A newborn baby yawns as he is being bathed in the tub.
Always support the newborn's head above the water during bath time.

Caring for newborn skin

Skin care of the newborn focuses on two main areas, bathing considerations and care of the umbilical cord.

Remember, the newborn has immature thermoregulation. For this reason, only perform the first bath once their temperature is stable. The duration of this bath should not exceed 10 minutes (Kain & Mannix, 2018). If possible, always bathe the baby in a warm and draught free environment. The baby does not require bathing every day, although in some cultures, daily bathing may be preferred (Patane, 2018; Kain & Mannix, 2018).

It’s recommended to bathe newborns by immersing their body up to the upper chest/neck in water, rather than sponging or using washcloths (Kain & Mannix, 2018). Of course, the newborn’s head and face is kept above the water level, by resting on the caregiver’s forearm.

Washing of the newborn’s head and hair can actually be performed by holding the swaddled baby over the edge of the bath and gently washing and rinsing with water. This technique has the advantage of keeping the rest of the baby warm while their head and hair are washed. See the images below. Two images show a swaddled baby having his hair washed, while the rest of his body is kept warm©Shutterstock

For preterm babies less than 32 weeks gestation, warm, gentle bathing with a damp cloth is recommended. For neonates in the intensive care unit, a swaddled immersion tub bath is used. In this, the neonate is swaddled and each limb is lowered into the tub, before being washed, dried and re-swaddled. This minimises physiological stress (Kain & Mannix, 2018).

In the hospital setting, all bathing equipment must be disinfected to prevent the spread of hospital acquired infections. Health professionals should use standard precautions such as wearing disposable gloves (Kain & Mannix, 2018). In the home environment, parents must take care to keep all bathing equipment clean and dry in between use.

Bathing products with fragrance and strong surfactants can be irritating to the newborn’s skin (Blume-Peytavi, Hauser, Stamatas, Pathirana & Garcia Bartels, 2012). Any bathing products used should have a neutral or mildly acidic pH (between the pH range of 6.1-6.5) in order to minimise any irritation to the delicate newborn skin (Kain & Mannix, 2018).

A comical image of a newborn baby wrapped in a towel. She lies back with a towel swaddled around her head as though she is in a beauty salon and there are pieces of cucumber all around her, as though she is in a spa environment©Shutterstock

Caring for newborn skin

When it comes to caring for the skin of a newborn, less is more! Babies don’t have a need for a complicated skin care regimen. Bathing a newborn should be kept to a minimum to avoid stripping the skin of its protective natural oils. The baby’s skin easily absorbs anything applied to it, so if you must use anything topical, fragrance-free, hypo-allergenic products are best.

Cord care

Umbilical cord care involves keeping the remnant stump clean and dry. If it is kept dry, uncovered and not exposed to trauma, it will heal within 12-15 days (Patane, 2018; Kain & Mannix, 2018). As mentioned earlier in the course, the use of alcohol is not necessary.

An important note on newborn skincare for nurses

Strategies to protect the skin should be used and regular assessments must be performed to detect risks and early signs of skin breakdown. This will help to prevent injury to the vulnerable newborn’s skin.

Although not covered in this course, it is essential for nurses to be aware of the potential for injury to the newborn skin due to the use of identification bands, tapes, ties, oxygen delivery devices, intravenous cannulae, lines, connectors and hubs, tubes (oro or nasogastric and endotracheal or nasotracheal), drains, probes, leads and monitoring equipment (Patane, 2018; Kain & Mannix, 2018).

Your task

In the comments section below, please post your experiences with newborn skin care. We’d love you to share stories about bathing babies, caring for the cord and skin care in general.

References

Blume-Peytavi, U., Hauser, M., Stamatas, G.N., Pathirana, D. & Garcia Bartels, N. (2012). Skin care practices for newborns and infants: Review of clinical evidence for best practice. Pediatric Dermatology, 29(1), 1-14.

Kain, V. & Mannix, T. (2018). Neonatal Nursing in Australia and New Zealand, 1st Edition. Australia: Elsevier.

Patane, I. (2018). Skin and Wound Care. In E. Forster & J. Fraser. (Eds.) Paediatric Nursing Skills for Australian Nurses. Port Melbourne: Cambridge.

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This article is from the free online course:

Assessment of the Newborn

Griffith University