Benefits of Using an Appropriately Formulated Wipe to Clean Diapered Skin of Preterm Infants

Abstract

The skin of premature infants is underdeveloped rendering it more prone to break down and irritation. Therefore, special care is needed to protect premature skin and ensure it is not adversely affected. Many health care professionals advise using just water and cloth to clean diapered skin after a bowel movement despite evidence that shows improved infant skin health with the use of modern appropriately formulated baby wipes. This article describes the unique physiology of premature infant skin, reviews clinical evidence comparing use of baby wipes to water and cloth, and describes attributes of appropriately formulated baby wipes.

Baby wipes and nappy rash – what is the relationship? A review

“…There is lacking evidence about premature infants and NR in the literature. This is a necessary area for further investigation as the properties of premature infants (<37 weeks) differ greatly from a term newborn, but studies are difficult due to their fragile state 7 . Tissue oedema can accumulate between the epidermis and dermis due to a weakness in the bonds from decreased presence of collagen.…”

“…Tissue oedema can accumulate between the epidermis and dermis due to weakness in the bonds from decreased presence of collagen 2 . Therefore, premature infants are at increased risk of blistering from friction from this decrease in elasticity 2,7 …”

Skin Barrier Function in Infants: Update and Outlook

“…Baby wipes comprise of a piece of non-woven cloth that has been impregnated with a water-based cleansing emulsion intended for skin cleansing. Clinical evidence has shown the safety and effectiveness of baby wipes for infants, including preterm infants during the first month after birth [101,102]. A number of studies have provided insights into the effects of baby wipes on infant skin physiology [98,[103][104][105][106][107].…”

“…With reference to baby wipes emollients are ingredients that can help to minimize SC barrier disruption by (1) avoiding frictional damage of the skin during wiping [101], (2) ameliorating the effects of interaction of surfactants and SC components (particularly lipids and proteins), and (3) replenishing the SC lipids that are lost during cleansing [125]. The use of baby wipes impregnated with emollients was reported to result in lower erythema scores and TEWL in infants (p < 0.05) compared with the use of cloth and water [106].…”

“…The majority of commercial baby wipe formulations contain organic acids and conjugate bases (such as citric acid and sodium citrate). Several authors have endorsed the use of these ingredients in baby wipes [101,102,108]. This is based on the perceived potential impact of the occlusive environment and exposure to urine and faeces on the skin pH of the diaper area [101,103,105].…”