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Larissa Lawrence with her premature baby
newborns

Premature baby skin care routines – caring for your preemie’s skin

4 mins

04/03/2020

Skincare is important for everyone, but it’s even more essential for premature babies’ skin. As they’re born before they’re fully developed1, your preemie has a greater risk of infection and it’s easier for them to lose heat and water through the skin2.

You must take time to nurture your infant’s skin, establishing an effective premature baby skin care routine that gives them what they need to grow healthy and strong. In this guide, we’ll provide you with helpful advice on how to care for your premature baby’s skin, covering topics like skin colour change, rashes, and dry skin.

What helps premature babies’ skin?

If your baby is in the neonatal intensive care unit (NICU), the trained nurses will have specialised methods in place when caring for your baby’s skin. This could include using premature baby skin-safe oils and other sensitive products like WaterWipes®.

WaterWipes prides itself on being purer than cotton wool and water. All WaterWipes contain minimal ingredients: 99.9% water and a drop of fruit extract which acts as a natural skin conditioner – making them suitable for a premature baby’s skin.

When caring for your baby’s skin yourself, you mustn’t use any products without checking with your nurse or doctor first3. Preemie skin is highly permeable and vulnerable and therefore has a greater risk for toxicity and chemical challenges1.

Putting your newborn in soft cotton clothing rather than synthetics or coarse-fibred wool that can be scratchy can also help to care for their skin and avoid irritation3.

Learning how to touch your premature baby’s skin is also key3. In some cases, parents may have to wait until their baby’s skin has developed enough to touch them1. Take advice from your NICU team, but always remember to be as gentle as possible1.

Once your baby’s skin has matured enough to handle skincare products, it’s advised that you use safe, organic lotions, gels, and creams that are free from synthetic fragrances and harsh chemicals1. Products should also hydrate the skin, improve its protective barrier, and help to keep it at its healthiest pH – this is usually slightly acidic at around 5.51.

How often should you bathe a preemie baby?

How often you wash your preemie will depend on how premature they are and how developed their skin is4. It’s usually advised that you don’t bathe or wash your baby’s hair more than 2 or 3 times a week4. However, in between baths, you can use cotton wool and tepid water to wash your infant’s face, neck, and bottom4. Always check the temperature of the water first and ensure there are no hot patches – you can do this with your wrist or elbow4.

Use plain water to wash your premature baby’s skin4. On occasions where you need to use soap, consult a nurse or doctor to find out which product is best for their delicate skin4.

When do premature babies get their skin colour?

Your baby will develop its permanent skin tone at around six months old6. Premature babies are often born with red, wrinkled transparent skin5. They also usually have tiny veins that are visible below the skin's surface. All premature babies, no matter their ethnicity, have the same dusky-red skin colour at first. Their natural skin colour will develop over time5.

Do premature babies skin colour change?

Yes, a premature baby’s skin colour will change over time. When you first give birth to your baby, their skin will be a dark red to purple colour. As they start breathing, this colour will change to red – this usually fades within the first day. Your baby’s hands and feet may remain a blush colour for a few days, this is completely normal due to their underdeveloped blood circulation. However, blue colouring on any part of your baby’s body is not normal. If you notice this, consult a medical professional.

Some infants develop yellow-coloured skin accompanied by yellow in the whites of the eyes, too – this is known as jaundice7. This is a very common skin condition caused by the removal of old red blood cells7. It’s estimated that around 3 in 5 babies (60 percent) develop jaundice8. In some cases, jaundice can indicate a more serious issue7. Consult a medical professional if your baby shows signs of jaundice, this way they can get the care they need.

How Larissa dealt with Jackson’s premature baby skin

When Larissa Lawrence and her partner found out they were expecting twins they knew their journey was going to be harder than they thought, however, nothing could have prepared the couple for what was to come. Just 25 weeks into Larissa’s pregnancy, one of the twin boys sadly passed away. This was an incredibly difficult and emotional time for the couple.

“Just as we were coming to terms with the loss, I went into labour with his brother at 27 weeks,” said Larissa.

