hand Before discharging your child, your doctor will make certain that you and the child understand how insulin should be given and how the child's diet should be changed. Most diabetic children require insulin daily and are instructed-from as early as four years of age-to give themselves injections. RELATED TOPICS: Bedwetting; Dehydration Diaper rash SYMPTOMS • Reddened skin • Rough, scaly skin • Ammonia odor • Red, scaly spots HOME CARE • Keep the baby as dry as possible. Change diapers often. • Do not use an airtight outer covering over diapers. • Try changing the products used to launder diapers. • For simple diaper rash: Apply petroleum jelly, zinc oxide, vitamin A & D ointment, or an ointment combining zinc oxide, cod liver oil, petrolatum, and lanolin. • For ammonia rash: Do not use an airtight outer covering over the diapers. Wash the diaper area frequently with clear water. • For allergic rashes: Stop giving the child any new foods or beverages started in the previous month. Ask your doctor if you should discontinue a recently prescribed medication. • For a rash from an injection: Wash the area with soap and water. Apply antibiotic ointment often. PRECAUTIONS • If the rash is spreading or severe, or worsens after two days of home treatment, see your doctor. • If the child has a fever, irritability, loss of appetite, or any other signs of illness, see your doctor. • Do not use more than one type of ointment at any one time (unless both were prescribed by your doctor). 187 186 Diaper rashes are irritations of the skin in the diaper area. Almost all babies get diaper rash in one form or another. Diaper rashes may be caused by moisture, urine, or irritating chemicals in the diapers or by an allergic reaction. SIGNS AND SYMPTOMS Rashes in the diaper area can usually be identified by their appearance, their location, and other typical symptoms. Simple diaper rashes are red, slightly rough, and scaly. The rash may appear over the whole area touched by the diaper. The skin may be irritated by chemicals in products used to launder cloth diapers (detergent, bleach, whitener, water softener, or soap). Plastic or rubber pants worn over cloth diapers sometimes affect the skin. The skin may also react to chemicals used in manufacturing disposable diapers or to the plastic outer layer on disposable diapers. Ammonia rash is a form of diaper rash caused by the urine itself. The skin is burned by ammonia that is formed when urine is decomposed by bacteria that are normally found on the skin. Ammonia rash is worse after the child has been asleep for long periods of time without a diaper change. It is identified by an ammonia smell that can be noticed when changing the diaper. Besides these basic diaper rashes, a variety of other rashes may appear in the diaper area, including rashes caused by an allergy to a food or drug, by a skin infection, or by contagious diseases (such as chicken pox and measles). scarlet