Wednesday, 20 November 2013

Seven things you must know about Baby's skin care

A common worry that bothers all parents is the care of baby's skin. In my new post I try to capture the frequently asked questions on skin and hair care for babies. 
I will start by explaining the skin structure in very simple language and then explore how to take care of baby's skin and hair.

Q 1 – How is the skin of my child different? Does it require some extra effort and then so, Why?
Ans -The skin of an infant is different from adults in many ways which is crucial for understanding the skin care regimen for the parents -
Skin  Structure of Newborn
         Implication for skin care
a)           Higher skin surface area to weight ratio (skin surface area of infant is 700 cm2/kg as compared to adult skin which is 250 cm2/kg) .
a) Increased absorption in the blood of topical preparations (applied products)on the skin.
b)           Connection between the upper layers  of skin (epidermis and dermis) is not very strong
b) Blisters can form easily.
c)           The skin barrier is not fully developed
c)More susceptibility to infections and allergic reactions
AND Increased water loss from the skin
d)           Smaller  and inactive sweat glands
d)Decreased sweating , more possibility of heat rash or prickly heat
e)           Acidic pH of the skin
e) Any increase of pH can increase bacterial colonization of the skin.

Q2-Doc, which soap should I use for my Baby?
Ans- Most of the soaps contain surfactants ( Read More here) which can have harmful effects on the skin of the newborn-
  1. They deplete the lipid part of the skin barrier hence making it weaker
  2. Increase the pH of the skin hence increasing the risk of skin infection
  3. Denature( destroy) skin proteins further weakening the skin barrier.

Q3- What are the alternative for soap ?
Ans-  Cocoyl isethionate,sodium lauryl sulphate, and betaines are examples of synthetic non soap detergents (syndets ) which retain the normal pH of the skin but can be drying. Such syndets with addd moisturisers like mineral oil , paraffin and glycerince are most suitable. Soap free cleansers should be preferred but in smaller quantities. Soaps which produce more foam are HARMFUL for your baby's skin.

Q4 – When should I start applying soap to my baby?
Ans- Minimal use in first few months.
Immediately after birth, skin pH may be >6.0 which  falls to 4.95 after birth. This protective “acid” mantle protects against pathogens. Any  soap application will raise the skin pH from acid to neutral hence  increasing the total number of bacteria and increased moisture  loss. Regeneration of skin pH takes at least an hour after washing with alkaline soaps.  If at all needed, healthyterm newborns and infants can be washed MINIMALLY  using cleansers of neutral or slightly acidic pH, which have a gentle surfactant, be chemically and physically stable, and should contain an emollient. BOTTOMLINE is MINIMAL use of soaps in the first month of age.

Q5 – How should I wash  my baby's hair?
Ans -  Shampoos should have minimal time of contact with the scalp to avoid irritant dermatitis. The shampoo should be free from fragrance, anti-inflammatory agents and natural products. Most baby shampoos in the market contain anionic surfactant which ensures adequate cleaning. The pH of the shampoo should be close to the a that of tears and should be non-irritating to the baby’s eyes.

Q6- What about the napkin area of my baby?
Ans- The diaper area is probably the most frequently washed area of the baby.
Cleaning the nappy area "Front to back"
  1. Regular nappy/diaper change is a must as baby’s stool and urine can macerate the skin of your baby if in prolonged contact.
  2. “Baby wipes”- they also should be alcohol and preservative free. Consult your Dermatologist for recommendations.
  3.  Always clean the area from front to back with soft cotton cloth or towel.
  4. Apply a  Bland moisturiser and a barrier cream containig Zinc Oxide for skin protection if prolonged Diaper wear is required.( Use Dermatologist /Pediatrician recommended Diaper rash creams) 

Q7- What precautions I should take while washing my Baby’s clothes?
Ans-  You should use gentle detergents for washing your baby’s clothes.
  1. Avoid  adding antiseptic solutions or cleansers ( e.g Dettol etc.). They are VERY HARSH for your baby’s skin.
  2. The detergent should be fragrance free
  3. Rinse the detergent thoroughly. (MACHINE WASH IS BETTER THAN HAND WASH)
  4. Donot add Fabric Conditioners/Bleaches
  5. Prefer cotton and linen waer for your baby
  6. Wash any new dress before making your child wear that.

I have tried to touch the most commonly asked questions about Baby Cleansing. Please feel free for comments/queries and spread this message across for Better skin care for our children which they truly deserve and desire. This will be followed by How to tackle dry skin in children. Happy Reading!!! Stay skin healthy and skin wiser!!

Dr Divya Sharma is a practicing dermatologist at Bangalore. The data shared in this blog is her personal opinion based on her knowledge and experience. The author is not responsible for any adverse event that arises out of following blog opinion
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