to diaper dermatitis and NICU length of stay. Journal of Neonatal Nursing, 27(5), 358-364.
  • Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods, 39(2), 175–191. https://doi.org/10.3758/bf03193146.
  • Garcia Bartels, N., Massoudy, L., Scheufele, R., Dietz, E., Proquitté, H., Wauer, R., . . . Blume‐Peytavi, U. (2012). Standardized diaper care regimen: a prospective, randomized pilot study on skin barrier function and epidermal IL‐1α in newborns. Pediatric dermatology, 29(3), 270-276.
  • Gozen, D., Caglar, S., Bayraktar, S., & Atici, F. (2014). Diaper dermatitis care of newborns human breast milk or barrier cream. J Clin Nurs, 23(3-4), 515-523. doi:10.1111/jocn.12047
  • Gökdemir, F., & Yılmaz, T. (2023). Likert tipi ölçekleri kullanma, modifiye etme, uyarlama ve geliştirme süreçleri. Journal of Nursology, 26(2), 148-160.
  • Gupta, A. K., & Skinner, A. R. (2004). Management of diaper dermatitis. International journal of dermatology, 43(11), 830-834.
  • Kayaoglu, S., Kivanc-Altunay, I., & Sarikaya, S. (2015). Diaper dermatitis in infants admitted to social pediatrics health center: role of socio-demographic factors and infant care. The Indian Journal of Pediatrics, 82, 904-908.
  • Kılıçarslan Törüner, E., & Büyükgönenç, L. (2017). Çocuk Sağlığı Temel Hemşirelik Yaklaşımları. Ankara: Nobel Tıp Kitabevleri.
  • Kim, J. S., Jeong, Y. S., Jeong, E. J., Kim, J. S., Jeong, Y. S., & Jeong, E. J. (2019). Knowledge of diaper dermatitis and diaper hygiene practices among mothers of diaper-wearing children. Child Health Nursing Research, 25(2), 112-122.
  • Kusari, A., Han, A. M., Virgen, C. A., Matiz, C., Rasmussen, M., Friedlander, S. F., & Eichenfield, D. Z. (2019). Evidence‐based skin care in preterm infants. Pediatric dermatology, 36(1), 16-23.
  • Li, C., Zhu, Z., & Dai, Y. (2012). Diaper dermatitis: a survey of risk factors for children aged 1-24 months in China. Journal of International Medical Research, 40(5), 1752-1760.
  • Manav, V. (2021). The severity of diaper dermatitis and the effects of caregivers' habits on infants' behaviors. Turkish Journal of Dermatology, 15(2), 34-39.
  • Maya, K., Pai, S., & D'Souza, A. (2015). Effectiveness of awareness programme on prevention and management of diaper dermatitis among mothers of children of age 0 to 1 year. Journal of Health and Allied Sciences NU, 5(03), 077-081.
  • Ng’ang’a, A. W. (2019). Factors Associated with Diaper Dermatitis among Children Aged 0-24 Months Admitted in Mbagathi Sub County Hospital, Nairobi County, Kenya. (Master of Science Master of Science). JKUAT-COHES, Kenya.
  • Önder, M., Adışen, E., & Velagiç, Z. (2007). Diaper dermatit. Çocuk Sağlığı ve Hastalıkları Dergisi, 50(2), 129-135.
  • Price, A. D., Lythgoe, J., Ackers-Johnson, J., Cook, P. A., Clarke-Cornwell, A. M., & Phipps, F. M. (2021). The BaSICS (baby skin integrity comparison survey) study: a prospective experimental study using maternal observations to report the effect of baby wipes on the incidence of irritant diaper dermatitis in infants, from birth to eight weeks of age. Pediatrics & Neonatology, 62(2), 138-145.
  • Santos, S. V., Ramos, F. R. S., Costa, R., & Batalha, L. M. d. C. (2021). Validation of nursing interventions to prevent skin lesions in hospitalized newborns. Texto & Contexto-Enfermagem, 30, e20190136.
  • Shao, L., & Yu, Y. (2023). The development of a nomogram model for the individualized prediction of diaper dermatitis risk in pediatric hospitalized children aged 1–36 months. Journal of Tissue Viability, 32(1), 85-93.
  • Sharifi-Heris, Z., Amiri Farahani, L., & Hasanpoor-Azghadi, S. B. (2018). A review study of diaper rash dermatitis treatments. Journal of Client-Centered Nursing Care, 4(1), 1-12.
  • Sikic Pogacar, M., Maver, U. s., Marcun Varda, N., & Micetic-Turk, D. (2018). Diagnosis and management of diaper dermatitis in infants with emphasis on skin microbiota in the diaper area. Int J Dermatol, 57(3), 265-275.
  • Stamatas, G., Nikolovski, J., Mack, M., & Kollias, N. (2011). Infant skin physiology and development during the first years of life: a review of recent findings based on in vivo studies. International journal of cosmetic science, 33(1), 17-24.
  • Taddio, A., & Katz, J. (2005). The effects of early pain experience in neonates on pain responses in infancy and childhood. Pediatric Drugs, 7(4), 245-257.
  • Visscher, M., & Narendran, V. (2014). Neonatal infant skin: development, structure and function. Newborn and Infant Nursing Reviews, 14(4), 135-141.
  • Visscher, M., Odio, M., Taylor, T., White, T., Sargent, S., Sluder, L., . . . Rider, M. (2009). Skin care in the NICU patient: Effects of wipes versus cloth and water on stratum corneum integrity. Neonatology, 96(4), 226-234.
  • Yılmaz, A., Bayar, A., & Esenay, F. İ. (2018). Annelerin doğum sonrası bebek bakım gereksinimlerinin belirlenmesi: Nitel bir çalışma. Mersin Üniversitesi Sağlık Bilimleri Dergisi, 11(2), 147-156.
  • Yonezawa, K., Haruna, M., Matsuzaki, M., Shiraishi, M., & Kojima, R. (2018). Effects of moisturizing skincare on skin barrier function and the prevention of skin problems in 3‐month‐old infants: a randomized controlled trial. The Journal of dermatology, 45(1), 24-30.
  • Zheng, Y., Wang, Q., Ma, L., Chen, Y., Gao, Y., Zhang, G., . . . He, C. (2019). Shifts in the skin microbiome associated with diaper dermatitis and emollient treatment amongst infants and toddlers in China. Experimental Dermatology, 28(11), 1289-1297.

