Adam R Skin care of the diaper area. Pediatr Dermatol. 2008; 25:(4)427-33

Adam R, Schnetz B, Mathey P, Pericoi M, de Prost Y Clinical demonstration of skin mildness and suitability for sensitive infant skin of a new baby wipe. Pediatr Dermatol. 2009; 26:(5)506-13

, 3rd Edn.. Washington DC: AWNONN; 2013

Blume-Peytavi U, Cork MJ, Faergemann J, Szczapa J, Vanaclocha F, Gelmetti C 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:(7)751-9

Callado MC, Cernada M, Bauerl C, Vento M Microbial ecology and hostmicrobiota interactions during early life stages. Gut Microbes. 2012; 3:(4)352-65

Capone KA, Dowd SE, Stamatas GN, Nikolovski J Diversity of the human skin microbiome early in life. J Invest Dermatol. 2011; 131:2026-32

Cooke A, Cork MJ, Danby S, Lavender T Use of oil for baby skincare: a survey of UK maternity and neonatal units. British Journal of Midwifery. 2011; 19:(6)354-62

Crozier K, Macdonald S Effective skin-care regimes for term newborn infants: a structured literature review. Evidence Based Midwifery. 2010; 8:(4)128-35

Danby SG, AlEnezi T, Sultan A Effect of olive oil and sunflower seed oil on the adult skin barrier: implications for neonatal skin care. Pediatr Dermatol. 2013; 30:(1)42-50

Darmstadt G, Badrawi N, Law P Topically applied sunflower seed oil prevents invasive bacterial infections in preterm infants in Egypt. Pediatr Inf Dis J. 2004; 23:719-25

Dizon MV, Galzote C, Estanislao R, Mathew N, Sarkar R Tolerance of baby cleaners in infants: a randomized controlled trial. Indian Pediatr. 2010; 47:(11)959-63

Furber C, Bedwell C, Campbell M The challenges and realties of diaper area cleansing for parents. J Obstet Gynecol Nenonatal Nurs. 2012; 41:E13-25

Garcia Bartels N, Scheufele R, Prosch F Effect of standardized skin care regimens on neonatal skin barrier function in different body areas. Pediatr Dermatol. 2010; 27:(1)1-8

Garcia Bartels N, Massoudy L, Scheufele R Standardized diaper care regimen: a prospective randomized pilot study on skin barrier function and epidermal IL-1á in newborns. Pediatr Dermatol. 2012; 29:(3)270-6

Grice EA, Kong HH, Conlan S Topographical and temporal diversity of the human skin microbiome. Science. 2009; 324:1190-2

Grice EA, Segre JA The skin microbiome. Nature Rev Microbiol. 2011; 9:244-53

Gupta SK Non-inferiority clinical trials: practical issues and current regulatory perspective. Indian J Pharmacol. 2011; 43:(4)371-4

Hale R Maintaining healthy infant skin. British Journal of Midwifery. 2008; 16:(6)403-6

Head SJ, Kaul S, Bogers AJ, Kappetein AP Non-inferiority study design: lessons to be learned from cardiovascular trials. Eur Heart J. 2012; 33:(11)1318-24

Hughes K Neonatal skin care: advocating good practice in skin protection. British Journal of Midwifery. 2011; 19:(12)773-5

Jones K Advice to promote healthy neonatal skin and treat common skin disorders. British Journal of Midwifery. 2013; 21:(4)244-7

Lavender T, Bedwell C, Tsekiri-O'Brien E, Hart A, Turner M, Cork M A qualitative study exploring women's and health professionals' views of newborn bathing practices. Evidence Based Midwifery. 2009; 7:(4)112-21

Infant skincleansing product versus water: a pilot randomized, assessor-blinded controlled trial. 2011.

Effect on skin hydration of using baby wipes to clean the napkin area of newborn babies: assessor – blinded randomised controlled equivalence trial. 2012.

