Skin and Cord care of your newborn

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Neonatal

You’ve survived 9 months of pregnancy. You’ve made it through the excitement of labor and delivery, and now you’re ready to head home and begin life with your baby. But it is at this stage you realize that you have so many doubts as how to go about it. Here is a guide on how to take care of skin and cord of your newborn baby.

Skin wraps the body in a protective covering and acts as the first line of defense against the harsh external environment. It is also a sensory organ which facilitates mother-baby bonding. Skin of a newborn differs in many aspects from adults – it is thinner, less elastic, more permeable and has higher pH – all this makes it more susceptible to bacterial attack and hence needs special care. Here are a few broad guidelines about newborn skin care-

BATHINGNeonatology

The initial bath in full term infants can be given once the baby’s temperature and breathing has stabilized. WHO recommends bathing after 6 hours of birth. However, you may require to delay bathing under special circumstances like low birth weight or premature baby, unwell baby and extreme cold weather conditions. .The bath of the newborn should not last more than 5 minutes, prolonged bath reduces threshold of skin for friction and increases chances of injury.

For the initial bath, potable clean water is sufficient, lukewarm with temperature around 37oC. Soaps and cleansers are best avoided in the first few weeks of life. The neonate should be bathed in a warm room, and should be dried quickly and thoroughly from head to toe, followed by wrapping in a warm dry towel and placing next to the mother. Sponge baths should be preferred over Tub baths till the umblical stump falls off. Frequent (i.e. daily) bathing and cause irritation and drying of the skin, but 2-3 times a week is appropriate.

TOILETRIES

Synthetic bathing products commonly used for newborn skincare contain chemicals which may affect skin pH and be potential irritants to the skin. It is suggested that the use of soap is unnecessary due to its skin drying potential for all babies during the first month of life.

Baby powders are useful to absorb moisture during hot and humid weather and prevent maceration in skin folds; however they are best avoided in the newborn period. Excessive use can also lead to blockade of sweat duct pores. Accidental inhalation with breathing is another potential hazard.

CARE OF THE DIAPER AREA

The diaper area represents a large moist and humid, occluded environment which is more prone to maceration and attack by bacteria. The skin is also in contact with strong alkalinizing agents e.g. urine and feces and the high pH damages the skin integrity.

It is advisable for the mothers to frequently change napkins, whether they are home laundered or of the superabsorbent variety. The skin should be dried and aired between napkin changes. If frequent changes are not feasible, moisturizers like coconut oil/Vaseline can be used on buttocks to form a physiologic barrier. Warm water and soft cotton wool can be used to wipe napkin area. The bottoms should be wiped from front to back. If a napkin rash occurs, petrolatum jelly or zinc oxide containing pastes can be used. For home laundered diaper, usually washing in lukewarm water followed by rinsing and drying is sufficient.

CARE OF SCALP

Baby shampoos can be used to remove crusts and scales from the scalp. Shampoos should have minimal time of contact with the baby’s scalp to avoid irritant dermatitis. The pH of the shampoo should be close to that of tears and should be non-irritating to the baby’s eyes.

CARE OF THE UMBLICAL CORDNeonatology

The umblical cord should be kept dry and clean.It is important to use only plain water for cleaning, as there is no evidence that other cleaning or drying agents, including creams, sprays or powders, are more beneficial. Care must be taken to tie diaper below the umblical cord and in case of soiling with urine or stools the area should be cleaned with water and kept open for drying.

USE OF EMOLLIENTS

An emollient in as agent that softens and smoothens the skin. They are also referred to as “moisturizers” and “lubricants”. There are two important types of emollient formulations i.e. oil in water emulsion (cream) or water-in-oil emulsion (ointment), out of which cream preparations are generally preferred because the other preparation would be occlusive in the hot Indian weather. The application of an emollient serves the following purposes –

Safe and effective way to decrease neonatal peeling and scaling dermatitis, maintains barrier function, reduces irritation in the napkin area, and also has a role in massage. In the Indian scenario, vegetable oils are used extensively for baby massage and as moisturizers. Coconut oil is preferable for oil massage in newborn as it is time-tested and owing to its small molecular structure, allows easy use and is ideal for dry skin. Olive oil is also useful but nut based oils like almond oil are better avoided for the massaging purpose. Mustard oil contains allylisothiocyanate which can cause contact dermatitis. However overzealous use of vegetable oils should be avoided as it can cause increased occlusion of sweat pores in newborns, and irritant follicullitis.

So, take care of your baby’s skin as explained above and keep it healthy and glowing!