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