Drooling, also called ptayalism or sialorrhea, is the excessive and unintentional flow of saliva in the oral cavity (1). Excessive drooling may cause skin irritation, leading to drool rashes around the mouth, on the neck, or the chest.
In this MomJunction post, we will discuss the causes of drool rash in babies, the preventive measures, and remedies for drool rash.
Is Drool Rash Common In Babies?
In healthy babies, drooling is generally associated with teething and usually subsides when they reach 15–36 months. In the early months, like 4-6 months, mothers get concerned that teething will start soon. However, teething starts around 8-9 months or even later. It is the irritation in the gums and slight swelling of the gums that leads to excessive drooling of the saliva. It is considered abnormal if a child continues to drool excessively even beyond four years of age (3).
Abnormal drooling is commonly observed in babies with neurological impairment like mental retardation or cerebral palsy (4). This is because of an abnormal swallowing reflex and the child cannot swallow the saliva.
What Are The Symptoms Of Drool Rash?
Drool rashes appear as reddened, swollen, and scaly patches of skin in areas that are exposed to excess saliva i.e., around the mouth and chin. These rashes may also lead to the development of blisters over time (5).
Causes Of Drool Rash In Babies
The presence of excess saliva on the tender skin of the baby for a long time causes drool rashes. The following are some of the common reasons for the formation of drool rash:
- Teething is one of the most common reasons for the excessive production of saliva in babies. The saliva might overflow from the baby’s mouth, thereby leading to the formation of a rash.
- At times, rashes also develop in babies, who use pacifiers for a long time, or babies who are bottle fed and keep on sucking on the bottle.
- Residual breast milk or formula might cause skin irritation, and consequently, rashes.
The following are some systemic conditions and other factors that might cause excessive drooling in babies (2).
- Central nervous system and muscular disorders
- Familial dysautonomia (Riley-Day syndrome)
- Wilson disease
- Rett syndrome
- Gastroesophageal reflux
Babies with excessive drooling problems due to a systemic disease are generally referred to a drooling clinic once they grow up a little (2).
Effective Treatments For Baby Drool Rash At Home
Medical intervention is not always necessary for a drool rash. A regular drool rash can be managed by taking some simple and practical steps at home. The most important thing that you could do is to help the baby maintain dry skin all through the day.
Doing certain things like the ones mentioned below might help you better manage your baby’s drool rash.
- Keep the area around the baby’s mouth clean. Use a soft wipe cloth to clean the area after every feed. Do not use pressure or a rough cloth.
- Keep the area around the baby’s mouth dry. You could keep a burp cloth handy to pat it dry every time the baby has an episode of drooling.
- Wash your baby’s mouth area with water two to three times a day to get rid of any food debris.
- Apply moisturizing lotions, barrier creams, etc., regularly to keep the baby’s skin supple and soft. However, avoid applying them directly to the rash.
- Use bibs to prevent the soaking of the neck, chest, and mouth area from drool.
- Dry and sanitize your baby’s pacifiers at regular intervals.
- Sterilize and clean the baby’s bottle thoroughly to avoid any infection.
- Use a gentle and mildly fragrant soap to clean the baby.
If the drool rash is persistent and recurring, consult your baby’s doctor. Avoid using any non-prescription ointments on the baby’s soft and sensitive skin.
When To See A Doctor
Keep an eye out for the following unusual symptoms which might indicate the need to see the pediatrician:
- The baby is crankier than usual.
- The baby is not sleeping well.
- The rash looks cracked.
- The rashes recur.
- The rash does not heal and is spreading.
- There is pus discharge or bleeding from the rash.
- The baby has a fever.
- The baby has difficulty in swallowing and breathing.
- The baby has a loss of appetite.
If you have a doubt, do not hesitate to consult your baby’s pediatrician. It might also be a good idea to document photos of the rash to gauge the improvement or deterioration.
Tips To Prevent A Baby’s Drool Rash
There are no effective ways to prevent your baby from drooling. But you can take some measures to prevent a drool rash from developing on your baby.
- Avoid scrubbing the baby’s skin when you are trying to dry up the area. Rubbing too harshly might irritate the skin.
- Avoid using harsh soaps to clean the baby.
- Use a mild and unscented soap to clean the baby’s bibs, bed sheets, blankets, and clothes. If possible, use the same mild soap to wash your clothes as well so that the side effects can be prevented when you lift the baby to burp them or cuddle.
- Avoid using very strong fragrances and perfumes on yourself. They might aggravate the rash.
- Change the baby’s clothes as soon as they are wet from the drool.
- Place a waterproof bib or sheet onto the baby to prevent the baby from soaking in their own drool.
- Consult the doctor to get suggestions and tips for the prevention and management of rash.
Does Aquaphor Help Treat Drool Rash?
Aquaphor is an OTC skincare ointment. Several parents use Aquaphor to create a barrier between the drool and the baby’s skin. Although some studies have proven the efficacy of Aquaphor in treating skin conditions in babies born with low birth weight (6), more research needs to be done to establish its efficacy specifically for drool rash. It is advisable to consult a doctor before using any OTC products for the baby.
Drooling is a natural phenomenon and subsides with age in healthy babies. It can be prevented and managed at home by following certain preventive measures. It is not a cause of concern in most cases.
Do you have any experiences to share about drool rash? Let us know in the comments section below.
2. Alexander KC Leung and C Pion Kao; Drooling in children; Journal of Paediatrics Child Health (1999)
3. Amanda Amrita Lakraj, Narges Moghimi, and Bahman Jabbari; Sialorrhea: Anatomy, Pathophysiology and Treatment with Emphasis on the Role of Botulinum Toxins; Multidisciplinary Digital Publishing Institute (MDPI) (2013)
4. NEIL G. HOCKSTEIN et al.; Sialorrhea: A Management Challenge; American Family Physician (2004)
5. Irritant contact dermatitis; DermNet NewZealand
6. Renee C Pabst et al.; The Effect of Application of Aquaphor on Skin Condition, Fluid Requirements, and Bacterial Colonization in Very Low Birth Weight Infants; Journal of Perinatology (1999)