What are good emollients to use in infants?

Recommended Emollients for Infants

Apply bland, thick emollients—specifically creams or ointments with minimal or no fragrances or preservatives—as the preferred choice for infant skin care. 1

Specific Emollient Recommendations

First-Line Options

Petroleum jelly (petrolatum) and mineral oil are the most appropriate emollients for healthy infants, as they are stable, non-oxidizing, and provide effective moisture barrier protection without risk of hydrolysis or rancidity that can occur with some vegetable oils. 2, 3

• Petroleum jelly is specifically recommended for wound healing, diaper area protection, and general moisturization 1
• Mineral oil is preferred over certain vegetable oils due to its stability and safety profile 2, 4
• Dimethicone-based products form a protective moisture barrier and are FDA-approved for preventing diaper rash 5

Application Guidelines

Apply emollients at least twice daily, ideally immediately after bathing (within 2-3 minutes) to maximize transepidermal water loss prevention and improve skin barrier function. 1, 6

• Bathe infants with water alone or with a nonsoap cleanser 2-3 times per week, followed by emollient application 1
• Use liquid cleansers with neutral or mildly acidic pH to avoid disrupting the skin's acid mantle 1, 4
• Pat skin dry or allow to air dry before applying emollients 5

Oils for Massage

For infant massage, sunflower oil, coconut oil, or mineral oil are preferred over olive oil or mustard oil, which have been shown to be detrimental to skin barrier function. 4

Special Considerations for High-Risk Infants

For infants at high risk of atopic dermatitis (family history of atopy), regular emollient application may reduce the risk of developing eczema, though recent large trials show conflicting evidence. 1, 4

• However, two high-quality RCTs with 3,791 combined participants found no evidence that early regular emollient use prevents atopic dermatitis in high-risk infants 3, 7
• The evidence remains mixed, with earlier smaller studies suggesting benefit while larger recent trials show no preventive effect 6, 7

Products to Avoid

Avoid emollients containing fragrances, preservatives, or potential contact allergens in infant skin care products. 1, 3

• Do not use olive oil or mustard oil for massage, as these may impair barrier function 4
• Avoid soap-based cleansers; use nonsoap cleansers instead 1

Formulation Characteristics

Choose products with appropriate surfactant blending or hydrophobically-modified polymers (HMPs) to ensure mildness and avoid disruption of skin surface pH or barrier perturbation. 2

• Ointments provide more occlusion than creams but may be less cosmetically acceptable 1
• The lipid-to-water content ratio affects emollient properties and should be considered based on individual infant needs 2

Safety Considerations

Be aware that emollient use may increase risk of skin infections (17 more cases per 1000 infants) and potentially infant slippage during handling. 7

• Monitor for stinging or allergic reactions to moisturizers, though these are uncommon 7
• Clean diaper area with emollient ointment rather than water or commercial wipes to reduce friction 1