A new born baby’s skin is as soft as a petal. With the birth of the baby begins the mother’s first endeavour – identifying the skin care products most suitable for her baby’s precious skin. But this is not as easy as it sounds. She needs to analyse a number of factors before making her decision. Read on to understand what our experts say about this.

A full-term baby (born after 37 weeks) has all structural components of an adult skin. However, your newborn is in a sudden transition from intrauterine environment to the external environment. This means your baby skin is working on three main aspects for survival;

i) adapting to the unfamiliar external environment,

ii) skin maturing process and

iii) protecting the body from encounters of mechanical, physical, chemical or biological nature..

The maturing process of the baby’s skin occurs over a period of 12 months from birth. Therefore, it is essential to follow good skincare practices in the first 12 months. In the case of preterm babies, this care is more critical due to underdeveloped skin structural components.

This article summarises the guidelines put forward by various health agencies around the world. Read on to understand the recommendations made for the first 12 months baby skin care needs.

 

Baby skin care

The top layer of your baby’s skin (stratum corneum) is a protective layer against the entry of irritants, microorganisms, allergens and other toxins. Your baby’s skin is relatively dry compared to yours, this means damage to the top layer of skin can easily occur if inappropriate skin care practices are followed.

The basics of baby skincare are (Research review, 2014):

  1. Cleanse – to remove, dirt, irritants, allergens, pathogens and environmental toxins.
  2. Moisturise – to reduce drying effects from low ambient humidity and other environmental factors.
  3. Protect- from sun damage by using sunscreens and protective clothing.

(Guidelines summarised in this article are from the American Academy of Pediatrics (1974); World Health Organisation (2006); the Second Edition of the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN)(2007); first European Round Table meeting on “Best Practice for Infant Cleansing (2007). Almost all guidelines were aligned with each other and had mostly based on clinical evidence to support the recommendations.)

 

Bathing your baby

Bathing and cleaning frequency for newborns are widely dependant on the geographical location and cultural practices in the region. Although unnecessary, in warmer regions the frequency of bathing a newborn is daily.  When bathing, you need to focus primarily on areas such as face, neck, folds and diaper area. Rubbing the skin with a sponge or cloth can sometime lead to damage the tender skin. In the case of preterm babies, frequency should be less since the skin components are yet to be formed completely.

Take care to ensure washing and cleaning of your baby does not cause the following;

i) damage the protective hydrolipid coating,

ii) induce any changes in the balance of the bacterial microflora of the skin.

iii) dry the skin or,

iv) destroy its natural acidity .

While WHO recommends that the first bath be given only 6 hours of a baby’s birth inorder to avoid risk of hypothermia, there are other recommendations which suggest that the first bath can be given once the baby’s vitals and temperature are stable.

Bathing, especially tub bathing, i.e. immersing the child in water till the chest level with assistance, is considered superior to washing. Studies show that tub bathing resulted in minimum temperature variability in the body. (Bryanton et al., 2004; Loring et al., 2012).

The table below are some of the important biological and environmental considerations in infant bathing and cleansing recommendations made based on clinical evidences (Table taken from Research review, 2014).

 

Table 1: Biological and environmental consideration for infant bathing

 

Age (months)

 

Biological and Environmental Factors

 

Cleansing consideration

Neonate (0 to 4-8 weeks)

• Skin barrier is immature and at risk of water and heat loss, and vulnerable to irritants and infection

• Neonates are relatively inactive

• Their environment is controlled

• Delay bathing 4-6 hours after birth to allow temperature to stabilise

• Duration: ≤5 minutes

• Immersion bathing is beneficial when feasible

• Water or mild, pH-neutral cleansing

Infant (4-8 weeks to 8 months)

• Skin barrier is maturing and still subject to water loss

• Infant is active (crawling)

• Environment is less controlled: infant is coming into contact with impurities, irritants, and bacteria

• More frequent: 2- to 3-times per week until crawling

• Longer bathing is possible

• Immersion bathing is beneficial

• Water or mild, pH-neutral cleansing

Toddler (8 months to 4 years)

• Skin barrier continues to mature

• Infant is more active (crawling and walking)

• Increased contact with impurities, irritants, and bacteria

• Regular and frequent bathing is needed

• Immersion bathing is beneficial

• Water or mild pH-neutral cleansing

 

The above article is an attempt to assist the new mother in her enticing task of caring for her infant. Though she gets adequate hands on assistance from her near and dear ones, our experts aim to provide the modicum of professional insight that will benefit her task.

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Bibliography:

Research review educational series, (2014). Newborn and Infant skin care, Research review publication, www.researchreview.co.nz.

Blume-Peytavi U, Cork MJ, Faergemann J et al. Bathing and cleansing in newborns from day 1 to first year of life: recommendations from a European round table meeting. J Eur Acad Dermatol Venereol 2009; 23:751–759.

World Health Organization. Pregnancy, childbirth, postpartum and newborn care: a guide for essential practice. Geneva: World Health Organization, 2006.

Lund CH, Kuller J, Raines DA et al. Neonatal skin care: evidence-based clinical practice guideline. Washington: Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN), 2007.

Bryanton, J, Walsh, D, Barrett, M and Gaudet, D (2004). Tub Bathing Versus Traditional Sponge Bathing for the Newborn. J Obstet Gynecol Neonatal Nurs.Volume 33, Issue (6), Pg. 704–712.

Loring, C, Gregory, K, Gargan, B, LeBlanc, V, Lundgren, D, Reilly, J, Stobo, K, Walker, C, Zaya, C. (2012). Tub bathing improves thermoregulation of the late preterm infant.J Obstet Gynecol Neonatal Nurs.Vol. 41, Issue (2), Pg: 171-9.

Yosipovitch, G, Metzger, A.M, Merlob, P, Sirota, L. (2006). Skin barrier properties in different body areas in neonates. Pediatrics. 2000, Vol: 106; Pg: 105-8.