Lavender T, Bedwell C, Roberts SA Randomized, controlled trial evaluating a baby wash product on skin barrier function in healthy, term neonates. J Obstet Gynecol Nenonatal Nurs. 2013; 42:(2)203-14

Ludriksone L, Garcia Bartels N, Kanti V, Blume-Peytavi U, Kottner J Skin barrier function in infancy: a systematic review. Arch Dermatol Res. 2014; 306:(7)591-9

Lyon SLondon: Johnson and Johnson and Royal College of Midwives; 2014

McNally NJ, Williams HC, Phillips DR Atopic eczema and domestic water hardness. Lancet. 1998; 352:527-31

London: NICE; 2006

Paller AS, Hawk JLM, Honig P New insights about infant and toddler skin: implications for sun protection. Pediatr. 2011; 128:(1)92-102

Piaggio G, Elbourne DR, Pocock SJ, Evans SJW, Altman DG Reporting of noninferiority and equivalence randomized trials: extension of the CONSORT 2010 statement. JAMA. 2012; 308:(4)2594-604

Stamatas GN, Nikolovski J, Luedtke MA, Kollias N, Wiegand BC Infant skin microstructure assessed in vivo differs from adult skin in organization and at the cellular level. Pediatr Dermatol. 2010; 27:(2)125-31

Stamatas GN, Nikolovski J, Mc M, Kollias N Infant skin physiology and development during the first years of life: a review of recent findings based on in vivo studies. Int J Cosmetic Sci. 2011; 33:17-24

Telofski LS, Morello III AP, Mack Correa MC, Stamatas GN The infant skin barrier: can we preserve, protect and enhance the skin barrier?. Dermatol Res Prac. 2012; 2012

Turnbaugh PJ, Ley RE, Fraser-Liggett CM, Knight R, Gordon JI The human microbiome project. Nature. 2007; 449:804-10

Visscher MO, Utturkar R, Pickens WL Neonatal skin maturation – vernix caseosa and free amino acids. Pediatr Dermatol. 2011; 28:(2)122-32

Visscher M, Narendran V Neonatal infant skin: development, structure and function. Newborn Inf Nurs Rev. 2014; 14:(4)135-41

Neonatal skin cleansing revisited: Whether or not to use skin cleansing products

02 October 2014
Volume 22 · Issue 10


Beyond the need to effectively remove urine and faeces from the nappy area and ensure that skin folds and creases do not become a potential focus of infection, the hygiene needs of most neonates are fairly minimal. Despite this limited need intense debate about skin cleansing and whether or not to use skincare products has endured. Currently the use of skincare products and preparations with neonates is widely proscribed. However, recent research is now challenging one of the central dogmas of neonatal skin care; that water alone is best. This article revisits advice about the use of skin cleansing products in term healthy newborns in the light of new research and suggests there is a need for a more considered and nuanced articulation of the advice provided to parents on this important aspect of care.

Midwives are commonly asked by parents for advice on how they should clean their newborn infant and what should they use on his/her skin. The answers are not as straight forward as might be supposed. Inconsistent and conflicting professional opinion, overwhelming retail choice and advertising by product manufacturers all conspire to be a source of confusion for many families and midwives alike (Lavender et al, 2009). Skin care is a topic that this journal periodically revisits (Hale, 2008; Hughes, 2011; Jones, 2013), thus this article reviews some new evidence about the use of skin cleansing products.

The human body is host to a complex population of symbiotic microorganisms that have a mutual, commensal and sometimes pathological relationship with their host. Collectively they are referred to as the human microbiome (Turnbaugh et al, 2007). The exact nature of the skin biome differs over time, body site and health status (Grice et al, 2009; Capone et al, 2011). However, little is known about how these microorganisms establish themselves during the first years of life (Grice and Segre, 2011; Callado et al, 2012). Nevertheless the roles of this microbiota in health and disease are becoming an increasingly important focus of research for its potential to have health promoting and therapeutic effects. It is widely understood that skin care choices and practises influence the integrity of skin barrier functionality (Garcia Bartels et al, 2010; Danby et al, 2013; Lavender et al, 2013). It is likely that everything which comes into contact with neonatal skin influences its maturation and the pattern of biome colonisation affecting health and pathology.

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