Yenidoğan Yoğun Bakım Ünitesinden Taburcu Olan Bebeklerin Annelerinin Taburculuk Sonrasında Diyaper Dermatit Deneyimleri

Year 2026, Volume: 19 Issue: 2 , 282 - 296 , 14.04.2026
https://doi.org/10.46483/jnef.1625854
https://izlik.org/JA95EL97WD

Abstract

Giriş: Diyaper dermatiti (DD), yenidoğan yoğun bakım ünitesinden (YYBÜ) taburcu edilen bebeklerde hassas cilt yapıları ve yüksek risk grubu olmaları nedeniyle yaygın bir sorundur.
Amaç: Bu çalışma, bir üniversite hastanesinin YYBÜ’den taburcu olan bebeklerin annelerinin taburculuk sonrası süreçte, diyaper dermatit deneyimlerinin ve ilişkili faktörlerin belirlenmesi amacıyla yapılmıştır.
Yöntem: Retrospektif, karşılaştırmalı ve ilişkisel olarak tasarlanan çalışmaya 180 anne dahil edilmiştir. Veriler, “Yenidoğanların Sosyodemografik ve Klinik Özellikleri Veri Formu” ile “Annelerin Sosyodemografik Özellikleri ve Diyaper Bakımı Uygulamaları Formu” kullanılarak toplanmıştır. Verilerin analizinde tanımlayıcı istatistikler ve ki-kare testi uygulanmıştır.
Bulgular: Bu çalışmada, bebeklerin taburculuk sonrasında DD insidansı %78.3 olarak bulunmuştur. Saf su içeren mendillerle yapılan bez bakımının DD sıklığını anlamlı ölçüde azalttığı görülmüştür. Buna karşılık, enfeksiyon ve diyare öyküsü olan bebeklerde DD gelişme oranında anlamlı bir artış tespit edilmiştir (p<0,05).
Sonuç: YYBÜ’nden taburcu olan bebeklerde DD görülme sıklığının yüksek olduğu belirlenmiştir. Bebeklerin alt bakımında saf su içeren mendil kullanımı düşük DD oranları ile ilişkiliyken, taburculuk sonrası enfeksiyon geçirme ve diyare olma durumları daha yüksek DD oranları ile ilişkili bulunmuştur. Yüksek riskli yenidoğanların taburculuk sürecinde, annelere alt bakımı ve DD ile ilgili bilgi verilmesi; taburculuk sonrası dönemde hemşirelerin telefon görüşmeleri veya ev ziyaretleri yoluyla anneleri takip etmesi, bebeklerin düzenli izlenmesi ve gerekirse eğitimin yinelenmesi önerilmektedir.

