What parents and professionals need to know about newborn skincare

By Rachel Scanlan - Practice and Standards Professional Advisor on 15 August 2018 Newborn

When it comes to looking after baby’s skin, midwives and MSWs often have to answer many questions from new parents. 

When should baby have their first bath? What can I put in the water? Should I use petroleum jelly every time I change the nappy? What can I put on baby’s skin if it looks dry?  It can be difficult to know the right answer because there is very little research and evidence to support parents in their search to do the right thing. We also know there is a rise in the prevalence of childhood atopic eczema. In addition to these factors, the most recent NICE guidance on infant skincare was written in 2006 and really needs updating.

As a response to this situation, the Royal College of Midwives commissioned the University of Manchester to undertake a review of the evidence on healthy newborn skincare, assess what the advice given by healthcare professionals is and how that information is received by parents. The team at the University of Manchester then developed recommendations and guidance detailing what and how parents want to know newborn skincare information. They have also produced key information for healthcare professionals on how to respond to parents’ questions and concerns.

The Royal College of Midwives wants to share these recommendations with other key health professionals who work with parents, so that the quality of evidence based information given is the same. We are holding a stakeholder event in the Autumn and the University of Manchester team are going to share their recommendations for professionals. In this way we are hopeful that some of the confusion that parents talk about when seeking advice on skincare can be removed and we can all give the same consistent advice.

We are sharing the professional recommendations here to make sure our members have the most up to date evidence when asked about newborn skincare. All the recommendations apply to newborn babies up to 6 months of age. A best expert opinion is provided to cover situations where there is insufficient evidence.


Bathing and cleansing:

Only certain products have been tested in robust clinical trials and found to be safe to use from birth as an alternative to water only

Product formulation should be pH balanced and should NOT include sodium lauryl sulphate

There is no evidence for the timing of the first bath


Best expert recommendation:

Delay bathing until the baby’s temperature has stabilised and only bath 2-3 times per week


Nappy care:

Only certain wipes have been tested in robust clinical trials and found to be safe to use from birth as an alternative to water only


Best expert recommendation:

Change the nappy as often as necessary to keep skin clean and dry, and the nappy area should be cleansed and dried at each change

The nappy area can be dried by exposing to the air or gentle patting

A small amount of emollient can be applied to the nappy area as a method of prevention or treatment of nappy rash


Care of the hair and scalp:

There is no specific evidence but only certain wash products have been tested in robust clinical trials and found to be safe to use from birth as an alternative to water only and these can be used to cleanse the hair and scalp

If parents have concerns about cradle cap suggest they consult their Health Visitor or GP


Best expert recommendation:

2 -3 times per week is the maximum frequency for cleansing the hair and scalp


Management of dry skin:

Olive oil and sunflower oil have been tested in a robust clinical trial and should NOT be used for the treatment or prevention of baby dry skin

NO other oils have been tested for safety in clinical trials on baby skin

The application of a full body emollient may be beneficial for babies with a family history of atopic eczema


Baby massage:

There is NO evidence regarding the implications for skin integrity and NO best expert recommendation as to a safe product to use for massage but over the counter cooking or kitchen oils must NOT be used, NOR olive or sunflower oil as specified above (see the management of dry skin). 


Relevant studies:

Infant skin-cleaning product versus water: A pilot randomized, assessor-blinded controlled trial

Randomised, Controlled Trial Evaluating a Baby Wash Product on Skin Barrier Function in Healthy, Term Neonates

Effect on skin hydration of using baby wipes to clean the napkin area of newborn babies: assessor-blinded randomised controlled equivalence trial.


Presentation of Findings

See the key findings from the study and implications for practice presented by Dr Alison Cooke at the 2018 RCM Conference.

You can also access her full presentation here.