Question about soap.

[NANSNURSE]

OK...another question.

What does your skin care policy say about using soap on neonates. The hospital I came from used Johnsons and Johnsons on everyone. My new hospital says mild soap (phisoderm) on babies except those under 1000g. The babies under 1000g only get warm water.

I would think soap for everyone, I can't imagine that warm water does anything other than smear everything around.

[SteveNNP, MSN, NP]

We only use J&J on babies old enough to be bathed, warm water on the little ones. I would imagine there are toxicity, as well as skin acid mantle disturbance issues with the

[jenn_rn_nj]

for those babies in an isolette still on humidity, we use gauze moistened with warmed, sterile water (the little enfamil sterile water bottles as they are easy to keep in the isolette and thus stay warm); as they transition to room air / being dressed we begin to use hypoallergenic wipes for diaper changes and johnson's & johnson's soap for bathing.

[NicuGal, MSN, RN]

We don't use soap on the under kilo kids either...it does cause problems with the skin mantle. We use warm sterile water on those kiddos. Older kids only get bathed twice a week unless they are really gross, and then we only use Johnsons. Our skin care came from NANN guidelines, so you might go to those for reference. There are also several good articles on Medscape about skin care.

[prmenrs, RN]

Years ago, my boss and I actually tested (w/ pH paper) dial soap and Johnson's baby soap--Dial was very alkali and would disturb the acid mantle; Johnson's was more acid and would match the skin. That was the only way we could get one particular nurse to stop using Dial, and get it out of the nursery.

When the babies are just born and have that gelatinous skin, I agree w/sterile water baths. After a week or so, the skin is more "normal", and if you need to get meconium off their butts, I don't think a little bit of baby soap should be a problem. (as long as everyone agrees what a "little bit" is-my definition is

jmo

[ilstu99]

We don't use soap until they're > 1500g. Under 1500g, we use the soft gauze, and warm water (also the Enfamil stuff, left in the isolette). When they move to soap baths, we use an Aveeno baby bath.

[UTVOL3]

Neato. I wish we could have Aveeno.

[NICU_babyRN, BSN, RN]

NANN guidelines for us also. Tiny ones get warm water and gauze, bigger babies J&J Head to Toe.

Baths are twice/week and PRN for the big stinky kids.