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.
• Infant skin is susceptible to trauma, toxicity, and breakdown, necessitating specific care protocols.

Purpose of the Study:

• To conduct a comprehensive literature review on neonatal skin care practices.
• To identify evidence-based recommendations for maintaining healthy infant skin.
• To inform the development of clinical practice guidelines for neonatal skin management.

Main Methods:

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

Main Results:

• Newborn skin is at high risk for barrier disruption from external factors and trauma.
• Evidence supports specific guidelines for bathing, lubrication, disinfection, and adhesive removal in neonates.
• Recommendations emphasize maintaining skin integrity, minimizing exposure to toxins, and promoting long-term skin health.

Conclusions:

• The review provides a foundation for a new, comprehensive clinical practice guideline for neonatal skin care.
• Ongoing evaluation of this guideline is being conducted across multiple clinical sites in the U.S.