Update on Newborn Bathing

Joanne McManus Kuller, RN, MS

Disclosures

NAINR. 2014;14(4):166-170. 

In This Article

Routine Bathing

If a baby has their diaper area wiped with diaper changes, they don't need bathing more than 2–3 days/week. More frequent bathing may dry out their skin. The effect of standardized skin regimes on neonatal skin barrier function was studied over an eight week period.[35] Sixty-four term infants were randomized to water only, water plus wash gel, water plus cream after bath and water plus wash gel plus cream after bath. Babies were bathed twice a week during the study. TEWL, stratum corneum hydration (SCH), pH, neonatal skin condition score and umbilical cultures were done on Day 2 and Weeks 2, 4 and 8. There was no difference in umbilical cultures among the groups. The TEWL was lower (improved) and SCH was better with cream compared to water alone. The result showed that skin care regimes are no worse than water on skin barrier adaptation.

Preterm infants have an immature stratum corneum and overall under-developed skin structures. They are at risk for skin disruption and toxicity from topically applied substances.[36] For preterm infants less than 32 weeks of gestation, gently clean skin surfaces using warm water only during the first week of life. Use soft materials such as cotton balls or cotton cloth but avoid rubbing the skin. Water can be squeezed onto the skin during rinsing. If areas of skin breakdown are evident, use warm sterile water.[8]

Bathing before sleep has been reported to enhance the quality of sleep.[37]

Applying a moisturizer immediately after bathing can prevent dry skin or potentially protect against worsening of eczema and the development of atopic dermatitis. A contributing factor to the development of atopic dermatitis may be sensitization to allergens and impaired barrier function of the stratum corneum.[38] A trial is underway to see whether atopic dermatitis can be prevented by improving the skin barrier function in infants with a strong family history of this skin disorder.[39] In developed countries, the incidence of atopic dermatitis seems to be on the increase with the current incidence cited as 20%. This is of concern because of its association with asthma and food allergies; known as "the atopic march".[40]

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