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NICU expert 'Blooming Littles' answers your questions on premature skincare
newborns

NICU expert Katie Ross answers your questions on premature skincare

10/24/2024

Caring for the delicate skin of a premature baby requires special attention and expertise. Premature infants have thinner, more sensitive skin, and knowing what products to use or how to handle common skin issues can be overwhelming for parents. In this FAQ guide, Neonatal Occupational Therapist Katie Ross offers expert advice on the most frequently asked questions about caring for preemie skin. Katie brings years of experience working with premature and medically fragile infants in the NICU environment. These tips are designed to help parents protect their baby’s delicate skin during this critical stage of development.

What is your role in premature baby care?

I’m a neonatal occupational therapist. My job is to support the development of premature babies by focusing on how the NICU environment, interactions, and developing body systems may influence the way they can participate in the world around them. In my role, I’m supporting a preemie’s positioning, movement, comfort, feeding goals, and more. I work closely with NICU families to help them engage and interact with their baby in a way that is developmentally supportive, and comforting and builds confidence during the NICU stay.

How long have you worked with premature babies?

I’ve been studying and working with premature babies for 10 years.

How is premature babies' skin different from babies born at full term?

Premature skin is different from the skin of term babies in several ways. The skin layers of a premature baby are significantly thinner than term babies. For some babies born extremely premature, the outer layer of the skin is almost nonexistent and doesn’t form a good barrier until they’re closer to 34-35 weeks gestation. Because the cell layers of a preemie’s skin are thinner, it’s more susceptible to injury, heat loss, fluid loss, and microbial invasion.

What do you look for when selecting products for use on premature babies’ skin?

When looking for products, whether it’s lotions, cleansers, or wipes…you want to look for something that has been tested on newborn skin. A helpful thing to look for when researching is to find out whether the product is ‘pH balanced’ for infant skin, meaning it keeps the acidity level of a baby’s skin in the appropriate range. You also want to look for products that only use essential ingredients and are free of fragrances, preservatives or alcohol.

Are there any ingredients parents of premature babies should avoid when purchasing products for their newborn’s skin?

It’s important to avoid any harsh ingredients that could dry or irritate the skin. It’s generally recommended to avoid products with alcohol, perfumes, or certain preservatives.

Why do you choose WaterWipes® for use with premature babies?

WaterWipes are a great choice for cleansing the skin of premature babies during diapering. There are minimal ingredients, and the wipes are effective at cleansing the area without stripping away the fragile skin barrier or impacting the microbiome of these medically fragile babies.

What are the biggest considerations you want parents of premature babies to know when it comes to caring for their newborn’s skin?

After your baby is discharged from the NICU, you’ll have the choice of which products you want to use. Your baby’s skin is continuing to develop throughout the first year and it’s important to choose products that support their underdeveloped microbiome and base pH levels. Choose gentle cleansers and wipes, and remember you don’t actually need to bathe your baby more than twice a week.

Are there any resources you typically recommend for parents with premature babies in the NICU?

I recommend several encouraging accounts on social media, like Dear NICU Mama and Miracle Moon. I also provide resources to support groups that families can join while they’re navigating the NICU journey or after discharge. Project NICU and Hand to Hold are consistently running support groups run by veteran NICU families that can really help families navigate the challenges of a NICU stay.

Are there any preemie skincare myths you hear from parents? What would you tell them?

It’s not necessarily preemie specific, because I’ve heard this from a lot of families in the NICU, but many parents are surprised to hear they don’t need to bathe their baby every night. I think we see bathing as part of that “bedtime routine”, and it can certainly be calming…but bathing every night can actually dry the skin of babies and strip their skin of important oils and hydration, so we recommend only twice a week for the first few months!

Is there anything else you think parents of preemies should know?

I always want parents of preemies to know they’re not alone. You have likely found yourself navigating a journey you never expected. Take it one day at a time. You are a good parent. You are important for your baby. Your baby knows you. You are enough, always.

WaterWipes® are the first baby wipes to be certified as microbiome-friendly by MyMicrobiome. Securing the Quality Seal ‘Microbiome-friendly’ from MyMicrobiome guarantees that using WaterWipes® Baby Wipes does not disrupt the microbial diversity and balance of the skin, leaving the healthy microbiome of the surface and deeper layers of the skin intact. WaterWipes® is committed to developing safe, high-quality products that support a healthy skin microbiome. The microbiome is important because it protects against pathogens that could impact people’s skin and their health. Our products have been specifically developed to be as mild and pure as cotton wool and water, to help maintain the important skin barrier of the outermost layers of the skin, while offering the convenience of a wipe. Made from minimal ingredients, the full WaterWipes® range provides safe cleansing for the most delicate skin.