References

Blume-Peytavi U, Lavender T, Jenorowicz D, Ryumina I, Stadler J-F, Torrelo A, Cork MJ. Recommendations from a European roundtable meeting on best practice healthy infant skin care. Pediatric Dermatology. 2016; 33:(3)311-321 https://doi.org/10.1111/pde.12819

Buckley B, Dofitas RB, Monteagudo A, Mantaring JBV, Lapitan MC. A new scale for assessing the severity of uncomplicated diaper dermatitis in infants: development and validation. Pediatric Dermatology. 2016; 33:(6) https://doi.org/10.1111/pde.12988

Cooke A, Bedwell C, Campbell M, McGowan L, Ersser SJ, Lavender T. Skin care for healthy babies at term. Midwifery. 2018; 56:29-43 https://doi.org/10.1016/j.midw.2017.10.001

Efird J. Blocked randomization with Randomly Selected Block Sizes. International Journal of Environmental Research and Public Health. 2010; 8:(1)15-20 https://doi.org/10.3390/ijerph8010015

Ehretsmann C, Schaefer P, Adam R. Cutaneous tolerance of baby wipes by infants with atopic dermatitis and comparison of the mildness of baby wipe and water in infant skin. Journal of the European Academy of Dermatology and Venereology (JEADV). 2001; 15:(1)16-21 https://doi.org/10.1046/j.0926-9959.2001.00004.x

Furber C, Bedwell C, Campbell M, Cork M, Jones C, Rowland L, Lavender T. The challenges and realities of diaper area cleansing n for parents. JOGNN. 2012; 41:E13-E25 https://doi.org/10.1111/j.1552-6909.2012.01390.x

Garcia Bartels N, Lünnemann L, Stroux A, Kottner J, Serrano J, Blume-Peytavi U. Effect of diaper cream and wet wipes on skin barrier properties in infants: a prospective randomized controlled trial. Pediatric Dermatology. 2014; 31:(6)683-691 https://doi.org/10.1111/pde.12370

Goldman M, Lodhi I. A real-world evidence study evaluating treatment for nappy rash. British Journal of Nursing. 2016; 25:(8) https://doi.org/10.12968/bjon.2016.25.8.432

Jones SR, Carley S, Harrison M. An introduction to power and sample size estimation. Emergency Medicine Journal. 2003; 20:453-458 https://doi.org/10.1136/emj.20.5.453

Kelley K, Clark B, Brown V, Stizia J. Good practice in the conduct and reporting of survey research. International Journal for Quality in Health Care. 2003; 15:(3)261-266 https://doi.org/10.1093/intqhc/mzg031

Lavender T, Furbur C, Campbell M, Victor S, Roberts I, Bedwell C, Cork MJ. Effect on skin hydration of using baby wipes to clean the napkin area of newborn babies: assessor blinded randomized controlled equivalence trial. BMC Pediatrics. 2012; 12 https://doi.org/10.1186/1471-2431-12-59

Lewis-Beck MS, Bryman A, Futing Liao, T. The SAGE encyclopedia of social science research methods.Thousand Oaks, CA: Sage Publications; 2004 https://doi.org/10.4135/9781412950589

Li CH, Zhu ZH, Dai YH. Diaper dermatitis: a survey of risk factors for children aged 1-24 months in China. The Journal of International Medical Research. 2012; 40:1752-1760 https://doi.org/10.1177/030006051204000514

Monk RL, Heim D, Qureshi A, Price A. ‘I have no clue what I drunk last night’: using smartphone technology to compare in-vivo and retrospective reports of alcohol consumption. PlOS ONE. 2015; https://doi.org/10.1371/journal.pone.0126209

National Institute for Health and Care Excellence. Maternal and child nutrition. 2014. https://www.nice.org.uk/guidance/ph11/chapter/2-public-health-need-and-practice (accessed 10 June 2020)

Oakley LL, Renfrew MJ, Kurinczuk JJ, Quigley MA. Factors associated with breastfeeding in England: an analysis by primary care trust. BMJ Open. 2013; 3:(6) https://doi.org/10.1136/bmjopen-2013-002765

Census aggregate data.: UK Data Service; 2016

Philipp R, Hughes A, Golding J. Getting to the bottom of nappy rash. British Journal of General Practice. 1997; 47:493-497

Price AD, Lythgoe J, Ackers-Johnson J, Cook PA, Clarke-Cornwell AM, Macvane Phipps F. The BaSICS (Baby Skin Integrity Comparison Survey) study: a prospective experimental study using maternal observations to report the effect of baby wipes on the incidence of irritant diaper dermatitis in infants, from birth to eight weeks of age Pediatrics and Neonatology. 2020; https://doi.org/10.1016/j.pedneo.2020.10.003