References

  • Adalat, S., Wall, D., & Goodyear, H. (2007). Diaper dermatitis‐frequency and contributory factors in hospital attending children. Pediatric dermatology, 24(5), 483-488.
  • Aker, M. N., & Gönenç, İ. M. (2019). Diaper Dermatitte Anne Sütü Kullanımı. Pediatric Practice and Research, 7, 588-591.
  • Akpinar, F., & Göçmen, İ. (2014). Yenidoğanlarda Deri Bakimi. Maltepe Tıp Dergisi, 6(2), 1-3.
  • Atherton, D. J. (2016). Understanding irritant napkin dermatitis. Int J Dermatol, 55 Suppl 1, 7-9. doi:10.1111/ijd.13334
  • Blume‐Peytavi, U., Hauser, M., Lünnemann, L., Stamatas, G. N., Kottner, J., & Garcia Bartels, N. (2014). Prevention of diaper dermatitis in infants—a literature review. Pediatric dermatology, 31(4), 413-429.
  • Capone, K. A., Dowd, S. E., Stamatas, G. N., & Nikolovski, J. (2011). Diversity of the human skin microbiome early in life. J Invest Dermatol, 131(10), 2026-2032. doi:10.1038/jid.2011.168
  • Chiabi, A., Kamdem, J. C. N., Nkoro, A. G., Siyou, H., Mah, E., Nguefack, F. D., . . . Angwafo III, F. (2018). Epidemiological and Clinical Features of Diaper Dermatitis in Infants at the Yaounde Gynaeco-Obstetric and Pediatric Hospital, Cameroon. Journal of Child Science, 8(01), e46-e49.
  • Cohen, B. (2017). Differential diagnosis of diaper dermatitis. Clinical pediatrics, 56(5suppl), 16-22.
  • Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Routledge. https://doi.org/10.4324/9780203771587.
  • Çavuşoğlu, H. (2011). Çocuk Sağlığı Hemşireliği (9 ed.). Ankara: Sistem Ofset Basımevi. Delgado, B. S., Costa, R., Dal Vesco, S. N. P., Santos, F. A., & Santos, S. V. (2019). Newborn skin care strategies in neonatal unit. Estima–Brazilian Journal of Enterostomal Therapy, 17, 1-9.
  • Ersoy‐Evans, S., Akıncı, H., Doğan, S., & Atakan, N. (2016). Diaper dermatitis: a review of 63 children. Pediatric Dermatology, 33(3), 332-336.
  • Esmaeilzadeh, H., Qolizadeh, A., Hosseini, S., Norouzi, K., Mafi, M., & Rafiei, H. (2020). Incidence and Risk Factors of Diaper Dermatitis in Hospitalised Children Aged 0-24 Months: An Epidemiological Descriptive Study in Iran. Journal of Clinical & Diagnostic Research, 14(4), 1-4.
  • Esser, M. (2016). Diaper Dermatitis: What Do We Do Next? Advances in neonatal care: official journal of the National Association of Neonatal Nurses, 16(5), 21-25.
  • Esser, M. S., & Johnson, T. S. (2020). An integrative review of clinical characteristics of infants with diaper dermatitis. Advances in Neonatal Care, 20(4), 276-285.
  • Esser, M. S., Ngui, E. M., & Johnson, T. S. (2021). Contributing factors to diaper dermatitis and NICU length of stay. Journal of Neonatal Nursing, 27(5), 358-364.
  • Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods, 39(2), 175–191. https://doi.org/10.3758/bf03193146.
  • Garcia Bartels, N., Massoudy, L., Scheufele, R., Dietz, E., Proquitté, H., Wauer, R., . . . Blume‐Peytavi, U. (2012). Standardized diaper care regimen: a prospective, randomized pilot study on skin barrier function and epidermal IL‐1α in newborns. Pediatric dermatology, 29(3), 270-276.
