The arrival of a new baby brings many concerns and issues for new and incumbent parents. While new parents are faced with a myriad of issues for the first time, incumbent parents have to deal with the information explosion and change in thought on issues which have evolved since their first parenting experience. In addition, when parents have a second child, if the sex is different some of the issues are also new. Chief among the issues for both new and incumbent parents is the proper care of newborn skin. In fact, in many surveys of parents of newborns this issue often ranks first on the list of concerns. For example, in one study published in the journal Bedside Nursing, a group of mothers with infants under the age of 15 months was asked to consider the chief problem they faced in their babies’ first year. The study reports that the most common concern was how to care for their babies’ skin. Not only are new parents unaware of how to treat their newborn’s skin, but most pediatricians are also unaware of optimal infant skin care. Pediatricians are given very little exposure to pediatric dermatology in medical school and residency training. The minimal experience they do have is usually with severely diseased skin, rather than the care of healthy, but vulnerable skin, as is the case with newborns. This topic is also not addressed in most textbooks of pediatric medicine St. Louis, MO: C.V. Mosby Co., 1983. The lack of clinically available information leads to the continued use of harmful chemicals on infants. Shockingly, while trying to treat the newborn cautiously and safely, the average newborn is exposed to as many as 48 different chemicals without consideration of the potential toxicity of the chemicals or the products that contain them.
A full-term newborn’s skin is only 40% to 60% the thickness of adult skin, thus rendering it considerably more vulnerable and more permeable. The ratio of body surface area to weight is up to five times that of an adult. Thus, the combination of thinner skin and high body surface area ratios render the infant at significant risk with any integrity disruption of the skin. The skin of premature infants is of even greater risk as it has a significantly less developed stratum corneum when compared to term babies. Accordingly they are at even greater risk of thermal instability due to transepidermal water loss (TEWL). Hence, the skin is a critical protectant of the infant for water and thermal control. When improperly cared for, an infant’s skin can be a serious potential health hazard.