Emma Pollon-MacLeod was initially puzzled by her 7-month-old son Calvin’s rash. His skin was red and irritated but only in one spot—on his abdomen. Then, she remembered the Jolly Jumper. Calvin had recently started teething, so he was drooling a lot. When he bounced in the Jolly Jumper—happy as can be—his drool would wet his clothing, which then rubbed against his skin, irritating a patch of his stomach. Mystery solved.
The experience was a reminder that while baby skin is idealized as soft and supple, it actually goes through a lot. “Baby skin is so new. It’s never been exposed to the outside environment before, it’s never felt fabric before,” says Pollon-MacLeod, a mom of one in Ottawa who also works as a naturopathic doctor.
At the same time, our babies’ skin is their first line of defence against the environment. Sam Cammisuli, a paediatric dermatologist at St. Michael’s hospital in Toronto, describes skin as a wall made of bricks and mortar that keeps good things in, like water, and bad things out, like bacteria, allergens, dust and animal dander. (If your baby has eczema, also called atopic dermatitis, it’s like they have loose mortar joints that leads to a porous wall, which lets water escape and irritants enter.)
As babies grow and develop and their skin is exposed to the outside world, issues like diaper rashes, irritations and dry skin are bound to happen. Thankfully, there are some practical things, like moisturizing and avoiding certain ingredients and products, that parents can do to help protect and avoid major skin issues. Emerging research is also giving us better insight into the complex skin microbiome as well as how baby skincare can help prevent the development of allergies. Here’s how to take care of your baby’s skin from the start:
Go fragrance-free: The aisles of baby-care products are overwhelmed with options for cleansers, shampoos and moisturizers, but Cammisuli recommends sticking with fragrance-free products. That’s because products with fragrances can irritate your baby’s skin and using them increases the risk of developing a contact allergy to various fragrances as they get older. This risk is higher for the 10 to 20 percent of babies with eczema. (Ninety percent of patients with atopic dermatitis develop it before age five, often starting in infancy.) Products with fragrances can also cause a baby with eczema’s skin to flare up and become red and itchy.
Moisturize to prevent allergies: Moisturizing the skin isn’t just about keeping that baby-soft feel—it could actually prevent food allergies. That’s because by moisturizing you’re protecting the skin barrier, and preventing allergens like peanut and egg residue from entering the body through cracks in the skin. “The skin is not meant for eating. And so, if food goes through the skin, the skin naturally, as an organ, makes allergic responses,” explains Donald Leung, head of paediatric allergy and clinical immunology at National Jewish Health in Colorado. It’s thought that this could explain why so many babies with eczema go on to develop food allergies.
A perfect time to moisturize is right after a bath when the skin is still damp, says Leung. After taking Baby out of the tub, apply an ointment or cream to lock in the moisture. Leung recommends avoiding lotions because they tend to contain more water and be alcohol-based, both of which can dry the skin.
Don’t scrub away bacteria: You’ve likely heard of the gut microbiome, but the skin has a microbiome, too. “The skin microbiome is a community or collection of microorganisms which include a lot of bacteria that live on the skin. This is normal, and in fact, serve some benefits to us,” explains University of British Columbia microbiology and immunology professor Bill Mohn. Our understanding of the microbiome is still evolving, but Mohn says the current theory is that our microbiome is developed early in life and there’s mounting evidence indicating that exposing babies to bacteria, within reason, can help build a healthy immune system and potentially protect against allergies and/or eczema and other diseases.
“No extreme is good. Obviously, hygiene is very beneficial, but you certainly don’t want to sterilize [their] skin,” says Mohn. For instance, if a baby is covered in food, simply wipe them down with a damp towel rather than washing their face with a cleanser.
But just because the skin microbiome is important, don’t feel you need to seek out a product that claims to “balance the microbiome.” Experts say that the efficacy of these products is not clear and it is too soon to draw concrete conclusions from skin microbiome research.
Double-rinse detergent: The detergents in laundry soap can also cause baby skin to react, says Leung. Detergents directly damage the skin by extracting lipids and proteins in the skin barrier (the bricks and mortar), resulting in further dryness or eczema flare-ups. “Parents should rinse baby clothing once or twice with water only so there’s no residual detergent,” he says. Mild laundry cleansers, such as those marked gentle or fragrance-free, will typically contain lower concentrations of detergents, but Leung says double rinsing is still important. “The key is to get rid of all the detergent residue at the end of the wash,” he says. Cammisuli adds that for the same reason, he doesn’t recommend the use of baby wipes but understands the convenience, and therefore recommends washing any residue from baby wipes rather than leaving the detergents on their skin. (You should also use them with minimal friction, and they should be unscented.)
Don’t over-bathe: Babies don’t need to be “squeaky clean” after bathing, says Cammisuli. That feeling is usually the result of stripping all the oils from the skin, which can be particularly harmful for babies because it disrupts normal skin barrier function and further dries out the skin. “Basically, it’s a short bath every day, they don’t even really need soap or cleanser, for the most part, except for if they soiled their diaper or that kind of thing. Generally, water alone is fine,” he says. Once Baby is out of the bath, avoid rubbing with a towel and removing moisture that can actually benefit the baby’s skin. “You can wrap the child so that they’re not cold, but you don’t want to apply friction to the skin,” says Cammisuli.
And as fun as bubble baths can be, they contain soaps and detergents that will further dry out baby’s skin, so Cammisuli says to steer clear, particularly if your baby has eczema.
Avoid (and treat) diaper rashes: Diaper rash is caused when your baby’s skin is kept in contact with a combination of urine and feces. Joseph Lam, a consultant paediatric dermatologist at BC Children’s Hospital, says that because disposable diapers are super absorbent and able to wick away urine, diaper rashes aren’t as common as they used to be. Still, frequent diaper changes can ensure that the baby’s skin isn’t in contact with waste for a prolonged period of time. Using a thick diaper cream, such as zinc-based products or petrolatum (i.e. Vaseline), can also create a barrier and protect against irritation, says Lam.
Since the experience with the Jolly Jumper, Calvin has had a few other skin issues, like a pretty bad diaper rash, but Pollon-MacLeod takes it all in stride, keeping his skin moisturized and avoiding irritants like strongly scented products.