  • Gozen, D., Caglar, S., Bayraktar, S., & Atici, F. (2014). Diaper dermatitis care of newborns human breast milk or barrier cream. J Clin Nurs, 23(3-4), 515-523. doi:10.1111/jocn.12047
  • Gökdemir, F., & Yılmaz, T. (2023). Likert tipi ölçekleri kullanma, modifiye etme, uyarlama ve geliştirme süreçleri. Journal of Nursology, 26(2), 148-160.
  • Gupta, A. K., & Skinner, A. R. (2004). Management of diaper dermatitis. International journal of dermatology, 43(11), 830-834.
  • Kayaoglu, S., Kivanc-Altunay, I., & Sarikaya, S. (2015). Diaper dermatitis in infants admitted to social pediatrics health center: role of socio-demographic factors and infant care. The Indian Journal of Pediatrics, 82, 904-908.
  • Kılıçarslan Törüner, E., & Büyükgönenç, L. (2017). Çocuk Sağlığı Temel Hemşirelik Yaklaşımları. Ankara: Nobel Tıp Kitabevleri.
  • Kim, J. S., Jeong, Y. S., Jeong, E. J., Kim, J. S., Jeong, Y. S., & Jeong, E. J. (2019). Knowledge of diaper dermatitis and diaper hygiene practices among mothers of diaper-wearing children. Child Health Nursing Research, 25(2), 112-122.
  • Kusari, A., Han, A. M., Virgen, C. A., Matiz, C., Rasmussen, M., Friedlander, S. F., & Eichenfield, D. Z. (2019). Evidence‐based skin care in preterm infants. Pediatric dermatology, 36(1), 16-23.
  • Li, C., Zhu, Z., & Dai, Y. (2012). Diaper dermatitis: a survey of risk factors for children aged 1-24 months in China. Journal of International Medical Research, 40(5), 1752-1760.
  • Manav, V. (2021). The severity of diaper dermatitis and the effects of caregivers' habits on infants' behaviors. Turkish Journal of Dermatology, 15(2), 34-39.
  • Maya, K., Pai, S., & D'Souza, A. (2015). Effectiveness of awareness programme on prevention and management of diaper dermatitis among mothers of children of age 0 to 1 year. Journal of Health and Allied Sciences NU, 5(03), 077-081.
  • Ng’ang’a, A. W. (2019). Factors Associated with Diaper Dermatitis among Children Aged 0-24 Months Admitted in Mbagathi Sub County Hospital, Nairobi County, Kenya. (Master of Science Master of Science). JKUAT-COHES, Kenya.
  • Önder, M., Adışen, E., & Velagiç, Z. (2007). Diaper dermatit. Çocuk Sağlığı ve Hastalıkları Dergisi, 50(2), 129-135.
  • Price, A. D., Lythgoe, J., Ackers-Johnson, J., Cook, P. A., Clarke-Cornwell, A. M., & Phipps, F. M. (2021). The BaSICS (baby skin integrity comparison survey) study: a prospective experimental study using maternal observations to report the effect of baby wipes on the incidence of irritant diaper dermatitis in infants, from birth to eight weeks of age. Pediatrics & Neonatology, 62(2), 138-145.
  • Santos, S. V., Ramos, F. R. S., Costa, R., & Batalha, L. M. d. C. (2021). Validation of nursing interventions to prevent skin lesions in hospitalized newborns. Texto & Contexto-Enfermagem, 30, e20190136.
