I always tell mums (and dads) that they should imagine their baby’s skin as a bricked wall, with many layers. Each layer has its own function, and how we nourish these layers, sets a foundation for the rest of their lives. It is also important to note that the skin is an organ, and as such, has the capacity to react to many things – which is why we should be careful with what we apply to the skin!
Recent research has also brought to light the importance of the skin barrier and its effect on decreasing the risk of allergies in the first few years of life.
What is Healthy Baby Skin?
Wrinkles, peeling, coarseness, redness, scaling and even fuzz…. Newborn skin is far from flawless but it usually doesn’t mean something is wrong. Your baby’s skin is just adjusting to life outside the womb. Most skin imperfections disappear over time.
It is important to remember that all baby skin is sensitive
Babies’ skin is thinner, more fragile and more sensitive than adults’ skin. It is also less resistant to bacteria and triggers that can irritate skin (e.g. chemicals, detergents, environmental changes). The skin includes a barrier that prevents the loss of too much moisture, and protects the skin from harmful germs or irritants. Appropriate cleansing, moisturising and sun protection will help maintain your baby’s skin barrier, and prevent skin problems in the future.
Skin-Care Products for Baby
Most skin-care products should not be used on very young infants because of the risk of exposure to chemicals, which may be absorbed at higher rates in the thinner, less developed skin of infants. Avoid products with dyes and fragrances, since these may result in allergic reactions. Many (but not all) baby skincare products are formulated to be safe for babies’ delicate skin. You likely don’t need any fancy lotions or creams during baby’s first month. When you do begin using skin care products, be sure to use only products which are specifically recommended for babies. Products formulated for adults may have colourants, fragrances, soaps, and dyes that are too harsh for infant skin.
Sometimes it’s hard to know what’s safe and what isn’t…..These are the ingredients to avoid and look out for on labels:
- SLS – sodium laureth sulphate
Fat based or oil based creams are always preferable to water-based ones, as water-based solutions tend to dehydrate the skin
Is it OK to Skip a Bath?
Babies don’t need a daily bath. During the first few weeks, keeping baby clean during dirty diaper changes and doing sponge baths should do the trick. No full bath is needed until baby’s about a month old. If they are younger than 1, they can be bathed just every 2-3 days. Bathing too often can dry the skin. Between baths keep baby’s face and hands clean by wiping with a damp, warm washcloth.
Bath-Time Skin Care
Bathing your infant can be a gratifying and enjoyable experience for both the parent and child. Remember, however, that an infant’s skin is very sensitive, so try not to “scrub” too hard.
First thing to remember is that Newborns get Rashes Easily! So anticipate them!
Because most newborn’s rashes are “normal”, there is generally no treatment needed other than patience. It’s important to ask the doctor for some guidance about what to expect when it comes to rashes and which require some additional treatment.
Newborn’s Dry Skin
Newborns often have very dry peeling skin in the initial period after birth. This is due to the fact that the infant has existed in a fluid environment for several months, and after birth, the skin cells start to regenerate, which results in the peeling of the old skin cells. There is no need to do anything since this will resolve on its own.
Cradle cap, also called seborrheic dermatitis, is a very common rash seen in newborns. The rash, usually seen in the first month of life, starts on the scalp and has a red, waxy, and scaly appearance. Sometimes the rash can extend to the face and neck. It is not generally itchy, and although it will resolve on its own, cradle cap treatment may include a special shampoo, petroleum jelly, and even a topical steroid. See your paediatrician if it becomes yellow, or pustular.
Diaper rash is often caused by irritation to the skin due to contact with urine, stool, and detergent. Sometimes it can be caused by bacterial infections, yeast infections, or even due to an allergy to diaper material. In general, most diaper rashes can be prevented by changing diapers when they are wet or soiled and allowing the diaper area to dry between changes. Using a topical barrier cream or ointment such as zinc oxide ointment can help.
Acne neonatorum is caused by maternal hormones. The same hormones (oestrogens) are involved in causing acne in adolescents. The big difference is that this will resolve on its own within a couple of weeks, and no treatment is needed. Baby acne on the face is very common and not a cause for concern.
Birthmarks can be found in 5%-10% of all babies. Most of these are common nevi (areas of skin discoloration) and need no further evaluation. Birthmark types are generally divided into three groups: pigmented, vascular, and anatomic. Some birthmarks develop over time, and some are present at birth. Always talk to a paediatrician about any concerns about birthmarks.
Eczema or Atopic Dermatitis
Eczema, also known as atopic dermatitis, is a pruritic (itchy) rash that occurs in response to a specific exposure or allergy. It is generally seen in children over 3 months of age and appears most commonly on the scalp, face, trunk, extremities (elbows and knees), and even in the diaper area. Infant atopic dermatitis treatment is focused on avoiding the trigger and then allowing the skin to “heal.” This may include using moisturisers and even topical steroids. Seeing a paediatrician, or allergist is crucial at this stage as Eczema is usually seen as the start of the so-called “atopic march” which describes the trajectory followed by babies with allergies. Managing the eczema correctly and identifying the allergic trigger can help decrease your infant’s risk of developing other allergies (food, hayfever, asthma) later on in life.
Dr Thulja Trikamjee
Paediatrician and Allergist
Mbchb, FC Paed(SA), Dip Allerg (SA), Cert Paed Allerg (SA), EAACI(UEMS) Allergy & Immunology Exam