Why might baby skin need extra care?

What does newborn skin need?

During roughly the first four weeks, a baby's skin matures and develops its protective barrier. Premature babies take longer. For at least the first month, use plain water for baths rather than adding cleansers, skin lotions or medicated wipes. Leave vernix, the white sticky coating present at birth, on the skin to absorb naturally. Vernix acts as a natural moisturiser and helps protect against infection in the first days, without arriving in a bottle labelled essential. Babies born overdue can have dry, cracked skin because their vernix was absorbed before birth.13

How do you protect the nappy area?

Wet or dirty nappies left against delicate skin can make it sore and red. Change nappies as soon as possible after a wee or poo rather than waiting for a scheduled change. Young babies can need 10 to 12 changes a day, which makes the changing table sound more like a workstation.4

1. 1Wash your hands and gather a clean nappy, cotton wool, warm water and a towel.
2. 2Clean the whole nappy area gently but thoroughly, including the skin folds. Cotton wool and plain warm water are suitable; alternatively, use wipes without fragrance or alcohol.
3. 3Clean girls from front to back. For boys, clean around the penis and testicles without pulling back the foreskin.
4. 4Allow some time without a nappy if the room is warm enough, or dry the bottom with a towel before putting on a clean nappy.
5. 5Wash your hands after the change.

Sun protection depends on age

For babies younger than 6 months, prioritise shade and protective clothing, including a wide brimmed hat, while preventing overheating. Avoid sunscreen if possible. From 6 months, choose sunscreen containing zinc oxide or titanium dioxide, which are less likely to irritate infant skin. Look for broad spectrum protection, SPF 30 or higher and water resistance. Continue using shade and protective clothing. Reapply sunscreen every two hours outdoors, after towelling off, and after 40 or 80 minutes in water as the label specifies.5

The FDA has not defined the word "baby" on sunscreen.5

Do baby spots need treatment?

Newborn acne usually appears before 6 weeks and clears by itself within weeks to months. Wash gently with lukewarm water, avoid scrubbing and stop oily or greasy skincare products if your baby has acne. Do not use acne medicines or acne washes unless your baby's dermatologist or paediatrician recommends them. Acne that first develops after 6 weeks needs a dermatologist's assessment. Other conditions can resemble acne, and later infant acne can leave permanent scars.6

Premature skin needs a separate care plan

Premature skin has fewer outer cell layers and absorbs substances more readily than skin in babies born at term. Medical adhesives can also injure it. In neonatal intensive care, staff check the skin daily or more often and use specific bathing, dressing and topical treatment protocols. Premature skin can resemble term skin after 2 to 4 weeks, but water loss remains high and full maturation can take 9 weeks or longer. Moisturiser choices need particular care: some studies link petroleum based products with increased infection in extremely premature infants.23

When does a rash need medical help?

Seek urgent medical advice for a worrying rash, especially with a temperature of 38C or higher in a baby under 3 months, or 39C or higher from 3 months. Get emergency help if a baby is unwell with a rash and has difficulty breathing, sudden mouth or throat swelling, unusual responsiveness, or spots resembling bruises that do not fade under a pressed glass. A baby can be seriously unwell without a fever. On brown or black skin, colour changes can be easier to see on palms, soles, lips and inside the eyelids.7