Skin so soft

Your baby’s skin needs spe­cialised care. Here’s why and how to look af­ter very young skin

Your Baby & Toddler - - Contents -

IF YOUR BABY WAS BORN at full term, you prob­a­bly thought her skin was pretty much like the rest of most of her or­gans: fully formed, and ready to take on the out­side world. In fact, while it does act as your baby’s first line of de­fence (pro­tect­ing her from harsh tem­per­a­tures, mi­crobes and in­fec­tions), your baby’s skin is dif­fer­ent from your adult skin.

Der­ma­tol­o­gists now know that a baby’s skin as a whole ac­tu­ally con­tin­ues to de­velop out­side the womb, and specif­i­cally the skin’s abil­ity to act as a wa­ter bar­rier con­tin­ues to de­velop af­ter birth for the first year of life.

When in utero, your baby was sur­rounded by am­ni­otic fluid and her skin was pro­tected by a waxy sub­stance, called vernix. Some vernix will still be on her at birth and you needn’t be in a rush to wash it off. Vernix has been found to have an­timi­cro­bial sub­stances (ef­fec­tive against group B strep and E coli bac­te­ria) sim­i­lar to the im­mune boost­ing, pro­tec­tive sub­stances found in breast­milk. It is there­fore per­fectly fine to de­lay your baby’s first bath for a day or two, al­low­ing the vernix to ab­sorb into the skin.

IT’S DRY OUT THERE!

Af­ter birth, your baby’s skin has to ad­just to a brand new, rel­a­tively dry en­vi­ron­ment. Stud­ies mea­sur­ing the rates of transepi­der­mal wa­ter loss (TEWL) found that three-to six-mon­tholds had the high­est rates of TEWL, as did those ba­bies with dis­eases man­i­fested in skin bar­rier ab­nor­mal­i­ties, such as atopic der­mati­tis. The rea­son for this wa­ter loss? Baby skin is struc­turally dif­fer­ent to adult skin. The cells are smaller and the col­la­gen fi­bre thin­ner. It con­tains fewer lipids and less melanin than adult skin, which also makes ba­bies lose wa­ter faster. Baby skin also has a higher ph than adult skin, leav­ing the skin bar­rier less ma­ture and more prone to dry­ness than that of adult skin.

An in­fant’s skin is able to ab­sorb more wa­ter than adult skin, but it also loses that wa­ter at a faster rate, says Jo­han­nes­burg der­ma­tol­o­gist Dr Rakesh Ne­waj.

“The ratio of the skin’s sur­face area to the body weight of the baby ex­posed to the ex­ter­nal en­vi­ron­ment is high,” he ex­plains. “There is more heat ex­change and wa­ter loss by con­duc­tion, con­vec­tion and evap­o­ra­tion.

As a baby’s im­mune sys­tem is still de­vel­op­ing, she also has a greater chance of de­vel­op­ing skin ir­ri­ta­tions and in­fec­tions. Her skin is more vul­ner­a­ble to the en­vi­ron­ment than adult skin. If not prop­erly cared for, the skin be­comes sus­cep­ti­ble to dis­eases such as nappy rash, atopic der­mati­tis and other skin rash in­fec­tions. This is why baby skin needs spe­cial care.

For all th­ese rea­sons, says Dr Ne­waj, it is es­sen­tial to main­tain a skin bar­rier. “The skin bar­rier helps reg­u­late the baby’s body tem­per­a­ture, main­tain her wa­ter bal­ance and also pro­tect the in­ter­nal or­gans from the sun and pol­lu­tion (from the en­vi­ron­ment), as well as mi­cro-or­gan­ism in­va­sion.”

You can help pro­tect your baby’s skin by min­imis­ing wa­ter loss. That’s achieved by giv­ing baby enough flu­ids, cleans­ing any dirt off with ap­pro­pri­ate prod­ucts, and keep­ing the skin hy­drated us­ing mois­turis­ers and bar­rier creams which, as their name sug­gests, form a pro­tec­tive bar­rier be­tween por­ous baby skin and the harsh en­vi­ron­ment out­side of it, keep­ing wa­ter in and the bad stuff out.

