Your questions answered by Sharon Trotter of Greatvine.com
Greatvine.com offers individual advice, by phone, direct from the country’s best parenting experts.

Sharon Trotter is a Registered Nurse and Registered Midwife with over 24 years of professional experience. Friendly and approachable, Sharon specialises in breastfeeding and baby skincare. Her work on baby skincare has helped to change NHS policy within maternity units nationwide and her book 'Breastfeeding: the essential guide' is a top-10 best seller. A mother of five, Sharon is looking forward to helping you. For individual advice from Sharon, by phone, book a private call at www.greatvine.com/sharon_trotter

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Q: Can you give me some advice on the safest way to look after my baby’s skin during the early weeks of life?

A: Since 1996 I have been advising parents to use water only for the first month of life. The overwhelming result of this approach has been positive, with newborn skin being in excellent condition. Rashes, spots and cradle cap are rare. Once introduced carefully chosen mild products are well tolerated.

Recent research suggests that it is safer to bath your baby in plain water for at least the first month of life.

At birth, the top layer of your baby’s skin is very thin and absorbent. This means it is more sensitive to damage from germs, chemicals and water loss. Over the first month (longer in premature infants) your baby’s skin matures and develops its own natural protective barrier. Skin conditions may develop if this natural barrier is damaged.

Remember that anything placed on, in or around your baby has the potential to harm.

The following advice is taken from the Babycare –back to basics™ leaflet. To give your baby the best start in life my key recommendations include:

• Wash your hands before and after carrying out any baby care
• Open cordcare is now recommended: there is no need to use antiseptic wipes or powders – top’n’tail your baby until the cord has separated
• Use water only for baby skincare for at least the first month of life
• Once introduced, read the labels of all products and avoid products containing sulphates (SLS and SLES), parabens, phthalates, artificial colours and perfumes
• Breastfeeding your baby will strengthen their immune system
• Do not overload your washing machine - this will help prevent a build up of washing powder chemical residues on clothing
• Cloth nappies are as efficient as disposables and do not present a higher risk of napkin rash - they are also kinder to the environment
• Use a thin layer of barrier cream on the napkin area to help protect against the development of napkin rash – this cream should ideally be free from preservatives, colours, perfumes, antiseptics, and clinically proven to be effective in the treatment of nappy rash
• Massage oils should be vegetable based and free from mineral oils, perfume and colours - if there is a history of nut allergies in your family you should also avoid nut-based oils. Contact a qualified baby massage therapist and ask for their advice on suitable oils.

Q: I suffer from psoriasis and am worried that my condition could be passed to my baby. Is it hereditary?

A: Psoriasis, like other chronic skin conditions, has many triggers. These include stress, injury, allergies, diet, medications, household or personal care products and even weather conditions.

The underlying cause is unknown but it is thought there is a genetic predisposition, which makes the immune system react by growing skin cells quicker than normal. This results in the characteristic psoriasis lesions, which contain piles of dead skin cells, which can look silvery and scaly.

The best advice for a pregnant woman who wants to help prevent passing on skin conditions to her baby is to take good care of herself, avoid undue stress, eat a well balanced diet and follow these common-sense guidelines:

• Eat fresh foods containing as few additives and preservatives as possible
• Use household and personal care products with care: detergent residues can be absorbed into the bloodstream through the skin and personal care products can pose a risk to her unborn child
• Wear rubber gloves when using harsh household products
• Choose products free from petrochemicals, parabens, phthalates, sulphates (SLS, SLES), alcohol and strong perfumes
• Avoid substances that you know you are sensitive to during pregnancy and while breastfeeding (this could be nuts or dairy products, if you are allergic to these products)

General advice for avoiding allergies:

Everything a pregnant woman eats drinks or uses on her skin can affect the fetus, but not necessarily in a bad way. The above advice will help the unborn baby prepare for the normal background environment they will encounter when they are born.

Breastfeeding should also be positively encouraged. The development of the immune system is closely related to the way a baby or child reacts to foreign agents and their subsequent risk of allergic disease. This begins before birth but it is especially advantageous for infants to be offered the protective factors transferred by breast milk for at least the first six months of life, as recommended by the World Health Organisation and the Department of Health.

The undisputed emotional, physical, psychological and social advantages of breastfeeding are well researched and documented. Although research has so far failed to establish a link between breastfeeding and a reduction in allergic disease it is important to consider the bigger picture. In the absence of breastfeeding, or where it is limited, the risk of early sensitisation inevitably increases for babies. If allergies do develop, continued breastfeeding will confer immunological strength to minimise the ill effects of allergic disease (in whatever form this may present itself).