Larissa then spent the next 90 days in the NICU with her newborn baby Jackson. He had a positive NICU experience growing stronger each day, and after one month Jackson came off CPAP and went onto high-flow oxygen. Soon after, he was breathing by himself.

“I found a lot of positives that went along with our NICU experience. We were taught so much about how to look after our baby, which was a big advantage as first-time parents,” said Larissa.

“They taught us the proper ways to bathe him, check his temperature, and most importantly how to change his nappy. The main difference I noticed was they only use soft disposable towelettes with plain water instead of baby wipes.”

It was after the couple returned home with Jackson that he received his first nappy rash. His skin was extremely sensitive and his parents hated seeing Jackson’s skin looking so sore, so Larissa checked with the nurse to see what the best cure for nappy rash was.

“The nurse said the best way to help was to use cotton wool and water, however, this felt impractical when changing countless nappies a day,” said Larissa.

According to Robert Guaran, Neonatology Advisor NSW Perinatal Services, “a newborn baby’s skin does not have the barrier layers of cells of older children. Parents should avoid chemicals, including fragrances, that may be directly absorbed across their baby’s sensitive skin. This is especially important for Premature babies.”

Larissa knew to avoid certain baby products including baby wipes as they contain harsh chemicals, particularly for Jackson’s sensitive skin. It was when Larissa received a Miracle Babies NICU Survival Pack containing WaterWipes that she found a solution to her newborn’s nappy rash.

Baby Jackson with WaterWipes
Baby Jackson with WaterWipes

The wipes in the Miracle Baby pack were a gamechanger. WaterWipes contain 99.9% water with just a drop of fruit extract so they are safe to use on a newborn baby. His rash went away almost immediately, and one year on we still only use WaterWipes and still have no rashes

“I’m so grateful to WaterWipes and Miracle Babies for providing a practical solution to Jackson’s sensitive skin.”

The NICI Survival Pack

WaterWipes has teamed up with Miracle Babies Foundation to provide wipes suitable for newborns as part of Miracle Babies’ NICU Survival Pack. These packs are provided to families in participating hospitals to equip parents with vital tools and resources for premature babies.

WaterWipes are the world’s purest baby wipes and have been carefully designed to be gentle on babies’ delicate skin. They provide gentle cleansing for the most delicate newborn skin and are so gentle they can be used on premature babies.

Miracle Babies Foundation is Australia’s leading organisation supporting premature and sick newborns, their families, and the hospitals that care for them. Since 2005, Miracle Babies Foundation has been passionate in developing and providing vital programs and resources to support and enhance a family’s experience from a threatened pregnancy, hospital journey with a premature or sick newborn, the transition to home, and beyond.

“We are proud to partner with WaterWipes on achieving better, healthier outcomes for premature and sick newborns and their families. WaterWipes’ commitment to providing pure, gentle, and effective cleaning for the most delicate skin is very important to the families we support as a premature baby is extremely vulnerable. The simple ingredients in WaterWipes can be very reassuring. With so many concerns and things to think about, it’s important that parents who have had a premature baby feel confident that they are doing the best for their baby,” Kylie Pussell, CEO and Co-Founder Miracle Babies Foundation.

FAQS

When should you start skin to skin for premature babies?

According to the World Health Organization (WHO), you should begin skin to skin (also known as kangaroo care) for premature babies immediately after childbirth. This should be done before any initial period in an incubator9.

How long should you do skin to skin with a preemie?

If your baby is in NICU, you’ll usually be encouraged to do skin-to-skin every day for at least an hour at a time10. This will help your baby relax, settle, and grow10. You can continue to do skin-to-skin for months to come, especially if you decide to breastfeed. Both parents can do skin to skin during bottle feeds, too11.

What is the most common neonatal skin condition?

Erythema toxicum neonatorum is the most common neonatal skin condition. It affects 30-70% and only occurs during the neonatal period12. Also known as toxic erythema, this skin condition occurs in the first few days after birth13. Scattered pink or red marks with papules (small bumps) and weals appear scattered across the baby’s face and the rest of the body. It’s a temporary condition and it does not bother the baby, so try not to worry too much. The condition should go away by itself over one to two days13. It’s a benign, asymptomatic self-limited, skin condition that only occurs during the neonatal period. It is one of the most common innocent and self-limited skin rashes mainly in full-term newborns. The condition affects 30-70% of the newborns.

