Benefits of Using an Appropriately Formulated Wipe to Clean Diapered Skin of Preterm Infants

Rebecca Vongsa, Karien Rodriguez, David Koenig, Corey Cunningham, Rebecca Vongsa, Karien Rodriguez, David Koenig, Corey Cunningham

Abstract

The skin of premature infants is underdeveloped rendering it more prone to break down and irritation. Therefore, special care is needed to protect premature skin and ensure it is not adversely affected. Many health care professionals advise using just water and cloth to clean diapered skin after a bowel movement despite evidence that shows improved infant skin health with the use of modern appropriately formulated baby wipes. This article describes the unique physiology of premature infant skin, reviews clinical evidence comparing use of baby wipes to water and cloth, and describes attributes of appropriately formulated baby wipes.

Keywords: baby wipes; diaper dermatitis; diapered skin; infant skin; premature infant skin; skin irritation; skin pH.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: All authors are employees of Kimberly-Clark Corporation.

Figures

Figure 1.
Figure 1.
Attributes of a properly formulated baby wipe.

References

    1. Visscher M, Narendran V. The ontogeny of skin. Adv Wound Care (New Rochelle). 2014;3:291-303. doi:10.1089/wound.2013.0467
    1. Kalia YN, Nonato LB, Lund CH, Guy RH. Development of skin barrier function in premature infants. J Invest Dermatol. 1998;111:320-326. doi:10.1046/j.1523-1747.1998.00289.x
    1. Eichenfield LF, Hardaway CA. Neonatal dermatology. Curr Opin Pediatr. 1999;11:471-474.
    1. Visscher MO, Chatterjee R, Munson KA, Pickens WL, Hoath SB. Changes in diapered and nondiapered infant skin over the first month of life. Pediatr Dermatol. 2000;17:45-51.
    1. Evans NJ, Rutter N. Development of the epidermis in the newborn. Biol Neonate. 1986;49:74-80.
    1. Sedin G, Hammarlund K, Strömberg B. Transepidermal water loss in full-term and pre-term infants. Acta Paediatr Scand Suppl. 1983;305:27-31.
    1. Agren J, Sjörs G, Sedin G. Transepidermal water loss in infants born at 24 and 25 weeks of gestation. Acta Paediatr. 1998;87:1185-1190.
    1. Rutter N, Hull D. Water loss from the skin of term and preterm babies. Arch Dis Child. 1979;54:858-868.
    1. Cartlidge P. The epidermal barrier. Semin Neonatol. 2000;5:273-280. doi:10.1053/siny.2000.0013
    1. Hammarlund K, Sedin G. Transepidermal water loss in newborn infants. III. Relation to gestational age. Acta Paediatr Scand. 1979;68:795-801.
    1. Kanti V, Bonzel A, Stroux A, et al. Postnatal maturation of skin barrier function in premature infants. Skin Pharmacol Physiol. 2014;27:234-241. doi:10.1159/000354923
    1. Rutter N. Percutaneous drug absorption in the newborn: hazards and uses. Clin Perinatol. 1987;14:911-930.
    1. Harpin VA, Rutter N. Barrier properties of the newborn infant’s skin. J Pediatr. 1983;102:419-425.
    1. McCormack JJ, Boistis EK, Fisher LB. An in vitro comparision of the permeability of adult versus neonatal skin. In: Maiback H, Boistis E, eds. Neonatal Skin: Structure and Function. New York, NY: Marcel Dekker Inc; 1982:149-166.
    1. Barker N, Hadgraft J, Rutter N. Skin permeability in the newborn. J Invest Dermatol. 1987;88:409-411.
    1. Steven BH, Howard IM. Neonatal Skin: Structure and Function. 2nd ed. New York, NY: Marcel Dekker; 2003.
    1. Visscher MO. Recent advances in diaper dermatitis: etiology and treatment. Pediatr Health. 2009;3:81-98. doi:10.2217/17455111.3.1.81
    1. Buckingham KW, Berg RW. Etiologic factors in diaper dermatitis: the role of feces. Pediatr Dermatol. 1986;3:107-112.
    1. Andersen PH, Bucher AP, Saeed I, Lee PC, Davis JA, Maibach HI. Faecal enzymes: in vivo human skin irritation. Contact Dermatitis. 1994;30:152-158.
    1. Berg RW, Buckingham KW, Stewart RL. Etiologic factors in diaper dermatitis: the role of urine. Pediatr Dermatol. 1986;3:102-106.
    1. Visscher M, Odio M, Taylor T, et al. Skin care in the NICU patient: effects of wipes versus cloth and water on stratum corneum integrity. Neonatology. 2009;96:226-234. doi:10.1159/000215593
