Lavender T, Furber C, Campbell M, Victor S, Roberts I, Bedwell C, Cork MJ, et al.
BMC pediatrics. Date of publication 2012 Jun 1;volume 12():59.
1. BMC Pediatr. 2012 Jun 1;12:59. doi: 10.1186/1471-2431-12-59.
Effect on skin hydration of using baby wipes to clean the napkin area of newborn
babies: assessor-blinded randomised controlled equivalence trial.
Lavender T(1), Furber C, Campbell M, Victor S, Roberts I, Bedwell C, Cork MJ.
Author information:
(1)School of Nursing, Midwifery and Social Work, The University of Manchester,
Manchester, UK. Tina.lavender@manchester.ac.uk
BACKGROUND: Some national guidelines recommend the use of water alone for napkin
cleansing. Yet, there is a readiness, amongst many parents, to use baby wipes.
Evidence from randomised controlled trials, of the effect of baby wipes on
newborn skin integrity is lacking. We conducted a study to examine the
hypothesis that the use of a specifically formulated cleansing wipe on the
napkin area of newborn infants (<1 month) has an equivalent effect on skin
hydration when compared with using cotton wool and water (usual care).
METHODS: A prospective, assessor-blinded, randomised controlled equivalence
trial was conducted during 2010. Healthy, term babies (n=280), recruited within
48 hours of birth, were randomly assigned to have their napkin area cleansed
with an alcohol-free baby wipe (140 babies) or cotton wool and water (140
babies). Primary outcome was change in hydration from within 48 hours of birth
to 4 weeks post-birth. Secondary outcomes comprised changes in trans-epidermal
water loss, skin surface pH and erythema, presence of microbial skin
contaminants/irritants at 4 weeks and napkin dermatitis reported by midwife at 4
weeks and mother during the 4 weeks.
RESULTS: Complete hydration data were obtained for 254 (90.7 %) babies. Wipes
were shown to be equivalent to water and cotton wool in terms of skin hydration
(intention-to-treat analysis: wipes 65.4 (SD 12.4) vs. water 63.5 (14.2),
p=0.47, 95% CI -2.5 to 4.2; per protocol analysis: wipes 64.6 (12.4) vs. water
63.6 (14.3), p=0.53, 95% CI -2.4 to 4.2). No significant differences were found
in the secondary outcomes, except for maternal-reported napkin dermatitis, which
was higher in the water group (p=0.025 for complete responses).
CONCLUSIONS: Baby wipes had an equivalent effect on skin hydration when compared
with cotton wool and water. We found no evidence of any adverse effects of using
these wipes. These findings offer reassurance to parents who choose to use baby
wipes and to health professionals who support their use.
TRIAL REGISTRATION: Current Controlled Trials ISRCTN86207019.
DOI: 10.1186/1471-2431-12-59
PMCID: PMC3418152
PMID: 22656391 [Indexed for MEDLINE]
