Neonatal skin care: the scientific basis for practice

Area of Science:

• Neonatal dermatology
• Pediatric nursing
• Skin integrity research

Background:

• Neonatal skin possesses unique anatomical and physiological characteristics that predispose it to barrier disruption.
• Immature skin barrier function in newborns increases susceptibility to trauma, toxicity, and infection.

Purpose of the Study:

• To conduct a comprehensive literature review on neonatal skin care practices.
• To identify evidence supporting best practices for maintaining neonatal skin integrity.
• To inform the development of clinical practice guidelines for neonatal skin care.

Main Methods:

• Systematic literature search of MEDLINE and CINAHL databases.
• Inclusion of articles published after 1963, with a focus on recent findings (1993-1999).
• Data extraction and organization covering skin anatomy, physiology, differences, nutritional factors, care practices, and breakdown management.

Main Results:

• Newborn skin is highly susceptible to barrier disruption from external factors.
• Evidence supports specific guidelines for bathing, lubrication, disinfection, and adhesive use.
• Recommendations are provided for maintaining skin integrity, minimizing toxic exposure, and promoting long-term skin health.

Conclusions:

• The review synthesized evidence to develop a comprehensive neonatal skin care guideline.
• Clinical practice guidelines are proposed for bathing, lubrication, antimicrobial skin disinfection, and adhesive removal.
• Ongoing evaluation of the developed guideline is in progress at multiple clinical sites.