The arrival of a new baby brings many concerns and issues for new and incumbent parents. While new parents are faced with a myriad of issues for the first time, incumbent parents have to deal with the information explosion and change in thought on issues which have evolved since their first parenting experience. In addition, when parents have a second child, if the sex is different some of the issues are also new. Chief among the issues for both new and incumbent parents is the proper care of newborn skin. In fact, in many surveys of parents of newborns this issue often ranks first on the list of concerns. For example, in one study published in the journal Bedside Nursing, a group of mothers with infants under the age of 15 months was asked to consider the chief problem they faced in their babies’ first year. The study reports that the most common concern was how to care for their babies’ skin . Not only are new parents unaware of how to treat their newborn’s skin, but most pediatricians are also unaware of optimal infant skin care. Pediatricians are given very little exposure to pediatric dermatology in medical school and residency training. The minimal experience they do have is usually with severely diseased skin, rather than the care of healthy, but vulnerable skin, as is the case with newborns. This topic is also not addressed in most textbooks of pediatric medicine, St. Louis, MO: C.V. Mosby Co., 1983. The lack of clinically available information leads to the continued use of harmful chemicals on infants. Shockingly, while trying to treat the newborn cautiously and safely, the average newborn is exposed to as many as 48 different chemicals without consideration of the potential toxicity of the chemicals or the products that contain them.
A full-term newborn’s skin is only 40% to 60% the thickness of adult skin, thus rendering it considerably more vulnerable and more permeable. The ratio of body surface area to weight is up to five times that of an adult. Thus, the combination of thinner skin and high body surface area ratios render the infant at significant risk with any integrity disruption of the skin. The skin of premature infants is of even greater risk as it has a significantly less developed stratum corneum when compared to term babies. Accordingly they are at even greater risk of thermal instability due to transepidermal water loss (TEWL). Hence, the skin is a critical protectant of the infant for water and thermal control. When improperly cared for, an infant’s skin can be a serious potential health hazard.
Hazardous Ingredients in Baby Skin Care Products
Many commonly used baby skin care products contain potentially very harmful ingredients. Baby skin care products containing dyes (artificial color) should be avoided as many of these artificial colors are known sensitizers and may result in dermatitis and allergic reactions. As this may become a health concern, dyes in products should be avoided. Fortunately, they are not life threatening. However, many of these products contain additional chemicals that may be life-threatening and must be unequivocally avoided. Three commonly used baby skin care chemicals that must be avoided are talc, propylene glycol and glycerin.
One of the most dangerous ingredients in baby skin care products is talc. It is a common ingredient of the most popular baby powders in use. In a survey conducted by Departments of Internal Medicine and Pediatrics, Loyola University Medical Center, Maywood, Il, 47% of the respondents used baby powder (talc). Another study of baby powder usage found that 69% of parents routinely applied baby powder to their newborns’ skin. In this study parents used the baby powder because they believed that the powder killed bacteria and yeast and prevented diaper rash, neither of which is a valid action of baby powder. Fewer than 500 of the respondents were aware that aspiration or ingestion of powder (talc) was a health hazard.
Baby powder use has been associated with morbidity and mortality due to inhalation. In a review of talc related infant deaths, it was found that of the 25 cases reviewed, fatality occurred in 20% of these reported cases. Based upon the potential hazard of talc use, baby powders containing talc should be discouraged for infants.
Propylene Glycol and Glycerin
Propylene glycol has been studied for its toxic effects that include seizures, sudden collapse, cardiac arrhythmia and asystole, hepatic damage, renal damage and hyperosmolality. In a survey conducted on neonatal skin care practices, the authors warned against the use of propylene glycol and glycerin on infants. They cited the associated risks of hyperosmolality and seizures. Propylene glycol is the second ingredient listed on the world’s leading baby lotion ingredient disclosure. While baby products containing propylene glycol and glycerin may bear names of “trusted” companies, further review of the wisdom of their use is warranted. Remedy products contain less than 0.30% propylene glycol.
Mineral oil is a hydrocarbon that is processed from crude oil. Many people confuse the name as having the connotation of containing vitamins and minerals, rather than its actual meaning which is derived from the earth’s crude oil. Mineral oil is a separation component along with kerosine and gasoline. While the Cosmetic Toiletry and Fragrance Association (CTFA), the leading industry lobbying group, has pointed out that mineral oil should not get the same treatment as other hydrocarbons such as kerosene and gasoline, the Commission continues to pursue the closure regulations. While mineral oil has not been studied to the same degree in the same pediatric literature as talc, propylene glycol or glycerin, it is clear that the Commission’s findings will trigger interest in warning against its use on infant skin. The Consumer Product Safety Commission is preparing a ruling that would mandate child-resistant closures on baby oil that contains more that 10% mineral oil. Beyond the available data, with the risk of other hydrocarbons well known in the causation of various cancers, it seems extremely unwise to apply a hydrocarbon to the delicate skin of a baby. This is especially true when no nutritive value of mineral oil to the baby or the skin can be identified, and there are many other, better options for skin ingredients.
While trying to do the best thing for baby, use of many commonly available baby skin care products is actually or potentially harmful to babies. Increasingly, parents are realizing the importance of early exposure of babies to damaging compounds in their first months of life. The marketplace is not only ready, but in many ways, through their purchasing choices for themselves, demanding natural alternatives with better health implications for their baby’s skin. McCord Research has developed a line of skin care products that can be used on babies. The line of skin care products is natural and has eliminated or greatly reduced potentially harmful ingredients. Remedy products, distributed exclusively by Medline Industries, were developed by scientist and physicians. This is the most scientifically developed skin care line in the marketplace and is environmentally-friendly as well as baby-friendly.