NAPNAP 2012: Newborn Skin Care: What the Evidence Shows

Infant’s skin is not fully developed until about the end of their first year. Until then, it is important to keep the skin moist to maintain it as a functional barrier against chemical, bacterial, and allergen infiltration.

Misconceptions about the proper care for young skin prevail throughout the pediatric community. During her presentation at the 2012 NAPNAP annual conference, Renee P. McLeod, PhD, APRN, CPNP, dean, School of Nursing and Health Professions, Brandman University, reviewed evidence-based recommendations for pediatric nurse practitioners and parents.

Preservatives are not a bad thing

Although parents are often looking for products that say natural, preservative-free, or organic, McLeod explained that these products are prone to contamination, especially in the bath setting. In one study, nearly half of emollient samples tested were contaminated with bacteria. Clinical guidelines support the use of products that include a preservative. Products should also be manufactured by and purchased from a well-known entity.

Cleansing

Parents are often told to use only water and a cloth to clean their newborn. The evidence clearly shows that water alone is not a good cleanser and, in fact, is a drying agent. Products used on babies should be clearly indicated for infant use, pH neutral, endorsed by pediatricians or pediatric nurses, and have a record of safety.

Moisturizing

Emollients (eg, Aquaporin) are also recommended for newborns because, when used regularly, they maintain skin integrity and create a mechanical barrier. Petrolatum and mineral oil have a long history of safe use in infants as emollients. Natural oils are not all appropriate for use on baby skin. Many (eg, vegetable oils, nut oils, and olive oils) contain oleic acid, which disrupts the skin barrier.

Sun Protection

Research clearly demonstrates the need for sun protection. In newborns, the primary methods of protection should be avoidance of sun exposure and use of protective clothing. The daily routine for children over six months of age should include application of a broad-spectrum, nonpenetrating sunscreen that is formulated for babies.

Neonatal and Infant Skin Care Guidelines

Bathing and Cleansing in Newborns from Day 1 to First Year of Life: Recommendations from a European Round Table Meeting (Journal of the European Academy of Dermatology and Venereology) http://onlinelibrary.wiley.com/doi/10.1111/j.1468-3083.2009.03140.x/abstract

Neonatal Skin Care: Evaluation of the AWH0NN/NANN Research-based Practice Project on Knowledge and Skin Care Practices (Journal of Obstetric, Gynecologic, and Neonatal Nursing) http://onlinelibrary.wiley.com/doi/10.1111/j.1552-6909.2001.tb01519.x/abstract

Neonatal Skin Care: Clinical Outcomes of the AWHONN/NANN Evidence-based Clinical Practice Guideline (Journal of Obstetric, Gynecologic, and Neonatal Nursing) http://onlinelibrary.wiley.com/doi/10.1111/j.1552-6909.2001.tb01520.x/abstract