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Infant skin care

May 17, 2017 | Illnesses

Vernix caseosa (surface biofilm consisting of dead epidermal cells and sebaceous secretions that covers the skin of the developing foetus) provides natural skin protection throughout the pregnancy. It is the best lotion imaginable and should be rubbed into the skin immediately after birth. New-born babies are usually bathed with antibacterial soaps which eliminate the natural, protective acid mantle, thus disturbing the delicate balance of the bacterial flora. Healthy babies born on time should not be washed with soap: simply use a sponge and some warm water to remove traces of blood (if there are any). Removing the vernix is not recommended. While the child is lying next to her, the mother can use her fingertips to gently massage the vernix into the infant’s skin. The skin of babies born after the due date is chapped and dry as the vernix has been absorbed. In these cases, applying products on the skin is not recommended. The surface layer will fall off, leaving healthy skin beneath.

“Less is more!”

Guided by the ideal of a clean and sweet-smelling baby, parents often feel the urge to provide as much care as possible by using a variety of products. However, due to its vulnerability and immaturity, the application of a large amount of different hygiene and care products can potentially endanger the infant skin. It is also likely to increase the frequency of eczemas, asthma and other allergic illnesses. For this reason, the only thing recommended for infant body care is water.

Before commencing the care, and especially prior to washing the umbilical cord stump, the hands must be washed thoroughly. Only water and cotton (gauze or bath glove) are recommended for the child’s first baths. This helps protect the gentle skin during a period of its increased sensitivity to infections, chemical products and dryness. Special attention during washing should be given to the armpits, the areas behind the ears and below the chin, as well as the areas covered by the diaper. The area between the fingers and toes should also be washed thoroughly. To keep the child warm, uncover only those parts of the body that are going to be washed.

Use a comb (take one to the hospital with you) to gently remove scalp sediments. Washing the skin around the eyes is not recommended; however, should a discharge appear, the area can be washed with thoroughly boiled water or a sterile physiological solution. The nasal and ear passages should not be cleaned (especially not with cotton swabs).

Chemical care products should be especially avoided in the case of prematurely born babies, at least before their due date. It is not necessary to wash the hair during each bath. If it appears dirty, a drop of mild shampoo can be gently massaged into the scalp.

Bellybutton care

The area of the umbilical cord stump has to be kept clean and dry. The stump has to be exposed to air, so make sure the upper edge of the diaper is folded inward. Use damp cotton gauze to wash the bellybutton area only if it is smudged with faeces. Previously, parents were advised to apply alcohol and antibiotic powders to the stump during each diaper change. However, recent studies have shown that the stump will simply fall off if left alone. Should you notice redness, pus discharge or an unpleasant smell of the umbilical cord stump, immediately consult your physician.

What to do after defecation?

The soiled body parts should be washed under a stream of lukewarm water immediately after defecation. Afterwards, dry the skin of the perianal and perigenital area. Damp wipes (alcohol-free and devoid of strong smells) may be used as an alternative, but only after the baby’s first month.

Genital care

With male infants, the prepuce (foreskin) should only be retracted to the point where this can be done without applying any kind of force. Dirt should be cleaned with cotton pads dipped in water. After the first year – if the prepuce can easily be retracted – soap and water can be applied. Typically, full retraction should be possible by the fifth year.

With female infants, remove all stool remains with a cotton pad dipped in lukewarm water by swiping it from the top to the bottom. Use a different pad for each new swipe.

Tub baths

Tub baths can begin after the bellybutton wound has healed. We recommend the use of larger flat-bottomed tubs as they allow for more freedom, which increases the joy of “swimming”. Everything needed for child care should be within reach. There is no need to move away from the baby – keep one arm in constant contact with the baby. The room temperature should be around 24°C, with the water temperature around 37°C. During their first year, most infants do not require shampooing. Should this be necessary (e.g. due to a large amount of hair), use mild shampoos that do not contain synthetic fragrances, colours or highly allergenic or irritating preservatives. Generally speaking, bath products are also not necessary during the first year: they are difficult to rinse off, so the baby needs to be showered afterwards. Soap used for infant (as well as adult) skin has to be neutral or mildly acidic (pH around 5.5; this is indicated on the product packaging). Synthetic detergents are a modern alternative to soaps. They wash just as well as soaps, but their stability in hard water, lower pH value and the fact that skin (especially skin with chronic eczema) responds to them better gives them an advantage over soaps. Bubbly baths are not recommended at an early age. In fact, the majority of bathing products contain detergents that destroy the useful bacterial skin flora and remove the skin’s protective acidic layer. They are considered to be a frequent cause of vaginitis and urinary tract inflammation in infants.

In winter, the skin is more exposed to excessive dryness, so infant baths should be less frequent during very cold periods.

If your child cries during the tub bath, try to remain calm and wash the child as much as possible at that moment. Then take the baby out of the water, wrap him/her in a towel and hold him/her close to you. After a few days of washing the baby with damp gauze or a soft towel, try the tub bath again.

Olive oil is not recommended for infant skin care, because the oleic acid contained there dissolves the two-layer membranes that work together to connect the cells from the surface of the skin. If necessary, use organic almond oil instead.

Diaper rash

This is a common type of skin inflammation (dermatitis). Most infants contract it between the age of eight and ten months. It is more frequent among infants with thrush (fungal infection of the oral cavity manifested as white layers on the tongue and the oral cavity mucosa) and infants taking antibiotics, or after the introduction of supplemental feeding. The use of new washing products, tight diapers and consequent mechanical friction, infrequent diaper changes, diarrhoea and the use of plastic underwear all contribute to diaper rash. Due to reduced immunity and impaired skin integrity, fungal, sometimes even bacterial, superinfections are common. To suppress diaper rash, it is important to frequently change diapers and dry the skin. If the rash is very prominent, consult your nurse or physician who will evaluate the need for using antifungal or antibacterial creams.