Gupta Piyush, Nagesh Karthik, Garg Pankaj, Thomas Jayakar, Suryawanshi Pradeep, Sethuraman Giridhar, Hazarika Rashna Dass, Verma Rahul J, Kumar C Suresh, Kumari Shantha, Taneja Sunil, Chavhan Vaishali, Thakor Priti, Pandita Ankita
Department of Pediatrics, University College of Medical Sciences, New Delhi, India.
Department of Neonatology, Manipal Hospitals Group (MHEPL), Bangalore, Karnataka, India.
Pediatric Health Med Ther. 2023 Aug 25;14:249-265. doi: 10.2147/PHMT.S414091. eCollection 2023.
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.
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.
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.
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.
基于个人经验和偏好的新生儿皮肤护理做法在不同医院环境中可能存在很大差异。本共识性建议的目的是为医疗保健从业者提供关于医院环境中从出生到出院的循证新生儿皮肤护理做法的临床实践指导。
2020年12月召开了一次关于“循证新生儿皮肤护理做法与方案”的科学咨询委员会会议，专家小组由新生儿科医生、儿科医生、妇产科医生和儿科皮肤科医生组成。截至2021年3月23日，使用PubMed和谷歌学术进行了全面的文献检索，以检索相关证据。
针对健康足月儿皮肤护理的关键方面制定了建议，包括出生时的清洁、皮肤接触护理、脐带护理、尿布区护理、初次和常规沐浴、清洁剂和润肤剂的使用以及选择合适皮肤护理产品的标准。建议包括在常规新生儿护理中纳入皮肤评估，出生后心肺和体温稳定6 - 24小时后进行首次沐浴；单独用水沐浴或添加温和的液体清洁剂可被视为合适，因为这不会影响发育中的皮肤屏障；建议对有较高湿疹发生风险的新生儿使用润肤剂，以维持和增强皮肤屏障功能及完整性；并在新生儿出院检查表中纳入皮肤护理建议。强调了严格质量控制、评估婴儿产品的高质量临床试验、使用为新生儿适当配方的产品以及婴儿产品标签完全透明的重要性。专家小组确定了文献中的空白，并讨论了未来研究的范围。
这些建议可能有助于规范印度医院环境中健康足月儿的循证皮肤护理，以提高新生儿在医院接受的护理质量，并促进整体新生儿健康结局的改善。
