What Midwives And Nurses Need To Know About Baby Skincare

A newborn’s lipid barrier is essential to the skin’s surface ecosystem, and should not be removed when cleaning Baby. Current guidelines for neonatal skincare make it clear that midwives and nurses, who are often those who give mothers advice on this topic, should be sharing these seven important points:

  1. After birth, leave the vernix caseosa layer on Baby’s skin until all of it is absorbed.
  2. Baby’s first bath should be with plain water, simply to remove birth debris.
  3. After this first bath, Baby should not be submerged in water again until the umbilical cord has fallen off. This will help facilitate the natural separation process.
  4. For the first month, Baby should only be washed with water to support the development of the skin barrier.
  5. After that, gentle skincare products may be gradually introduced.
  6. Only skincare products that have been specifically developed for babies should be used, and not those containing fragrances and phthalates, as these are linked to atopic dermatitis and skin irritations.
  7. Nappies and wipes may trigger irritations. Baby’s buttocks should be cleaned with the gentlest products possible as Baby grows, and wipes should be hypoallergenic and alcohol free.
  8. New clothes and bedding should be washed before use to remove formaldehyde and other potentially harmful chemicals from the manufacturing and packaging processes.

Bathing Baby

Most mothers feel intimidated by the thought of bathing their newborn babies, a sentiment intensified by books and magazines that portray the bathing of a baby as an intricate science. And yet, most of their anxiety is about handling their Baby safely. Although it’s helpful to share bathing tips and techniques, it’s more important to reassure mothers that their instincts will prevail and that soon, they’ll be caring for their babies with confidence.

Bathing should be limited to two or three times a week in the early months, to reduce the risk of skin irritation and changes to the skin’s pH. At birth, a baby’s skin is covered by vernix caseosa (VC), a biofilm with sophisticated antimicrobial properties. Most of the VC dries off, or is reabsorbed into the skin within 24 hours after birth. The skin also undergoes various changes in Baby’s first month to adapt to the extra-uterine environment:

  • A protective acidic layer forms on a newborn’s alkaline skin surface.
  • Lipids get deposited in the stratum corneum layer of the skin, and play a crucial role in maintaining the skin’s barrier, integrity and health.
  • The skin is colonised with microorganisms, and forms its own stable microbiota

Chemical skincare products disturb these processes, increasing the risk of skin infections and allergies. Soaps, detergents and moisturisers should be avoided as much as possible for Baby’s first month. Any products that are used must be extremely mild, and formulated for a baby’s skin. Cleansers and emollients with a neutral pH have better safety profiles.


About the Author:

Lilian Paramor (known as Sister Lilian) holds a B.Nursing degree from the University of Stellenbosch (1978) and is a qualified and registered SANC nurse and midwife (1980). She is also a qualified reflexologist and natural health practitioner. Sister Lilian has close to 40 years of health professional experience, and is South Africa’s leading pregnancy and parenting advisor. She is well-known in both the maternity professional world as well as amongst the parenting community in South Africa and beyond. Her trademarks are her compassion, credibility and innovation ability, showcased by her longstanding approach of ‘first do no harm’ and her work slogans ‘with nature, knowledge and experience’ and ‘advice you can trust’. Sister Lilian has had six pregnancy and parenting books published in South Africa, edited and adapted a Canadian parenting book for the South African market and contributed to a renowned Juta handbook for midwives. She has also written and published numerous topic-specific booklets for midwives and parents, on subjects like breastfeeding, nutrition, birth, and sleep. Sister Lilian’s has also been a popular radio and TV presenter and often contributes to parenting magazines. She started in private practice in Pretoria in 1988; this morphed into the Sister Lilian Centre® in 1994, which also runs one of the most renowned midwifery conferences in the southern hemisphere, called Sensitive Midwifery Symposium, and publishes Sensitive Midwifery Magazine for professionals, as well as an online pregnancy, birth and parenting magazine called eBaby.

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