Teething and nappy rash – what helps a baby
What teething really does and does not cause, why teething gels are not recommended, how to clear nappy rash, and the signs that mean it is not teething at all.
What teething actually causes
Teeth usually start coming through in the second half of the first year, though the range is wide and a late start is not by itself a problem. Teething can make a baby irritable, dribble more, want to chew on things, sleep less well, and have slightly sore, swollen gums.
- What helps: something firm and clean to chew, a cool (not frozen) teething ring, gentle gum rubbing with a clean finger, and extra comfort.
- Weight-appropriate paracetamol (Panado), or ibuprofen (Nurofen) if suitable for that baby's age, if they are genuinely uncomfortable. Ask a pharmacist to confirm the dose for their weight.
- Wipe drool off the chin to prevent a rash from the moisture.
Nappy rash: air, barrier, and treating the cause
Most nappy rash is irritation from wetness and stool against the skin, made worse by friction. It shows as redness on the areas the nappy touches, often sparing the deep skin creases.
- Change the nappy as soon as it is wet or soiled, more often than usual while the rash is there.
- Clean gently with water or a fragrance-free wipe, and pat dry rather than rubbing.
- Leave the nappy off for stretches of time. Air does more than any cream.
- Apply a barrier ointment at every change so the skin is not sitting against moisture.
- Avoid soap, bubble bath and anything perfumed on that skin while it heals.
Products used for nappy rash and thrush in South Africa:
Aqueous Cream BP / Emollient — Aqueous Cream Lennon, E45, Epizone
Dry skin; eczema (as emollient/moisturiser and soap substitute)
Clotrimazole — Canesten, Candid, Trimysten, Mycelex
Vaginal candidiasis; dermatophyte infections; oral candidiasis
When to take the baby in
- Nappy rash that is not improving after about three days of proper care, or is spreading, blistering, weeping or bleeding.
- A baby who seems in pain, is feeding poorly, or has a fever with the rash.
- Any rash together with an unwell baby.
Common questions
- Can teething cause a fever?
- No. Teething can cause irritability, dribbling and sore gums, but not a high fever, diarrhoea or a body rash. A baby with those signs should be assessed for an infection rather than assumed to be teething.
- Are teething gels safe for babies?
- Numbing teething gels are not recommended for babies, and amber teething necklaces are a choking and strangulation risk with no evidence of benefit. Use a cool teething ring, gum rubbing and weight-appropriate pain relief instead.
- How do I treat nappy rash?
- Change nappies more often, clean gently and pat dry, leave the nappy off for stretches, and use a barrier ointment at every change. Bright red rash reaching into the skin creases usually needs an antifungal cream instead.
Sources
- Paediatric Hospital Level Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- Medicines Online Directory and approved patient information leafletsSouth African Health Products Regulatory Authority
- Clinical and public health guidanceWorld Health Organization
Last reviewed 11 August 2026.