Ravanfar P, Wallace JS, Pace NC. Diaper dermatitis: a review and update. Current Opinion in Pediatrics. 2012; 24:(4)472-479 https://doi.org/10.1097/MOP.0b013e32835585f2

Robson C, McCartan K. Real world research. A resource for users of social research methods in applied settings, 4th edn. Chichester: Wiley and Sons Ltd; 2016

Rogers S, Thomas M, Chan B, Hinckley SK, Henderson C. A quality improvement approach to perineal skin care. Using standardized guidelines and novel diaper wipes to reduce diaper dermatitis in NICU infants. Advanced Neonatal Care. 2020; https://doi.org/10.1097/ANC.0000000000000795

Salkind NJ. Encyclopedia of research design.Thousand Oaks, CA: SAGE Publications; 2010

Smith MV, Kruse A, Weir A, Goldblum J. Diaper need and its impact on child health. Pediatrics. 2013; 132:(2) https://doi.org/10.1542/peds.2013-0597

Stamatas GN, Tierney NK. Diaper dermatitis etiology, manifestations, prevention and management. Pediatric Dermatology. 2014; 31:(1)1-7 https://doi.org/10.1111/pde.12245

Visscher MO. Recent advances in diaper dermatitis: etiology and treatment. Pediatric Health. 2009; 3:(1)81-98 https://doi.org/10.2217/17455111.3.1.81

Visscher M, Odio M, Taylor T, White T, Sargent S, Sluder L, Smith L, Flower T, Mason B, Rider M. Skin care in the NICU patient: effects of wipes versus cloth and water on stratum corneum integrity. Neonatology. 2009; 96:226-234 https://doi.org/10.1159/000215593

Walters SJ, Bonacho dos Anjos Henriques-Cadby I, Bortolami O, Flight L, Hind D, Jacques RM, Knox C, Nadin B, Rothwell J, Surtees M, Julious SA. Recruitment and retention of participants in randomized controlled trials: a review of trials funded and published by the United Kingdom Health Technology Assessment programme. BMJ Open. 2017; 7:(3) https://doi.org/10.1136/bmjopen-2016-0-15276

Yoshioka H, Iseki K, Fujita K. Development and differences in intestinal flora in the neonatal period in breastfed and bottle-fed infants. Pediatrics. 1983; 72:317-321

698 mothers and babies, 38 390 nappy changes: what did we learn?

02 March 2021
12 min read
Volume 29 · Issue 3

Abstract

Background

Several industry funded studies between 2001–2018 have compared the use of a single brand of baby wipes to cleansing with water and either cloth or cotton wool during nappy changes. All of these studies found that wipes were safe and effective from birth. Recommendations from these studies have included the need for brand or formula comparison but to date, no previous study has done this.

Aims

The ‘Baby skin integrity comparison survey’ (BaSICS) study was designed to compare three brands of baby wipes to determine if there was any difference in the incidence of irritant diaper dermatitis (IDD or nappy rash) during the first eight weeks of life.

Methods

Mothers who were allocated to a single brand of nappy but divided into three baby wipe allocation groups, collected and reported survey data on infant skin integrity during one nappy change daily with the use of a user-friendly smartphone application.

Findings

All brands of wipes were acceptable to mothers and safe and effective when cleaning during nappy changes. The brand containing the fewest ingredients showed a clinically significant advantage of fewer incidents of rash than the other two brands.

Conclusion

This study demonstrated that wipe formulation is a significant factor in prevention or reduction of IDD during the first eight weeks of life.

In 2018, a midwifery research group in the North of England was commissioned by a manufacturer of baby wipes to compare three brands of wipes, including their own, to determine whether there was any significant difference between products. The manufacturer's initial hypothesis that their wipes protected against nappy rash was based on anecdotal evidence. To ensure lack of bias, good scientific practice and ethical research conduct, they engaged a university based research group to design and implement a prospective experimental study, as defined by Salkind (2010), to conduct a brand comparison with daily use of baby wipes during the first eight weeks of life.

The title of the study is the ‘Baby skin integrity comparison survey’ (BaSICS) study and the location in which the study took place was a major urban district that included outlying suburban and rural areas. This location was selected as it represented a diverse population in terms of both ethnicity and socioeconomic classification. The aim of the research was to determine whether there was any difference in the incidence of irritant diaper dermatitis (IDD), also known as nappy rash, when different brands of baby wipes were used to cleanse the skin during nappy changes when the brand of nappy was the same across all three arms of the study.

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