From the Guidelines
It is recommended to leave the crusting on a newborn's hair unless it becomes excessive, and the first bath should be delayed until the umbilical cord stump falls off, typically 1-2 weeks after birth, to prioritize the baby's skin health and temperature regulation. According to the most recent guidelines, bathing with water alone or with a nonsoap cleanser at least 2 to 3 times per week, followed by the application of a bland emollient, can help improve skin hydration and skin barrier function 1. If cleaning of the crusting is necessary, gently massaging baby oil or petroleum jelly into the scalp, letting it sit for a few minutes, then using a soft brush to loosen the flakes before washing with mild baby shampoo is a suitable approach. Key considerations for newborn care include:
- Delaying the first bath until the umbilical cord stump falls off to allow for proper healing and minimize the risk of infection
- Using warm water and mild soap only where needed for sponge baths until the first bath
- Keeping regular bathing sessions brief (5-10 minutes) in warm water (about 100°F/38°C) to protect the baby's sensitive skin barrier
- Using fragrance-free, mild cleansers specifically formulated for babies to maintain skin health 1.
From the Research
Newborn Hair and Skin Care
- The crusting on newborn hair is a natural occurrence and is part of the vernix caseosa, a white, creamy, naturally occurring biofilm that covers the skin of the fetus during the last trimester of pregnancy 2.
- This vernix coating on the neonatal skin protects the newborn skin and facilitates extra-uterine adaptation of skin in the first postnatal week if not washed away after birth 2.
- It is recommended to delay the first bath until the baby's temperature has stabilized and the infant is hemodynamically stable 3.
Optimal Time for First Bath
- The initial bath in full-term infants can be given once the baby's temperature has stabilized and the infant is hemodynamically stable 3.
- There is no specific evidence on the optimal time for the first bath, but it is generally recommended to delay it until the baby is stable 3, 4.
- Newborn bathing can be performed without harming the infant, provided basic safety procedures are followed, and water alone or appropriately designed liquid cleansers can be used during bathing without impairing the skin maturation process 4.
Cleaning the Crusting Off Newborn Hair
- There is no specific evidence on the need to clean the crusting off newborn hair, but it is recommended to use gentle cleansing and avoid harsh products 3, 4.
- The use of emollients on newborns should be limited in warm weather, and baby products that are left on should be formulated to buffer and maintain babies' skin surface at approximately pH 5.5 3, 4.
- Baby bath products as well as baby wipes are safe to use and do not appear to affect an infant's skin barrier integrity, but it is sensible to use cleansers that have been specially designed for baby's skin, which are pH neutral and very mild to avoid irritant dermatitis and allergic dermatitis 5.