How to care for delightful, but delicate, baby skin

click to enlarge Baby skin can pretty quickly go through changes that may be unsettling to new parents.
Baby skin can pretty quickly go through changes that may be unsettling to new parents.

"Smooth as a baby's bum" refers to that delightfully soft and blemish-free skin that babies enjoy. Until they don't. Newborns arrive having spent nine months in an amniotic waterworld. While there, an amazing waterproofing called vernix caseosa develops, starting about 20 weeks along. This cheesy layer of whitish goop is actually a collection of shed skin cells and sebaceous oils secreted from the baby's developing sebaceous ducts. As the due date approaches, the coating thins out — that's why babies born earlier tend to be cheesier. It has actually become common not to be in a rush to wash away that protective coating right after birth, with some caregivers waiting up to 24 hours for that first bath.

Once introduced to our dry, cruel world, however, baby skin can pretty quickly go through changes that may be unsettling to new parents. Quite often, the hands and feet initially develop dryness. One approach is to allow them to adjust to the drier conditions outside the womb. But if the dryness is intolerable, or certainly if it seems uncomfortable in any way, applying moisturizer is fine, just look for a neutral but greasy product: Consider Aquaphor, Vaseline, Cerave, vegetable shortening or even coconut oil. Creams and lotions have more water in them, tend to absorb too quickly and they often sting. When choosing moisturizer, it's always best to avoid products with added fragrance.

A somewhat unsettling development new parents may encounter is cradle cap — thickened, crusty plaques that can coat the baby's scalp. Watchful waiting is one approach to deal with cradle cap. Another option is to grease up the plaque with some olive oil and give it a good scrub with a soft brush. But to really get at the underlying cause of the plaque, a dandruff shampoo can be applied every other day, left on the scalp two to three minutes, and then rinsed away. Just be careful not to get any shampoo into the baby's eyes, because it will sting.

When it comes to bathtime, there are a number of baby-friendly body washes and shampoos out there. Aveeno, the Honest Company, Johnson and Johnson and many others have products that are designed to gently keep your baby clean. But while freshly bathed baby skin is a parenting delight, it is not OK to bathe the baby every day. Bathing every other day will be easier on that sensitive skin, while still maintaining hygiene. In the interim, you can spot-clean the pits, bits and folds when slobber, spit-up and sweat find their way to those nooks and crannies. Keeping the skin dry in the folds is half the battle, while the other half is making sure to moisturize and waterproof dry, vulnerable areas.

Speaking of vulnerable areas, life in a diaper can be very aggravating to the skin, although not nearly as much as it used to be back when cotton cloth diapers were the norm. Disposable diapers and some of the modern fabric diapers do a much better job keeping the ones and twos away from the skin. At times, a diaper ointment may still be helpful, should their bums get rashy or red. Diaper ointments containing zinc tend to protect the skin best, although some are better at staying on the skin, not just ending up in the diaper. I prefer a product called Calmoseptine, but there are numerous other options out there that should also work pretty well. If sores develop, or a diaper rash just does not want to clear up, a visit to the primary care office would be best, as there may be some yeast on the scene or another reason the rash won't go away.

Fingernails are actually extensions of skin and can use a little care, too. If a little one is scratching up their skin with those sharp little blades, the nails can be carefully filed to smooth them out. Or, the nails can be trimmed. But rather than scary little clippers that can cut a little too close, I would suggest using little safety scissors with a snubbed tip — like the ones their dad may use for his nose hair (but not the actual pair he uses).

Skin rashes are seen quite often with babies. But with so many different causes, it's best to check with the baby's care provider if a rash develops. In fact, don't hesitate to reach out for help with skin care or any other concerns — getting support in taking care of a new baby will help you relax and enjoy this magical time.

Matt Thompson is a pediatrician at Spokane's Kids Clinic.

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