Skin Care of Newborns

Abstract

The recent concern related to bathing newborns with hexachlorophene has led to a redefinition of appropriate skin care for newly born infants in hospital nurseries. Skin manipulations are performed (1) for prevention of infection and (2) for aesthetic and cleansing purposes. The skin is a protective organ and any break in its integrity affords an opportunity for initiation of infection. In addition, it is clear that protection against invading pathogenic organisms is afforded by skin secretions or contents and the normal skin biota. Therefore, skin care should involve cleansing with a non-toxic, non-abrasive neutral material. Consideration of skin care of the newborn is further complicated by the fact that the infant does not have protective skin flora at birth, has at least one and possibly two open surgical wounds, the umbilicus and circumcision site, and is exposed to fomites and personnel that harbor a variety of infectious agents. Risks and benefits of each skin-care technique in the newly born must be weighed. Is the agent used absorbed and toxic directly or indirectly? What is the effect of the technique on the skin itself? Does the agent predispose to a biota change that is detrimental to the infant? The currently available data suggest that perhaps the best method for managing infant skin is to minimize manipulation. The recommended technique is referred to as dry skin care. "Dry technique" is recommended for the following reasons: (1) it subjects the infant to less heat loss by exposure; (2) it diminishes skin trauma; (3) it requires less time, and (4) it does not expose the infant to agents with known or unknown side effects.