    1. Boralevi F, Hubiche T, Leaute-Labreze C, et al. Epicutaneous aeroallergen sensitization in atopic dermatitis infants—determining the role of epidermal barrier impairment. Allergy. 2008;63:205-210. doi:10.1111/j.1398-9995.2007.01556.x
    1. Ehretsmann C, Schaefer P, Adam R. Cutaneous tolerance of baby wipes by infants with atopic dermatitis, and comparison of the mildness of baby wipe and water in infant skin. J Eur Acad Dermatol Venereol. 2001;15(suppl 1):16-21.
    1. Odio M, Streicher-Scott J, Hansen RC. Disposable baby wipes: efficacy and skin mildness. Dermatol Nurs. 2001;13:107-112,117-118,121.
    1. Johnson DE. Extremely preterm infant skin care: a transformation of practice aimed to prevent harm. Adv Neonatal Care. 2016;16(suppl 5):S26-S32. doi:10.1097/ANC.0000000000000335
    1. Lavender T, Furber C, Campbell M, et al. Effect on skin hydration of using baby wipes to clean the napkin area of newborn babies: assessor-blinded randomised controlled equivalence trial. BMC Pediatr. 2012;12:59. doi:10.1186/1471-2431-12-59
    1. Adam R, Schnetz B, Mathey P, Pericoi M, de Prost Y. Clinical demonstration of skin mildness and suitability for sensitive infant skin of a new baby wipe. Pediatr Dermatol. 2009;26:506-513. doi:10.1111/j.1525-1470.2008.00804.x
    1. Rutter N. Clinical consequences of an immature barrier. Semin Neonatol. 2000;5:281-287. doi:10.1053/siny.2000.0014
    1. Oranges T, Dini V, Romanelli M. Skin physiology of the neonate and infant: clinical implications. Adv Wound Care (New Rochelle). 2015;4:587-595. doi:10.1089/wound.2015.0642
    1. Ngai D, Vongsa RA, Rodriguez K. Infant skin barrier damage inflicted by fecal enzymes and ways to mitigate: why water is insufficient. Paper presented at: 18th Annual National Neonatal, Advanced and Mother Baby Nurses Conference; September 5-8, 2018; New Orleans, LA.
    1. Gelmetti C. Skin cleansing in children. J Eur Acad Dermatol Venereol. 2001;15(suppl 1):12-15.
    1. Cunningham C, Mundschau S, Seidling J, Wenzel S. Baby care. In: Schlossman M, ed. The Chemistry and Manufacture of Cosmetics: Science. Vol 2 4th ed. Chicago, IL: Allured; 2008.
    1. Seigert W. Preservative trends in wet wipes. SOFW J. 2011;137:44-51.
    1. Blume-Peytavi U, Lavender T, Jenerowicz D, et al. Recommendations from a European Roundtable Meeting on best practice healthy infant skin care. Pediatr Dermatol. 2016;33:311-321. doi:10.1111/pde.12819
    1. Senses DA, Ozturk CE, Yar NE, et al. Do baby wet wipes change periurethral aerobic flora? Jpn J Infect Dis. 2007;60:225-226.
    1. Fox C, Nelson D, Wareham J. The timing of skin acidification in very low birth weight infants. J Perinatol. 1998;18:272-275.
    1. Rippke F, Schreiner V, Schwanitz HJ. The acidic milieu of the horny layer: new findings on the physiology and pathophysiology of skin pH. Am J Clin Dermatol. 2002;3:261-272.
    1. Berg RW. Etiologic factors in diaper dermatitis: a model for development of improved diapers. Pediatrician. 1987;14(suppl 1):27-33.
    1. Berg RW. Etiology and pathophysiology of diaper dermatitis. Adv Dermatol. 1988;3:75-98.
    1. Tsai TF, Maibach HI. How irritant is water? An overview. Contact Dermatitis. 1999;41:311-314.
    1. US Environmental Protection Agency. Secondary drinking water standards: guidance for nuisance chemicals. . Published 2015. Accessed January 29, 2019.
    1. Hills RJ, Unsworth A, Ive FA. A comparative study of the frictional properties of emollient bath additives using porcine skin. Br J Dermatol. 1994;130:37-41.
    1. Kiechl-Kohlendorfer U, Berger C, Inzinger R. The effect of daily treatment with an olive oil/lanolin emollient on skin integrity in preterm infants: a randomized controlled trial. Pediatr Dermatol. 2008;25:174-178. doi:10.1111/j.1525-1470.2008.00627.x
    1. Lane AT, Drost SS. Effects of repeated application of emollient cream to premature neonates’ skin. Pediatrics. 1993;92:415-419.
    1. Salam RA, Das JK, Darmstadt GL, Bhutta ZA. Emollient therapy for preterm newborn infants—evidence from the developing world. BMC Public Health. 2013;13(suppl 3):S31. doi:10.1186/1471-2458-13-S3-S31
    1. US Food and Drug Adminstration. Alcohol-free. . Accessed January 29, 2019.

Source: PubMed

Подписаться