THE ATOPIC MARCH

Al­ler­gic dis­eases of­ten be­gin and progress in sim­i­lar ways in dif­fer­ent peo­ple, a process doc­tors call the al­ler­gic, or atopic, march. Atopic der­mati­tis is one of the first symp­toms (the first step in the march), and most chil­dren with asthma or al­ler­gic rhini­tis first showed symp­toms of atopic der­mati­tis. Whether or not your child will join the atopic march de­pends on many as­pects: en­vi­ron­men­tal fac­tors such as ex­po­sure to en­do­tox­ins, early in­fec­tions, pets, pol­lu­tants, to­bacco smoke, an­tibi­otics and chem­i­cals, as well as hered­i­tary com­po­nents.

Pro­fes­sor Michael Cork, a lead­ing UK der­ma­tol­o­gist, be­lieves that the atopic march can be pre­vented by main­tain­ing the skin bar­rier and pre­vent­ing al­ler­gens and harm­ful sub­stances from en­ter­ing through the skin.

The best way to do this is with rou­tine sk­in­care us­ing prod­ucts spe­cially for­mu­lated for a baby’s del­i­cate skin. While you may not be able to avoid it if your baby is prone to al­ler­gic dis­eases, you may well lessen her chances by tak­ing very good, care­ful care of her skin.

En­vi­ron­men­tal fac­tors such as some sk­in­care prod­ucts, sur­fac­tants, air pol­lu­tion, and food can have a pos­i­tive or neg­a­tive ef­fect on the skin bar­rier. Harsh prod­ucts can ir­ri­tate or even break the thin baby skin and must be avoided.

SOAPS AND CREAMS Avoid us­ing adult sk­in­care prod­ucts on your baby for a start, says Dr Ne­waj, though luck­ily, “creams that are too harsh for a baby’s skin tend to have a warn­ing on them.”

Also avoid an­tibac­te­rial or ster­il­is­ing so­lu­tions, as well as creams that con­tain retinol, glyc­er­ine soaps, or chlorhex­i­dine so­lu­tions. Ex­fo­liant scrubs are, of course, a no-no. Go sim­ple.

“The best is not to have per­fumes, al­co­hol or strong de­ter­gents in creams,” says Dr Ne­waj.

Nat­u­ral sk­in­care reme­dies are pop­u­lar, but bear in mind that prod­ucts that are “nat­u­ral” are also not nec­es­sar­ily ideal for baby.

Olive oil, for in­stance, is not a good skin bar­rier be­cause it con­tains too much oleic acid, which can ir­ri­tate and even break the skin.

Some par­ents feel anx­i­ety about us­ing baby skin prod­ucts with preser­va­tives in them. How­ever, it is very im­por­tant to pre­vent prod­ucts from be­com­ing in­fected with mi­cro-or­gan­isms, many of which can cause se­ri­ous ill­ness.

There are proven safe preser­va­tives that have been rec­om­mended for us­age by global reg­u­lar­ity bod­ies, and any wa­ter-based prod­uct must have preser­va­tives in it to pre­vent spoil­ing.

The other op­tion is to skip all ar­ti­fi­cial cleansers and just use wa­ter in­stead of soap. It’s the sim­plest, isn’t it? But wa­ter is not a good cleanser on its own. In fact, it dries out skin. Although wa­ter does hy­drate the skin, the ef­fect is tem­po­rary, last­ing only about 30 sec­onds. Once the wa­ter evap­o­rates, the skin begins to dry. Dirt par­ti­cles on your baby’s skin are usu­ally fat-sol­u­ble and so need to be re­moved by sur­fac­tants.

Wa­ter alone is less likely to “pick up” the dirt off the skin and carry it off. YB

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