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Expert Q&A: Bathing and Soothing Baby’s Skin

An interview with Jeremy F. Shapiro, MD .
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Are there common baby skin care mistakes parents tend to make?

Sometimes parents simply try to do too much. Doing less when caring for baby’s skin is very often more.

The thing to remember is that babies go from a fluid-filled environment to a much drier one. So during the first month, I prefer no creams or ointments be used on a baby’s skin. Even if baby acne appears, almost always nothing needs to be done. Parents just need to give their baby’s skin time to adjust to its new environment.

Also, although fragrances can leave a very nice scent, your baby’s skin can actually be very sensitive to them. This can result in a rash or increased nasal congestion. And be careful of “natural” creams or ointments -- just because it says “natural” doesn’t mean your baby’s skin will not be sensitive to it.

What sort of skin care does baby’s umbilical cord stump need, and what should parents do if the stump doesn’t fall off?

There is some debate about caring for the umbilical cord stump. One school of thought says that swabbing the cord with a triple dye right after the clipping and cutting is all that’s needed. The other school of thought suggests applying rubbing alcohol (70% isopropyl alcohol) to the base of the stump a couple times a day to keep the area clean and dry it out sooner. And a recent study says there may be no difference between the two treatments.

I recommend that alcohol be rubbed around the base of the stump a few times a day. I also recommend that parents:

  • Don’t pull on the umbilical cord stump at any time. You don’t want to cause a premature tear or bleeding.
  • Fold the top of the baby’s diaper away from the umbilical cord stump until the stump falls off.
  • Contact your pediatrician immediately if there’s odor, redness, or swelling at the stump site; if the baby has a fever; or if you see red streaking on the skin going toward the liver (the upper left). These may be a signs of infection.
  • When the stump does finally fall off, expect that the area will not look so great. In fact, a fleshy portion -- also known as an umbilical granuloma – may remain. If you have any concerns, always contact your pediatrician.

If the umbilical cord stump doesn’t fall off by four weeks, let your pediatrician know, as a follow up evaluation may be in order.

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