Why Dr. Sears is Wrong About Diaper Rash

Elimination Communication Cures Diaper RashI’m a pretty avid follower of Attachment Parenting practices. We cosleep, breastfeed, babywear…we do Elimination Communication, which is in-line with AP principles (albeit missing from the AP books).

In fact, I bought 7 of Dr. Sears’ parenting books and read them as the Gospel of my early months with my newborn boy.

However, the rare holes in his theories are beginning to show up in a few places as I get wiser as a mom…namely: Pottying. Toilet Training. Diapers.

And, (the topic I’m covering today) Diaper Rash.

Our [Lack of] Experience with Diaper Rash

When my baby was born, we began observing him during diaper-free time to get to know his elimination patterns and the signals he gave off right before he peed or pood. We began the Elimination Communication method (EC, also known as Infant Potty Training) with him on the day of his birth.

At 16 months, he has been diaper-free in the daytime for over 7 months (a dry back-up at night) and is pretty reliable in his pottying habits and communication.

Anyway, because of these choices, we’ve never had diaper rash. Not even a little bit.

What Appalled Me on Dr. Sears’ Site

So, you can imagine my horror when I trounced over to Dr. Sears’ website yesterday and looked up what he had to say about diaper rash. Just curious. Wanting to see his take on it all. I like him. I look up to him.

I wasn’t looking for advice to clear up a case of it, just his professional Attachment Parenting perspective on it.

Then. Ah my! In all caps, the words on his website read: “ALL BABIES HAVE DIAPER RASH!”

Further, it states:

“There are many misconceptions about a baby’s bottom:

  • It is supposed to be perfectly smooth and rash-free
  • Diaper rash is abnormal
  • Diaper rash is a sign of food or formula allergies
  • Diaper rash means the baby has bad diarrhea or a yeast infection

Having a diaper rash is a normal part of being a baby. There are many ways you can limit the amount of rash, but from time to time it will flare up again.”


Deep breaths, Andrea.

Let’s take a closer look at Dr. Sears’ diaper rash “facts,” point by point.

My Elimination Communication -Oriented Response to Dr. Sears’ “Diaper Rash Facts”

1. “All babies have diaper rash!” – Sorry, Dr. Sears: All Babies do NOT have diaper rash. Or…perhaps my little boy is not actually a baby. He might be an alien or possibly a malformed puppy. It’s possible.

2. A baby’s bottom is not supposed to be perfectly smooth and rash-free. – Okay, Dr. Sears, so what I hear you say ing is that baby’s bottoms are supposed to be red, irritated, rashy, splotchy, and rough? Supposed to be, eh?

I’ll use Kaiva (my boy) as an example again. His bottom has never had a rash. Never been rough or irritated. Never been anything but perfectly smooth and rash-free. Occasionally (in the first 2 months of life) we had to put balm in his crack because he sweated into it and I failed to wash the area in time. But the pinkish crack would heal within the day.


3. Diaper rash is normal. – Was diaper rash “normal” before disposable diapers (prior to 1959)? Nope…not the norm, although it did occasionally occur when yeast colonized a cloth diaper. But, generally, not common or normal.

Was it normal before commercial cloth diapers hit the market about 150 years ago? Nope.

The beautiful paintings in the Getty Museum in Los Angeles come to mind. The medieval babes depicted in the great works of art all feature supply skin, a lack of diapers, and no red areas.

4. Diaper rash is not a sign of food or formula allergies. – Agreed. Diaper rash is, however, a sign of a diapered baby. (Duh.) Only babies who wear diapers get diaper rash (cloth or disposable)…and out of these, only those who are left to sit in their urine and feces for longer than a few minutes develop diaper rash at all. These days, that would be *most* diapered babies who are susceptible to rash.

5. Diaper rash is not caused by bad diarrhea or a yeast infection. – Take my friend, we’ll call her Mary…her baby had recurring diaper rash due to the yeast growing in her cloth diapers. She had to use disposables to get rid of the rash because the yeast kept inflaming the diaper rash, over and over again.

And, if a baby is left to sit in diarrhea (or yeast, for that matter), I guarantee you that soft, supple skin will become irritated.