Q: My baby’s ankles and hands are very dry. Her skin looks like it’s peeling – what can I do?

A: If your baby is overdue, their skin may be dry and cracked. This is to be expected, as the protective vernix (the white sticky substance that covers your baby’s skin in the womb) has all been absorbed. Don’t be tempted to use creams or lotions as this may do more harm than good. The top layer of your baby’s skin will peel off within a few days leaving perfect skin underneath. Continue using plain water only for at least the first month.

Q: My baby is covered in little spots! She’s two weeks old and her forehead is covered. Should I see a doctor?

A: It is not unusual for babies to suffer from skin problems in the early weeks of life. Some will resolve with no treatment while others may need to be seen by a health professional. If you have any worries then speak to your midwife, health visitor or doctor.

Common skin conditions seen in babies include:

Erethema neonatorum
This is a non-infective rash that is commonly seen in the first few weeks of life. There is no treatment and it usually clears within a few days. Great care must be taken to avoid all manufactured skincare products or contact with carer’s make-up and perfumes, as these can also be a cause of irritation to newborn skin.

Miliaria (also known as milk spots)
Due to obstruction of the sweat glands and are seen in babies who become overheated. This will resolve once normal temperature control is maintained.

Heat spots
This is similar to the erythema rash but the cause is overheating and the rash is more evident around skin folds. Take care to dress a baby in layers so you can add or remove them in order to maintain a stable temperature. A baby’s room should be kept at a constant 16 - 20°C. Do not cover a baby’s head, avoid duvets and if possible use lightweight baby sleeping bags to avoid overheating.

Infantile eczema
A diagnosis for this condition is not made until three months old. The cause is unknown but reactions to harsh ingredients in skincare products are known to exacerbate the condition. Atopic eczema is the commonest type seen in babies and can also signal an allergic reaction to proteins such as milk, eggs or wheat. Treatment includes finding the source of the allergy and avoiding contact with such allergens plus maintenance of the delicate epidermal barrier by way of emollient treatments.

Napkin rash (ammoniacal dermatitis)
Usually confined to the nappy area and caused by the skin’s reaction to high levels of ammonia from urine and faeces. Frequent nappy changes, gentle but thorough washing (using only water for neonates) plus a thin layer of barrier cream will help to avoid and control this condition.

Sticky eyes (conjunctivitis)
This is a very common condition-affecting neonates, which often necessitates treatment with chloramphenicol eye drops or ointment. A simple remedy is the application of a few drops of fresh colostrum. Colostrum and breast milk are known to contain many anti-infective properties. They are commonly used to treat eye infections in developing countries.

If you need any further advice, please feel free to contact me direct on Greatvine.com or one of their many qualified and experienced midwifes or health visitors and speak to someone one-to-one from the comfort of your own home today.

Q: My 7-week old has got terrible cradle cap. It looks awful and I’m worried it might hurt her. I’ve used specialist shampoo, almond oil and olive oil, but nothing seems to work.

A: Cradle cap (sometimes called infantile seborrhoeic dermatitis) is a greasy scaly rash usually confined to the scalp of a baby. It is thought to be caused by an over activity of the sebaceous glands due to increased circulating hormones from the mother or overuse of harsh skincare products in the early weeks of life. This condition can be treated with an application of vegetable oil (which should be left overnight) followed by gentle combing of the loosened skin flakes. Strong shampoos aimed at the treatment of cradle cap should be avoided. These products may contain harsh detergents that could aggravate the condition further.

It is not necessary to wash baby’s hair with shampoo until they are a year old. Once you have introduced baby bath products, simply rinse your baby’s hair in the bath water. Make sure any shampoo your use is free from sulphates (SLS and SLES) parabens, phthalates, artificial colours and perfumes. Q: My daughter had chicken pox and was left with terrible scars all over her face, chest and back. How long will they take to fade and is there anything I can do to make them better?

A: The healing process differs between each baby and child so it is difficult to say how long it will take for these scars to fade.

During an attack of chickenpox it would be wise to keep your child’s nails short and discourage them from scratching the scabs (to avoid infections occurring). This will help to speed up the healing process. Natural fabrics (100% silk or cotton) are useful to avoid overheating (which itself can increase itchiness) with new generation fabrics now available which are designed to help regulate the body temperature. The application of calamine lotion is a great way to cool irritated skin but if the skin is very itchy antihistamines may be prescribed by your Doctor. Should any spots become infected antibiotics may also be needed. If you follow this advice it is unlikely that scars will occur but even if they do they are likely to be minor and will fade in time.

Copyright Sharon Trotter



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