Despite every parent's best efforts, most babies will develop a bothersome diaper rash sometime during their days in diapers. Diaper rashes may be treated with numerous creams and lotions and everyone seems to have their favorites. I have always been a fan of the zinc-based preparations as I think they coat the skin and provide more protection. I recently had a phone call from a patient who said she had "tried everything" and her son's bottom was still red, raw, bumpy and causing him discomfort. Of course it was over the weekend, so she wanted to see if we could figure this out before the office opened on Monday. If your child develops a diaper rash that does not respond in the first couple of days to the usual "potions" then you might assume they have developed a secondary fungal infection with their diaper rash. Yeast diaper dermatitis is more common than even pediatricians think and doesn't always look like the classic picture of "satellite lesions" on a red base. In a recent article it was estimated that more than 50% of persistent diaper rashes involve yeast, so I think it would make sense to try an over the counter anti-fungal cream in addition to your usual diaper cream. So for that bothersome diaper rash a trial of a zinc-based diaper cream mixed with a little Maalox (yes, the antacid) and a yeast cream may just do the trick and get rid of the red and the yeast. If the rash persists, it's time for a visual diagnosis by your pediatrician. That's your daily dose, we'll chat again tomorrow.