Pediatric Health, Medicine and Therapeutics (Aug 2023)

Evidence-Based Consensus Recommendations for Skin Care in Healthy, Full-Term Neonates in India

  • Gupta P,
  • Nagesh K,
  • Garg P,
  • Thomas J,
  • Suryawanshi P,
  • Sethuraman G,
  • Hazarika RD,
  • Verma RJ,
  • Kumar CS,
  • Kumari S,
  • Taneja S,
  • Chavhan V,
  • Thakor P,
  • Pandita A

Journal volume & issue
Vol. Volume 14
pp. 249 – 265

Abstract

Read online

Piyush Gupta,1,* Karthik Nagesh,2,* Pankaj Garg,3,* Jayakar Thomas,4,* Pradeep Suryawanshi,5,* Giridhar Sethuraman,6,* Rashna Dass Hazarika,7,* Rahul J Verma,8,* C Suresh Kumar,9,* Shantha Kumari,10,* Sunil Taneja,11,* Vaishali Chavhan,12,* Priti Thakor,13,* Ankita Pandita13,* 1Department of Pediatrics, University College of Medical Sciences, New Delhi, India; 2Department of Neonatology, Manipal Hospitals Group (MHEPL), Bangalore, Karnataka, India; 3Department of Neonatology, Sir Ganga Ram Hospital, New Delhi, India; 4Department of Dermatology, The Tamil Nadu Dr. M.G.R. Medical University, Chennai, Tamil Nadu, India; 5Department of Neonatology, BVU Medical College, Pune, Maharashtra, India; 6Department of Neonatology, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India; 7Department of Pediatrics & Neonatology, Nemcare Superspecialty Hospital, Guwahati, Assam, India; 8Department of Neonatology & General Pediatrics, Sir H.N Reliance Hospital, Mumbai, Maharashtra, India; 9Department of Pediatrics, Apollo Cradle, Jubilee Hills, Hyderabad, Telangana, India; 10Department of Obstetrics and Gynecology, Yashoda Hospitals, Hyderabad, Telangana, India; 11Sushrut Medical Centre Pvt Ltd, Kanpur, Uttar Pradesh, India; 12Department of Obstetrics and Gynecology, Sahyadri Superspecialty Hospitals, Pune, Maharashtra, India; 13Department of Medical Affairs, JNTL Consumer Health (India) Pvt. Ltd., Mumbai, Maharashtra, India*These authors contributed equally to this workCorrespondence: Ankita Pandita, JNTL Consumer Health (India) Pvt. Ltd., 501 Arena Space, Behind Majas Bus Depot, off Jogeshwari Vikhroli Link Road, Jogeshwari (E), Mumbai, 400060, India, Tel +91 98735 98808, Fax +91-22 25643410, Email [email protected]; [email protected]: Neonatal skin care practices guided by personal experience and preferences might be substantially different across different hospital settings. The aim of this consensus recommendation is to provide clinical practice guidance to healthcare practitioners on evidence-based neonatal skin care practices from delivery-to-discharge, in hospital settings.Patients and Methods: A Scientific Advisory Board meeting on “Evidence-based Neonatal Skin Care Practices and Protocols” was held in December 2020 with an expert panel comprising neonatologists, pediatricians, obstetricians and gynecologists and pediatric dermatologist. Comprehensive literature search was performed up to 23 March 2021 using PubMed and Google Scholar to retrieve relevant evidence.Results: Recommendations were developed on critical aspects of skin care in healthy full-term neonates including cleansing at birth, skin-to-skin care, cord care, diaper area care, initial and routine bathing, cleansers and emollients use, and criteria to choose appropriate skin care products. Recommendations include inclusion of skin assessment in routine neonatal care, first bath timing after cardio-respiratory and thermal stabilization, 6– 24 hours after birth; bathing with water alone or adding a mild liquid cleanser could be considered appropriate as it does not impact the developing skin barrier; use of emollients is recommended for neonates with higher risk of development of eczema to maintain and enhance skin barrier function and integrity; and inclusion of skin care advice in neonatal discharge checklist. Importance of rigorous quality control, high-quality clinical trials for assessment of baby products, usage of products that are formulated appropriately for newborns, and full label transparency for baby products were highlighted. The panel identified gaps in literature and discussed the scope for future research.Conclusion: These recommendations may help to standardize evidence-based skin care for healthy full-term neonates in Indian hospital settings to improve the quality of care that neonates receive in hospital and facilitate improvement in overall neonatal health outcomes.Keywords: baby products, bathing, cleanser, emollient, hospital setting, neonatal skin care practices

Keywords