  • Shao, L., & Yu, Y. (2023). The development of a nomogram model for the individualized prediction of diaper dermatitis risk in pediatric hospitalized children aged 1–36 months. Journal of Tissue Viability, 32(1), 85-93.
  • Sharifi-Heris, Z., Amiri Farahani, L., & Hasanpoor-Azghadi, S. B. (2018). A review study of diaper rash dermatitis treatments. Journal of Client-Centered Nursing Care, 4(1), 1-12.
  • Sikic Pogacar, M., Maver, U. s., Marcun Varda, N., & Micetic-Turk, D. (2018). Diagnosis and management of diaper dermatitis in infants with emphasis on skin microbiota in the diaper area. Int J Dermatol, 57(3), 265-275.
  • Stamatas, G., Nikolovski, J., Mack, M., & Kollias, N. (2011). Infant skin physiology and development during the first years of life: a review of recent findings based on in vivo studies. International journal of cosmetic science, 33(1), 17-24.
  • Taddio, A., & Katz, J. (2005). The effects of early pain experience in neonates on pain responses in infancy and childhood. Pediatric Drugs, 7(4), 245-257.
  • Visscher, M., & Narendran, V. (2014). Neonatal infant skin: development, structure and function. Newborn and Infant Nursing Reviews, 14(4), 135-141.
  • Visscher, M., Odio, M., Taylor, T., White, T., Sargent, S., Sluder, L., . . . Rider, M. (2009). Skin care in the NICU patient: Effects of wipes versus cloth and water on stratum corneum integrity. Neonatology, 96(4), 226-234.
  • Yılmaz, A., Bayar, A., & Esenay, F. İ. (2018). Annelerin doğum sonrası bebek bakım gereksinimlerinin belirlenmesi: Nitel bir çalışma. Mersin Üniversitesi Sağlık Bilimleri Dergisi, 11(2), 147-156.
  • Yonezawa, K., Haruna, M., Matsuzaki, M., Shiraishi, M., & Kojima, R. (2018). Effects of moisturizing skincare on skin barrier function and the prevention of skin problems in 3‐month‐old infants: a randomized controlled trial. The Journal of dermatology, 45(1), 24-30.
  • Zheng, Y., Wang, Q., Ma, L., Chen, Y., Gao, Y., Zhang, G., . . . He, C. (2019). Shifts in the skin microbiome associated with diaper dermatitis and emollient treatment amongst infants and toddlers in China. Experimental Dermatology, 28(11), 1289-1297.
There are 41 citations in total.

Details

Primary Language Turkish
Subjects Pediatric Health and Illnesses Nursing
Journal Section Research Article
Authors

İnci Gökçe Bağcı 0000-0001-9987-5509

Bahise Aydın 0000-0001-9815-2843

Submission Date January 23, 2025
Acceptance Date July 2, 2025
Publication Date April 14, 2026
DOI https://doi.org/10.46483/jnef.1625854
IZ https://izlik.org/JA95EL97WD
Published in Issue Year 2026 Volume: 19 Issue: 2

Cite

APA Gökçe Bağcı, İ., & Aydın, B. (2026). Yenidoğan Yoğun Bakım Ünitesinden Taburcu Olan Bebeklerin Annelerinin Taburculuk Sonrasında Diyaper Dermatit Deneyimleri. Etkili Hemşirelik Dergisi, 19(2), 282-296. https://doi.org/10.46483/jnef.1625854

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