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Parental concern over infant dry skin is a common challenge that midwives and other maternity professionals frequently address in the early postnatal period. Although infant dry skin is a normal process of adaptation to extra-uterine life, parents often wish to treat it, and there is uncertainty among health professionals about what is safe and best practice. For decades, health professionals have recommended the use of topical natural oils to prevent or treat infant dry skin, but more recently, there has been increasing concern that use of these oils on the skin may be a contributory factor in the rising prevalence of childhood atopic eczema. This article will consider how infant skin may be affected by topical products, the role of the health professional giving infant skin care advice and current evidence to support clinical practice. [ABSTRACT FROM AUTHOR]

Objectives to identify what skin practices are important for the protection of baby skin in healthy term babies (0–6 months) and generate evidence-based conclusions to inform health professionals and parents. Design eleven databases were searched for all empirical quantitative and qualitative research published between 2000–2015 which explored baby skin care for bathing and cleansing, nappy care, hair and scalp care, management of dry skin or baby massage, for healthy term babies up to 6 months old. Papers not published in English were excluded. A total of 3062 papers were identified. Pairs of reviewers assessed all citations and extracted data independently. There were 26 included papers: 16 RCTs, 3 non-randomised experimental studies, 1 mixed-methods study and 6 qualitative studies. Primary and secondary outcome measures were analysed using meta-analysis or narrative descriptive statistics. Synthesis of qualitative data was not possible due to disparity of the evidence. Findings from the small numbers of studies with comparable data, there was no evidence of any significant differences between tested wash products and water or tested baby wipes and water. There was some evidence to suggest that daily use of full-body emollient therapy may help to reduce the risk of atopic eczema in high risk babies with a genetic predisposition to eczema; however, the use of olive oil or sunflower oil for baby dry skin may adversely affect skin barrier function. There was no evidence about hair/scalp care or baby massage. Qualitative research indicates that parents and health professionals believe that water alone is best. Key conclusions meta-analysis was restricted due to the lack of consistency of study outcome measures. Although there is considerable RCT evidence comparing the use of specific products against water alone, or another product, for bathing, cleansing and nappy care, the power of this evidence is reduced due to inconsistency of outcome measures in terms of outcome, treatment site or time-point. The development of a core outcome measure set is advocated for trials assessing skin care practices. Implications for practice this review offers health professionals best evidence available on which to base their advice. Of those studies with comparative outcomes, the evidence indicates no difference between the specific products tested and water alone; offering parents a choice in their baby skin care regimen. Protocol available: http://www.crd.york.ac.uk/PROSPEROFILES/28054_PROTOCOL_20151009.pdf [ABSTRACT FROM AUTHOR]

Topical oils on baby skin may contribute to development of childhood atopic eczema. A pilot, assessor-blinded, randomized controlled trial assessed feasibility of a definitive trial investigating their impact in neonates. Onehundred and fifteen healthy, full-term neonates were randomly assigned to olive oil, sunflower oil or no oil, twice daily for 4 weeks, stratified by family history of atopic eczema. We measured spectral profile of lipid lamellae, trans-epidermal water loss (TEWL), stratum corneum hydration and pH and recorded clinical observations, at baseline, and 4 weeks post-birth. Recruitment was challenging (recruitment 11.1%; retention 80%), protocol adherence reasonable (79-100%). Both oil groups had significantly improved hydration but significantly less improvement in lipid lamellae structure compared to the no oil group. There were no significant differences in TEWL, pH or erythema/skin scores. The study was not powered for clinical significance, but until further research is conducted, caution should be exercised when recommending oils for neonatal skin. [ABSTRACT FROM AUTHOR]

Parents across the globe have been massaging their babies for centuries. The popularity of infant massage in Western countries is a relatively recent phenomenon; the trend has probably developed due to the perceived health benefits. In some Eastern cultures, the practice of infant massage is passed on from one generation to the next. In Western cultures, it is more likely that new parents will attend a local baby massage class with an instructor. Whichever form the practice takes, it is important to know that there is no potential for harm to the baby. This article will consider the perceived benefits of infant massage, how to massage, the role of the health professional and whether we should be concerned about what products, if any, should be used for infant massage. [ABSTRACT FROM AUTHOR]

Olive oil is commonly recommended by health professionals to new parents for use in the prevention and treatment of the term baby's dry skin, and for baby massage. There is no evidence to support this practice. The use of olive oil may be harmful to skin, affecting skin barrier function. This effect may be a contributory factor in the prevalence of childhood conditions such as atopic eczema. This paper discusses a national online audit of UK maternity hospitals (n = 67) and neonatal units (n = 33) performed between November 2010 and January 2011. Our findings confirm that oil use on babies' skin is common practice. As the direct cost to the NHS for treatment of atopic eczema is high, it is imperative that further research in this area is performed, preferably in the form of a randomized controlled trial. Health professionals will then be in a position to provide accurate information to parents with regard to oil in baby skin care regimens. [ABSTRACT FROM AUTHOR]