What are skin abnormalities seen in neonates?

Some of the most common skin abnormalities in neonates, otherwise known as a newborn infant under 28 days of age, include erythema toxicum, cradle cap, milia, miliaria, desquamation, neonatal cephalic pustulosis, neonatorum and transient pustular melanosis14.

References
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1. Beb Organic. Protect Your Preemie's Skin. Accessed 21 September 2023. Available: https://www.beborganic.com/blogs/journal/protect-your-preemies-skin

2. Afsar FS. Skin care for preterm and term neonates. Clin Exp Dermatol. 2009;34(8):855-8. doi:10.1111/j.1365-2230.2009.03424.x

3. Raising Children. Premature babies: physical appearance, bones, and skin. Accessed 21 September 2023. Available: https://raisingchildren.net.au/newborns/premature-babies-sick-babies/development/premature-appearance

4. Tommys. Caring for your premature baby at home. 23 August 2021. Accessed 21 September 2023. Available: https://www.tommys.org/pregnancy-information/premature-birth/taking-your-baby-home/caring-your-premature-baby-home

5. Enfamil. The Premature Baby Development Process. Accessed 21 September 2023. Available: https://www.enfamil.com/articles/premature-baby-development-process/

6. Babycentre. When do babies get their skin color? 23 June 2022. Accessed 21 September 2023. Available: https://www.babycenter.com/pregnancy/your-baby/fetal-development-your-babys-skin_400058507.

7. Stanford Childrens. Newborn Appearance. Accessed 21 September 2023. Available: https://www.stanfordchildrens.org/en/topic/default?id=newborn-appearance-90-P02691

8. March of Dimes. Newborn jaundice. April, 2013. Accessed 21 September 2023. Available:https://www.marchofdimes.org/find-support/topics/planning-baby/newborn-jaundice#:~:text=Newborn%20jaundice%20is%20very%20common,can%20lead%20to%20brain%20damage.

9. World Health Organization. WHO advises immediate skin to skin care for survival of small and preterm babies. 15 November 2022. Accessed 21 September 2023. Available: https://www.who.int/news/item/15-11-2022-who-advises-immediate-skin-to-skin-care-for-survival-of-small-and-preterm-babies#:~:text=The%20guidelines%20advise%20that%20skin,initial%20period%20in%20an%20incubator.

10. USF Health. Holding Your Baby Skin-to-Skin. Accessed 21 September 2023. Available: https://health.usf.edu/-/media/Files/Public-Health/Chiles-Center/FPQC/HoldingYourBabySkintoSkin.ashx#:~:text=Premature%20infants%20will%20relax%20better,an%20hour%20at%20a%20time.

11. Tommys. Kangaroo Care. 23 August 2021. Accessed 21 September 2023. Available: https://www.tommys.org/pregnancy-information/premature-birth/how-long-do-you-stay-in-hospital-after-birth/kangaroo-care

12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574071/#:~:text=Erythema%20toxicum%20neonatorum%20is%20a,%2D70%25%20of%20the%20newborns.

13. Kutlubay Z, Tanakol A, Engýn B, Onel C, Sýmsek E, Serdaroglu S, Tuzun Y, Yilmaz E, Eren B. Newborn Skin: Common Skin Problems. Maedica (Bucur). 2017 Jan;12(1):42-47. PMID: 28878836; PMCID: PMC5574071.

14. About Kids Health. Skin conditions and birthmarks in newborns. June 28th 2023. Accessed 21 September 2023. Available: https://www.aboutkidshealth.ca/Article?contentid=455&language=English#:~:text=The%20most%20common%20skin%20conditions,neonatorum%20and%20transient%20pustular%20melanosis.

How we wrote this guide

The information in this guide is based on parental and medical information from a variety of sources including the WHO, Stanford Medicine Children’s Health and Tommy’s.

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