Newborn Skin Care: Tips for Keeping Baby’s Skin Healthy and Soft

At birth, a newborn infant goes from the warm, wet, sterile, and safe mother’s womb to a cooler, dry, bacteria-laden environment. The baby begins the journey to self-sufficiency by breathing air, taking nutrition, and maintaining body temperature. Newborn skin is critical to this transition and performs many functions, including:

• Providing a barrier to water loss, light, and irritants
• Infection prevention
• Resilience to mechanical trauma
• Sensation and tactile discrimination
• Body temperature regulation

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Components of Newborn Skincare 

Skin-To-Skin Care (SSC)

• SSC is recommended immediately after birth for all mothers and newborns without complications, irrespective of the mode of delivery.
• Soon after birth, the baby should be placed on the mother’s abdomen before the cord is cut, after which the entire skin and hair are wiped with a dry, warm cloth.
• Baby is left on the mother’s chest, with both of them being covered with pre-warmed blankets for at least 1 hour after birth; this promotes breastfeeding and prevents hypothermia.

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First Cleansing

Baby can be wiped immediately after birth, preferably with a dry towel. It is important to note that the thin white layer over the baby’s skin (vernix caseosa) has important hydration, thermoregulation, bacterial protection, and wound healing effects; it should not be rubbed off and should be retained for at least 6 hours after birth.

Bathing

• The first bath should be conducted only after the newborn’s temperature has stabilised (after 6 hours of birth).
• In newborns, bathing should last not more than 5–10 minutes 
• Bathing should be conducted at least two to three times a week or as often as local culture requires
• The skin may be cleansed with water alone or by adding a liquid cleanser that is free of irritants or mildly acidic (pH 5.5-7)
• Water temperature should be 37°C–37.5°C and depth should be up to the baby’s hips (5 cm)
• Swaddle immersion bath has less risk of hypothermia as compared to sponge bathing
• Room air temperature should be 25 °C and above
• Baby should be immediately covered with a towel and patted dry
• Routine use of powders is not recommended in newborns

Oil Massage

• The oil acts as a source of warmth and nutrition and helps in the weight gain of the baby. Babies massaged with oil show less stress behaviour.
• Coconut oil is the best oil for newborns for massage. Olive oil / Mustard oil not recommended
• Massage should be done only by parents, not by a masseuse.

Care of the Umbilical Cord

• Nothing should be applied to the cord stump. The diaper should be cladded below the stump.
• If soiled with urine/stool, clean it with water and a pH-neutral cleanser and mop it dry.
• Avoid exposing periumbilical skin to chemicals to prevent periumbilical burns.

Care of Scalp

• The cradle cap of the scalp is a common problem in newborn babies. Application of mineral oil to the crust and removal after 2 to 3 hours is helpful.
• Shampoos that are used in babies should be mild, fragrance-free and should not irritate the eyes.
• Hair wash can be given once or twice a week or as and when required in case of soiling.

Nappy Care

• Change diapers frequently to keep the area clean and dry
• The skin of the diaper area should be gently cleansed with cotton balls, squares or washcloths and water alone.
• Drying can be achieved by air drying or gentle mopping with cloth
• The diaper area should be cleaned before bathing 

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Summary

• Skin-to-skin care (SSC) for at least one hour is recommended for all mothers and newborns without complications
• Vernix caseosa should not be rubbed off
• The first bath should be delayed until at least 6 hours after birth. The duration of the bath should not exceed 5-10 minutes. A liquid cleanser with an acidic or neutral pH is preferred.
• Routine use of powders is not recommended in newborns
• Hair wash can be given once or twice a week or as and when required in case of soiling.
• Massage, preferably with coconut oil, should be done by the parents
• Prevention of diaper dermatitis: frequent change of diapers is recommended to keep the area clean and dry.