A baby who drools all day often ends up with a red, chapped chin and sore neck folds. Drool rash is common, and it usually improves with simple skin care.
Why It Happens
HealthyChildren.org says drooling is not usually harmful, but constant exposure to saliva can irritate a baby’s sensitive skin and cause a drool rash. The rash often appears around the mouth, chin, and cheeks, and can spread to the neck, chest, and hands. Rubbing from bibs and clothing, and wipes that contain alcohol or fragrance, may dry and irritate the skin further. Heavy drooling and a rash on the face are both recognized as part of the teething stage.
How It Differs by Age
Drooling often increases at around 3 to 4 months as the salivary glands become more active, and it tends to stand out during teething. HealthyChildren.org points out, however, that teething does not cause fever, diarrhea, diaper rash, or a runny nose, and that a slight rise in temperature is possible but a temperature above 101°F (38.3°C) is not attributed to teething. Drooling usually tapers off after about 18 months. If a toddler still cannot keep saliva in the mouth after that, the AAP suggests talking with your pediatrician.
Care at Home
The core step is gentle, frequent cleaning. Blot drool from the chin, neck, and cheeks with a soft cloth, pat rather than rub, and let the skin dry. Use a soft, absorbent cotton bib and change it when it is wet. Wash bibs and cloths in mild, fragrance-free detergent, and skip fabric softeners and stain removers; fragrance- and alcohol-free wipes are the safer choice. If the skin is very raw, ask your pediatrician about a barrier cream or ointment and apply a thin layer. Remove bibs before naps and nighttime sleep so your baby can breathe safely.
Common Misunderstandings
One is that a drool rash means a tooth is about to erupt. Some babies drool heavily without teething, and others teethe without a rash. Another is that it is contagious or caused by poor hygiene, but it is simply irritation from saliva sitting on the skin. A third is blaming a high temperature on teething; the AAP says a temperature above 101°F is not explained by teething. A fourth is using teething remedies such as benzocaine gels, homeopathic teething gels or tablets, or amber necklaces, which HealthyChildren.org advises against.
When to Seek Medical Care
A drool rash is not an emergency. But if a baby suddenly drools far more than usual and has trouble swallowing, makes noisy breathing sounds, struggles to breathe, or has bluish lips, go to the emergency room right away. The same is true if you think a small object may have been swallowed. Outside emergencies, talk with your pediatrician if the rash spreads, oozes or forms yellow crusts, comes with a fever, or does not improve after several days of care, since it may be infected or another skin condition. This information is based on U.S. (AAP) guidance; if you live elsewhere, check with a local pediatrician for country-specific recommendations. This information isn’t a diagnostic tool and doesn’t replace advice from a medical professional.