Rash caused by abuse or neglect

Rashes in the diaper area are common. Prevention and home treatment measures are generally all that are needed to prevent and treat a diaper rash.

Diaper rash may be a sign of neglect. Without home treatment, the rash will not go away and may get worse. Since children and vulnerable adults cannot treat a diaper rash themselves, it is the caregiver's responsibility to treat a diaper rash. Ask your day care provider to keep a record of each diaper change if you think that your child's diaper is not being changed often enough.

Diaper rash may also be a sign of abuse. A caregiver may purposely not treat a diaper rash because of anger directed at a child or vulnerable adult.

Suspect possible abuse or neglect when:

• The diaper rash does not get better after home treatment and other causes have been ruled out.
• The diaper rash only gets better when the child is taken out of the setting. For example, a parent might suspect neglect if a child's diaper rash gets better or goes away over a weekend but returns when the child is in day care during the week.
• Explanations change for the cause of the rash or how it is treated.

You may feel uneasy if your doctor brings up the issue of abuse. Doctors have a professional duty and legal obligation to check for the possibility of abuse. It is important to consider this possibility, especially if there were no witnesses to an injury.

If you suspect abuse, seek help. You can call the local child or adult protective agency, police, or clergy or a health professional such as a doctor, nurse, or counselor.

If you think your child has been abused, it is your responsibility to call your doctor or contact the National Child Abuse Hotline and Referral Service at 1-800-422-4453. Adults need to protect young children, because they cannot protect themselves.

If you are having trouble controlling your anger with a child or vulnerable adult in your care, resources for help are available.