Understanding the vulnerability of a baby's skin to help treat and prevent nappy rash
With an estimated one third of all nappy wearing babies and toddlers experiencing nappy rash at any one time, it is critical that health professionals both understand the causative factors of nappy rash while also having full insight into prevention and management of this common complaint. Nappy rash can range in severity from mild to severe and can cause great discomfort and distress. Understanding the process and timescale of how a newborn's skin changes and develops helps support health professionals in understanding why certain skin cleansing regimes are supported, ensuring best practice is implemented.
The first breath taken within seconds of birth is a vital role allowing the lungs to fill with air (Kenner and Lott, 2014)—signifying the moment the baby is now living in a gaseous (air) environment rather than a fluid (amniotic fluid) environment. This change in environment can greatly impact the skin, the bodies largest organ; moving from a wet to dry environment. A crucial role of the skin is to act as a barrier; problems occur if this barrier becomes impaired. Watkins (2016) acknowledged how many common health complaints in newborns relate directly to the skin, these include: cradle cap, dry skin and rashes, including milia, heat rash and nappy rash.
Establishing good skincare regimes from birth has been seen to be beneficial in supporting healthy skin throughout life (Ness et al, 2013). Nikolovski et al (2008) identifies how the stratum corneum (the outer most layer of the skin) fully develops during the first 12 months of life; making this first year even more critical in ensuring appropriate evidence-based skincare regimes are implemented.
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