Skin is the body’s window to the outside. Skin has a versatile importance for human life. Prevents fluid and electrolyte loss. It has a thermoregulation (body temperature balancing) task. It also protects the body from harmful rays and toxins. At the same time, it is the organ of the sense of touch. The top layer of the skin performs the task of protecting the fluid. It also has a bactericidal effect on the skin.
The skin of newborns differs from the skin of adults in many ways. The function of the protective layer of the skin in premature babies is 15 times less than in term babies. For this reason, premature newborns can lose 30% of their weight by evaporation in a short time as one day. Due to the thin skin of newborns, drugs that are not absorbed in adults may be absorbed in newborns and cause systemic toxicity. For this reason, drugs applied in the form of smears should be used with caution. The most important source of microbe colonization in the newborn is the hands of the caregiver. It is important to wash hands with effective soaps. Continuous use of normal soaps should not be preferred as it may cause the spread of bacteria. Soft alkaline or neutral pH soaps with antimicrobial properties should be used. In addition, sticky substances such as band-aids should be avoided as much as possible. Alcoholic solutions should not be applied to the skin of the newborn. Because it causes drying and the absorption of alcohol from the skin is very high. It can also be toxic. Iodine compounds should not be applied to the skin of the newborn. Because iodine can cause skin necrosis, increased iodine in serum and urine, over- or under-operation of the thyroid, and goiter.
NEWBORN BELLY CARE
The dried tissue in the umbilical stump can be a good settlement for bacteria. The umbilical infection is important in terms of the mixing of microbes called tetanus and sepsis into the blood. For this reason, apart from measures such as tying the diaper away from the umbilical cord and not applying emollient creams to the navel, antiseptic cord care is required. The best choice for belly care today is solutions with chlorhexidine. Solutions containing alcohol and iodine should not be used. When applying antiseptic to the navel, spillage of the antiseptic on the abdominal wall and groin area should be prevented.
BABY WASHING
Bathing the newborn in the baby’s room as soon as he is born is unnecessary and harmful. The PH of the newborn’s skin is between 6.5-7.5. After the first week it shifts towards acid and at the end of the first month it goes down to the adult PH level (4.0-5.5). It takes more than 1 hour for the skin PH of newborns washed with alkaline soaps to return to normal. In addition, it may take more than 1 month for the skin of babies washed with soaps with high pH to return to the normal level. The appropriate pH for the skin’s optimal antibacterial function is below 5.0. For this reason, neutral soaps should be used, which allow the skin to go down to its old PH in a short time after washing. It is important to use neutral soaps to prevent diaper rash. The PH of the wet wipes used to wipe the bottom of the babies is also important. After the dirty diaper is removed, the baby’s bottom should be wiped with a wet cotton and soft cloth. The genital area of girls should be wiped from front to back with a wet cotton pad. Wiping from back to front causes urinary tract infections.
Points to be considered while bathing the newborn:
. The first bath should not be done before vital signs (fever, pulse, blood pressure, respiration) stabilize.
. Gloves must be worn.
. Vernix Kazazeosa (the layer that covers the baby when he is first born) should not be washed. If it is too much, it can be reduced. Vernix baby should be touched with gloves.
.Warm water is sufficient for routine washing in the first weeks. If necessary, a mild, neutral PH soap that does not contain abrasive, deodorant, dye or preservative chemicals should be used for heavily soiled groin areas. This soap should be applied softly and without rubbing too much, without damaging the skin. The scalp of the baby should be washed once or twice a week with a baby shampoo that does not burn the eyes. The skin should be rinsed thoroughly after washing It should not be forgotten that the mildest soap removes the protective oil layer of the real skin.
During home care, it is sufficient for babies to be washed 2-3 times a week for the first few months. Not lowering the navel below the water level until the navel falls is important in terms of preventing possible infections and late falling of the navel. It does not matter if the umbilical cord is slightly wet. Washing the face helps to remove the milk residues that are contaminated around the mouth. The eyebrows should be wiped, the genital area should be washed. Soap should not be used in cleaning the genital area of girls, as it may cause irritation. It should only be cleaned with water and wiped from front to back. It should not be forgotten that avoiding bubble baths in girls until puberty protects against vaginal irritations and urinary infections. If not rinsed thoroughly after washing, remaining soap may cause irritation. After washing, the baby should be dried thoroughly and the skin should not be damaged too much. Keeping the genital area wet can cause fungal infections. Nails should be trimmed to avoid self-injury. Cutting it too deep can cause infections around the nails such as ingrowns. In an uncircumcised male newborn, the foreskin is attached to the glans penis. Between 5-10 years of age, this adhesion is removed. It is sufficient to wash the outside of the foreskin. Retraction (retraction) should not be done.
SOFTENERS
The skin of the newborn is drier and less water-holding capacity than the older children. Therefore, moisturizing the skin is of great importance. Vegetable oils are used for this purpose in our country as well as in many countries. Essential fatty acids or vegetable oils containing essential fatty acids (such as sunflower oil) can be used as emollients. Many ready-made baby oils can meet this need. In very low-weight newborns, damage to the skin by rubbing should be avoided during application, and protective creams containing perfumes and preservatives should be avoided. Talcum powder should never be used because of the danger of chemical pneumonia.
