Skin Care in Neonates and Infants: A Scoping Review

Abstract

Background Skin care is a basic, daily activity performed by formal and informal caregivers from birth until end of life. Skin care activities are influenced by different factors as e.g., culture, knowledge, industrial developments and marketing activities. Therefore, various preferences, traditions and behaviours exist worldwide including skin care of neonates and infants. Objective of this scoping review was to obtain an overview about the evidence of skin care activities in neonates and infants. Studies from 2010 were eligible if the population were (skin) healthy neonates and infants, if the concept were skin care interventions and if the context was at home, in a community setting, in a paediatric outpatient service or in a hospital. We searched for literature via OVID in Medline and Embase, in the Cochrane Library, in trial registries and for grey literature. Summary We identified 42 studies since 2010, which examined four main skin care interventions: bathing, wiping, washing, and topical application of leave-on products. Details of interventions were often not reported and if they were, they were not comparable. The four skin care interventions focused on 13 different care goals, mainly prevention of skin diseases, maintaining skin barrier function and improving (skin) health. We evaluated effects of skin care interventions using 57 different outcome domains; 39 of 57 were skin related and 18 were not. Mostly, laboratory or instrumental measurements were used. Key Messages Our scoping review identified four skin care interventions with a broad heterogeneity of product categories and application details. Studies in skin care interventions should include all relevant information about product category and application details to ensure comparability of study results. This would be helpful in developing recommendations for formal and informal caregivers. We identified 13 skin care goals. “Maintaining healthy skin/skin barrier function/skin barrier integrity”, “prevention of atopic dermatitis”, “cleansing” and “improving skin barrier function” were most often allocated to skin care interventions. There is substantial variability regarding outcome domains in skin care research. Our results support the need of developing core outcome sets in the field of skin care in healthy skin, especially in this age group of neonates and infants.

Effects of Liquid and Bar Soaps on the Skin of Brazilian Newborns: A Randomized Controlled Trial

“…However, the authors demonstrated the most significant increase in alkaline soap (+0.453) compared to the other groups [26]. Recently, a scoping review of neonatal skin care concluded that cleansing was one of the interventions with the most evidence and pointed out the impact of all cleansing products on moisturizing and skin pH, mainly that exposure to alkaline soaps could impact the skin barrier, produce irritation, and cause pathogenic colonization [27].…”

What is the evidence on skin care for maintaining skin integrity and prevention of wounds? An integrative review

“…The reviews covered the effect of topical oils on neonatal skin, 23 effect of skin care practices on healthy term babies' skin, 24 and a scoping review on skin care in neonates and infants. 6 The systematic review of topical oils (n=5683, mostly preterm infants) reported 11 of 14 studies were of moderate quality and found topical oils (sunflower (8), coconut (5), almond (2), olive (1), mustard (1), vegetable (1)) improved skin condition and barrier function of skin compared to 'standard care' or 'no oil application' groups.…”

“…Many outcome domains were found ( 57), e.g., dryness, erythema, nappy/diaper dermatitis, oedema, excoriation, trans epidermal water loss (TEWL) and overall skin condition. 6 Eight RCTs investigated topical oils, baby cleansing wipes, timing of bathing, or timing of moisturising. Of these, five RCTs, (four with preterm infants, ranging from 72−995 participants) of sunflower seed oil, almond oil, liquid Vaseline, coconut oil, or a general moisturiser, all found improved skin hydration and condition or pH compared to the control groups.…”

“…The skin of neonates has thinner layers of epidermis, dermis and hypodermis with a higher pH than mature skin and continues to develop in the first few months of their life. [4][5][6] Premature infants are at even higher risk due to less connective tissue between the epidermis and dermis and exposure to medical tapes and devices. 5 As we grow older, this largest organ of the human body also undergoes chronological ageing leaving the skin less elastic and moisturised with reduced adipose tissue, which can be exacerbated by the lifelong consequences of the environment.…”

Effect of Educational program on Nurses' Performance Regarding Acquired Skin injuries at Neonatal Intensive Care Units

“…(9,19-21-) It was developed by the researchers and used to assess nurses' practice regarding neonates ' skin care after reviewing recent related literatures. (22)(23)(24)(25)(26)(27)(28)…”