Education Guide

Fragility of the skin increases risk of premature babies in the first two weeks of life

The skin is the body’s largest organ, it would have two square meters and weigh around four pounds. Although highly visible, not everyone gives due importance to this organ that has several functions, among them, to be a barrier protecting the body.

The skin of newborns and infants during the first year of life requires great care because it is still in development. In case of premature, that attention should be even greater because it is more a risk factor.

However, there may such care are related to the nursing staff of hospitals as the health of babies requiring prolonged hospitalization, often beyond the two to four weeks needed to mature the babies in general.

Second, Dr. Paulo Telles, a pediatrician and neonatologist Albert Einstein Hospital in São Paulo, 35 premature, 36 weeks, born with the skin much like a newborn with full-time pregnancy. As for the extremely premature infants at 26 weeks of gestation, usually stay in hospital for at least two months, the care of medical and nursing teams. When discharged, the skin no longer requires a treatment different from other babies.

The pediatrician explains how they should be the skin care of children:

Educating and Caring - What are the functions of the skin and how it develops in the first year of life?
Paul Telles - At birth, the baby’s skin is already structurally very similar to that of an adult, having various functions. It is a sensory organ, through the skin have the perception of heat and cold, pressure, touch, pain. It is a excretory organThrough the sebaceous glands (sebum) and sweat (perspiration), also involved in the regulatory system of body temperature. It is a secretory organ, Producer of vitamin D. It is a watchdogSince it functions as a selective permeability barrier as a barrier to UV light, as well as a mechanical barrier against infection and injury. For this complexity and multiplicity of functions, it is a great example of the interaction between the psychic systems, nervous, endocrine and immune

Educating and Caring - Since these functions are found in preterm infants?
Paul Telles - In the first two weeks of life preterm infants, the barrier function is greatly diminished, resulting in loss of heat, water, calories, electrolytes and proteins.

Educating and Caring - How important is the developmental stage of the skin to the preterm infant?
Paul Telles - The more premature the baby, the more immature your skin. Thus, the lower the gestational age of the baby, the greater risks and more immature their functions. The skin of premature infants is quite different from the baby at term (nine months). Just beginning to develop around 30 weeks of gestational age between 24 and 30 weeks, the stratum corneum of the epidermis is limited to a thin layer of flattened cells, increasing insensible water loss and absorption of chemicals and drugs. The mechanical barrier is also compromised, increasing the risks, trauma and infections.

Educating and Caring - In general, what is the time to complete development of the skin after a premature birth?
Paul Telles - Normally, after birth, regardless of gestational age, the skin undergoes a premature maturation accelerated, with increased thickness of the epidermis and the stratum corneum, making it in about two weeks like the term newborn.

Educating and Caring - What precautions should be taken with the skin of premature babies? Exposure to sun bathing, the use of hygiene and hydration are factors that can help or hinder the smooth skin of premature infants?
Paul Telles - Normally, the direct care in the premature baby’s skin will be made in the nursery or neonatal intensive care unit. Some features of the incubator, such as increased air humidity and double wall, reduce the senseless loss of water. Given the fragile skin and unstable clinical status in early life, only if strictly necessary to clean with warm water or saline and cotton. After a few weeks of life, the skin may be washed with warm water, possibly with moisturizing creams or oils after bathing, always careful not to use perfumes or preservatives to prevent absorption of chemicals. Similarly, exposure to the sun in an immature skin should be avoided.

Educating and Caring - In that period, care should be higher? What else attacks the skin of premature babies, cold or heat?
Paul Telles - Care must be larger in the first two weeks of life, as stated earlier, the period of premature skin aging. Cold and heat should be avoided as they will act more aggressively the greatest difficulty in maintaining body temperature in the skin of premature.

Educating and Caring - What are the risks of skin badly cared for the overall health of the premature baby?
Paul Telles - The main risks are increased insensible water loss and dehydration, infection and even systemic skin, heat loss and hypothermia.

Considering the children in general:

Educating and Caring - What are the signs of skin that must be observed by their parents?
Paul Telles - The most important thing is to always be alert to changes in the usual aspect of baby’s skin, such as appearance of new spots, red, white, or dark, cracking, peeling, blisters, pustules and edema or swelling.

Educating and Caring - Red spots on the cheeks or other body parts and signs of dryness and scaling should be considered normal and passengers or need to be treated?
Paul Telles - All these changes described are now very common in winter, mild redness on the cheeks may be normal, but we must always be attentive to the flaking and dryness, which can worsen and require treatment. Therefore, hydration and skin protection should be made daily as prevention for sensitive baby skin.

Educating and Caring - The use of moisturizers is recommended in infants? Routinely for all children or only in exceptional cases?
Paul Telles - The skin has an excretory function through the sweat and oil glands that produce sebum that protects and moisturizes the skin. In some situations, we need to change this production and extrinsic moisture, which can be made with moisturizing creams and oils, however, it is best to always consult a professional, as a pediatrician or dermatologist who will evaluate the baby’s skin and indicate frequency and the ideal product to use.

Educating and Caring - What is more harmful to the skin of children in general, lack or excess of baths?
Paul Telles - The long bath, hot or the inadvertent use of soap and soap can remove the protective skin oils and may therefore be harmful to the baby

Educating and Caring - What are the damages caused by long baths?
Paul Telles - Dry skin, eczema, cracks, and secondary to infectious processes.