So, maybe the diarrhea or yeast itself doesn’t cause the rash, but sitting in it does.

6. “Having a diaper rash is a normal sign of being a baby.” – IF “being a baby” means being diapered full-time and left to sit in baby’s waste all day, then, yes, diaper rash is a normal sign of being a baby in modern, industrialized, Western nations. Agreed.

However…IF “being a baby” means having all needs met until the baby can do for himself (such as being fed, helped to sleep, comforted, kept warm, and having potty needs tended to)…then, no, diaper rash is not a normal sign of being a baby.

What does “being a baby” mean, anyway? Perhaps this other post of mine will help you wrap your head around that.

7. “There are many ways you can limit the amount of rash, but from time to time it will flare up again.” – IF you diaper full-time, yes, this is probably true.

But, as he’s an expert and so respected, perhaps Dr. Sears can expand his page to include an alternative to diaper rash for parents who are desperately seeking one.

Perhaps he could replace this sentence with this:

“There is one way you can totally avoid diaper rash, and it happens to be in alignment with my Baby B’s. It’s called Elimination Communication. You can both avoid diaper rash and honor the communication value of your baby’s cries by pottying your young baby.”

I wrote Dr. Sears to ask him about this but I never heard back.

What I Did Agree with on Dr. Sear’s Site

He then has this to say:


Start with ultra sensitive skin, add the chemicals and moisture of urine and stools, cover the area with a diaper that rubs back and forth, and you have diaper rash. This damaged skin is susceptible to the invasion of bacteria and yeast, which can make the rash worse.

Okay, Dr. Sears. You are getting back to good, solid facts here. Thank you!

Then, he goes on to say this:


If your baby does not have a problem with diaper rash, then you don’t need to be too strict with these preventative measures. However, if you are constantly battling rash, here are some helpful hints to minimize it:

  1. Change diapers frequently – at least every two hours in newborns. You can space this out as baby starts to urinate less often.
  2. Change poopy diapers right away – this is a lot of trouble at first since newborns often have small, frequent stools. This will slow down as baby grows.


I disagree with the first sentence. I think every parent should follow this advice…whether they are dealing with diaper rash or not. No baby deserves to sit in a diaper for longer than 2 hours…pee or poop. Just sayin’….

However, I’d recommend that Dr. Sears add an “Eighth” way to prevent diaper rash…it prevents it altogether by addressing #’s 1 and 2 above….

Elimination Communication: Your Prescription for Diaper Rash

Elimination Communication: Your Prescription for Diaper RashHow to avoid the dreaded diaper rash? Elimination Communication is your best bet. 

With EC, the baby doesn’t become accustomed to going in the diaper and sitting in moisture and feces all day…and thus diaper rash and other infections caused by unsanitary stuff on the skin are less likely.

Whether you use disposables or cloth diapers as a “back-up,” if you practice EC along with drying any wet areas prior to replacing the diaper, you may avoid diaper rash altogether.

So many do…yours truly included.

I’d even go so far as to say that Elimination Communication is the #1 diaper rash cure & method of prevention in the world!

Also, diaper-free time (which is recommended intermittently whether practicing full-time or part-time EC) helps air out the bum and can help quickly resolve diaper rash and/or the yeast that causes it. Sometimes putting a cloth diaper back on continues the yeast growth.

Diaper-free time is a time to heal.

Skip the diaper rash problem altogether by practicing the Infant Potty Training method.

How to Heal Diaper Rash the Natural Way – Where Dr. Sears and I Agree!

IF you are struggling with diaper rash with your infant, give plenty of diaper-free time (The Baby Book by Dr. Sears covers this on page 113).

Also, try doing some part-time EC.

Add in treatment with copious amounts of the magical cream I recommend in my Gear section and…problem solved.

So, I’m curious…do you have any tricks for halting diaper rash in its tracks (EC or not)? Or…has the Elimination Communication method helped you heal your baby’s diaper rash? Do share!

I look forward to hearing your thoughts!!


