Aquaphor burning skin??

Specialties NICU

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Just wondering if anyone else is having this problem...our micropreemies' skin is burning and we think it is related to the aquaphor. Obviously, we know that their skin is fragile as is their water/fluid/temp balance and thus we use aquaphor for that. What we are finding is: skin emaciation - looks like burns almost- under temp probe gold hearts (adhesive stickers to hold the temp probe to skin) and when the baby is under phototherapy. We are only seeing it when the baby has Aquaphor on their skin. Has anyone else seen this? Do you use something different for the skin that doesn't react to gold hearts or to phototherapy???

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Specializes in Maternal - Child Health.
Just wondering if anyone else is having this problem...our micropreemies' skin is burning and we think it is related to the aquaphor. Obviously, we know that their skin is fragile as is their water/fluid/temp balance and thus we use aquaphor for that. What we are finding is: skin emaciation - looks like burns almost- under temp probe gold hearts (adhesive stickers to hold the temp probe to skin) and when the baby is under phototherapy. We are only seeing it when the baby has Aquaphor on their skin. Has anyone else seen this? Do you use something different for the skin that doesn't react to gold hearts or to phototherapy???

I was always taught never to use a cream, lotion, or ointment of any kind on the skin of a baby under phototherapy. I don't know why you would notice a change if your unit has used Aquaphor on phototherapy babies in the past, unless the manufacturer has changed the formulation of the product. Have you contacted them?

The CNS in one unit where I worked also strongly discouraged the use of skin creams, etc. under anything occlusive (temp probes, dressings, UAC tape, etc.) stating that it placed the babies at risk for fungal infections.

Perhaps you could contact the manufacturer for their recommendations and/or ask your CNS, infection control or wound care nurse for advice.

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Specializes in nursery, L and D.

We aren't supposed to use any creams or lotions on any baby. Not NICU here, well newborn. I have noticed lots of babies react to our temp probes and electrodes.

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Just wondering if anyone else is having this problem...our micropreemies' skin is burning and we think it is related to the aquaphor. Obviously, we know that their skin is fragile as is their water/fluid/temp balance and thus we use aquaphor for that. What we are finding is: skin emaciation - looks like burns almost- under temp probe gold hearts (adhesive stickers to hold the temp probe to skin) and when the baby is under phototherapy. We are only seeing it when the baby has Aquaphor on their skin. Has anyone else seen this? Do you use something different for the skin that doesn't react to gold hearts or to phototherapy???
Since the reactions are underneath the adhesive-attached temp probes and not on the rest of the baby, but the Aquaphor (I'm assuming) is all over the baby, it really sounds like Aquaphor is not the problem.

Could the baby be sensitive to adhesives? Just a thought....

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You shouldn't use anything petroleum based under phototherapy or a radiant warmer. You are frying the baby! (unless you use the blue lights which I understand are cool).

I agree that it sounds more like a reaction to the adhesive. On micros we use medipore between the adesives and the baby.(The exception is IVs or PICC dressings) We don't use bandages, but wrap with a small bit of gauze and tape that.

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Specializes in Neonatal ICU (Cardiothoracic).

Agree with dawngloves.... we are never to put any type of lotion or ointment on a baby under a RW or photo banks. We put any infants

Stevern21

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Specializes in NICU, Infection Control.

You can put a [small] piece of Op-site/Tegaderm down; I've also seen the skin barriers used for stoma bags (help, can't remember the name!)--you put the probe down, then the stoma thing, then the foil heart. Also can be used for securing the Umbi lines.

Do you use humidity w/your really immature babies? That can definitely help their skin and fluid balance. After a week in the humidity, the skin surface has matured a lot and they don't need humidity.

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We have begun a new skin protocol that calls for covering the the trunk (anterior and posterior) elbows, knees, hips, upper amrs, upper thighs, and other boney prominences with a bioclusive dressing. We do this for all infants less than 1250 gms. With this, we no longer need to aquaphor the skin, which I understand increases risk for infection since it allows germs to sit on the skin. We also have an easier time with temp control and fluid/electrolyte balance. We leave it on until it falls off by itself. This way you dont have to worry about burns from ointments.

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Thank you all so much for your replys and suggestions. I am going to print this out and give it to my nurse manager. We are not currently using humidity. Maybe that is something that we should be doing instead of the Aquaphor. Are any of you aware of any research articles related to this topic? That would be helpful in policy changes too. Thank you!

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Specializes in NICU, PICU, educator.

We go round and round about the aquafor thing. If it is name brand Aquafor,then it is safe for under the lights, but some of our neos think that it increased the risk of fungus when paired with high humidity.., hard to tell since those tiny micros seem to end up with it anyways. You can sign onto Medscape and see if there are articles there. Many kids get burns from the leads and such...we have had better luck with limb leads on the micros. Also, if you are using the white lights, make sure they are the proper number of cms away from the baby. We have had 2 kids burned while on warmers with those lights because they were too close. We are phasing those out and going to all blue lights.

We talked about the occlusive dressing also....but we would use on only the under kilo bunch.

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Specializes in ER, NICU, NSY and some other stuff.

Premnrs I believe you are talking about Duoderm.

I have worked in units that we had an Aquaphor protocol and we had no problems such as that related to the product.

I have seen babies get the types of injuries you are noting because staff either PULL the lead or temp probe off partially dried and adhered to the skin without reweeting to loosen, or not rotating sites as they should

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We have been using Aquaphor on micropreemies for many years now, and we have not had the problem you described. We use it for a period of two weeks, and the babies are kept on radiant warmers. If you are having a problem with the temp probe cover, you could try what we do, which is to tuck the probe behind the ear, and we fashion a stretchy "headband" out of surginet to hold it in place. This works well for us, and no adhesive on the babies skin.

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