9 replies
  1. Rebecca
    Rebecca says:

    So, I saw this recently as well and while I would prefer that he not write it that way, I think Dr. Sears is speaking broadly and trying to be kind to a wide variety of people. I don’t think he is necessarily insisting that ALL babies (literally) will have rashes. The Sears’ are also parents to numerous children, so he can speak very generally and still be accurate. I think my preference is a bit more in line with yours, but I’ll let his writing slide there. That being said, I have attempted EC with one of my children and while convinced that it is ‘real’ or that it ‘works’ and is preferable, I get busy and don’t understand how I can actually keep up with EC while homeschooling multiple children and all else I have to do.

    I think that you have one child at this point and while our experiences are surely different, I would like to hear how you might imagine I would succeed at EC with my latest child (#6). Some tips/suggestions would send me back to trying; otherwise, I’m using cloth, but suddenly have a raging rash for no obvious reason (I change diapers frequently and *believe* all the detergent rinses well).

    Also, how do you pay attention to your child on car trips? Do you have to stop constantly? Thanks for any insight.

    • Andrea Olson
      Andrea Olson says:

      Hi Rebecca…sorry, Disqus must’ve lost this comment in the mix and didn’t notify me that it was posted. Better late than never, I suppose! :) I think Dr. Sears is great except in his very conventional potty training ideals and perspectives. We do disagree on that point, but that’s fine. Different stuff works for different people. With 6 kids it is definitely a balancing act, I’m sure, and although I only have one child myself, I work with 1,000s of parents on this topic and know of several who do EC successfully with multiple children. The thing with them, though, is that they do it on a part-time (poops and waking and feeding only) basis and then wrap it up at a currently-seen-as-early age. They don’t shoot for perfection, but they weave EC into their day. One of these women is Kristen of naturalbirthandbabycare.com. So, it’s possible. I can’t know how to help you given just one blog post comment, and it has been 5 months since you posted it, but I do help folks come up with creative solutions for problems like this every single week in my private forum.

      As for car trips…if your child is strongly signaling, then you’d be best to stop and offer a pottytunity. If not, lots of folks put a (disposable, mostly) diaper on the baby and tell the baby that she can go in there until it’s safe/convenient to stop. This generally does not hinder the process.

      Good luck! xx Andrea

    • Andrea Olson
      Andrea Olson says:

      Thanks…and fair enough. I purposefully linked to his website so folks can get it “in context”. But I do take Dr. Sears literally on the topic of toilet training. He is extremely mainstream on this particular topic. :) Andrea

  2. Lana
    Lana says:

    neither of my sons have ever had diaper rash. Or rash cream plastered to their crotch to prevent it. We just did EC from birth. Diapers where something we put on them if we had a nervous visitor. Although he’s probably right about DIAPERED babies. last week I was in a family restroom and there was a little girl with bleeding cracked and all round very sore looking diaper rash it extended half way down her thighs! poor baby.

    • Lana
      Lana says:

      btw my boys are 20 months apart and we do full-time EC. I only have the 2 kids but I have managed to do it. Ditched diapers all together at 4 months with the first and almost 8 months with the 2nd and have been tight rope walking without a net ever since. Unless we have visitors.. then it gets a bit awkward. This ended up as a sign on my front door at one stage ” Welcome visitors to the home of a nappy-free baby. Please do not ask me to put a nappy on him just because you want to hold him, he is learning and this hinders the learning process. We have water proof puddle pads you can sit him on if you’re worried and you can even have a go at reading his signals. Thanks Lana”

      At first I was peeved that so many people would ask me to do this but it’s all they knew.. literally. He’s now 12 months and nobody asks for him to be diapered. He’s also never peed on anyone.. just the floor.. and his undies.. because if he needs to pee he will squirm his way down and they put him on the floor instead of the potty.. I gotta teach him not to do that:-p

  3. EAS
    EAS says:

    In all respect for Dr. Sears, I think it is important to note that the information printed on his website simply states the views of all doctors concerning babies wearing diapers. In other words, it is not Dr. Sears specifically who is the guilty party in revealing this information. It is the fact that people assume all babies wear diapers. So this is the myth that needs to be dispelled.

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