The baby skincare market is enormous and the claims on product labels are frequently misleading. "Natural," "organic," "dermatologically tested," and "gentle" are marketing terms with no standardised clinical meaning. What matters is whether a product is appropriate for the particular immaturity of newborn skin — and the evidence here is more cautious than most product ranges suggest.
The simplest, most evidence-supported approach for newborn skin in the first weeks is: water only for bathing, minimal handling of the cord stump, leave the vernix alone, and if the baby's skin appears dry, less is more.
Healthbooq (healthbooq.com) covers newborn care and skin health in the first months.
Newborn Skin Is Different
The stratum corneum (the outermost protective layer of the skin) in newborns is thinner than in adults and has a higher water content. The skin barrier, which prevents water loss and limits absorption of substances from outside, is less complete. This means:
Newborn skin loses water faster (transepidermal water loss is higher).
Topically applied substances are absorbed more readily and at potentially higher concentrations than in adults.
The skin is more susceptible to irritation from soaps, detergents, and fragrances.
The vernix caseosa — the white, waxy coating on a newborn's skin at birth — is a protective substance produced in utero. It contains antimicrobial peptides, water-binding proteins, and lipids. There is good evidence that leaving it on the skin to absorb naturally provides antimicrobial protection and supports barrier function. NICE CG37 recommends leaving it in place; hospital practices of immediately wiping it off are not evidence-based.
What NICE Recommends
NICE CG37 (Postnatal care for women and their babies, updated 2021) provides the following guidance:
Use only water for bathing a newborn during the first month. This includes plain warm water for all bathing, without any products. If anything is used for cleaning the nappy area, plain water or a mild unperfumed soap is acceptable.
Avoid scented lotions, bubble baths, and products containing perfume, alcohol, or preservatives like methylisothiazolinone.
Top-and-tail washing (cleaning the face, neck, hands, and nappy area without a full bath) is appropriate when the cord stump is present and a full bath is not practical.
Eczema Prevention and Moisturisers
Eczema affects approximately 15 to 20 per cent of children in the UK, with onset in most cases in the first year of life. Several trials investigated whether regular moisturiser use from birth could prevent eczema in high-risk infants. The results have been more nuanced than early enthusiasm suggested.
The BEEP trial (Chalmers et al., Lancet 2020), which randomised over 1,200 infants at high risk of eczema to daily emollient (moisturiser) from birth versus no emollient, found no reduction in eczema rates at 2 years in the emollient group — and found a slightly higher rate of skin infections in infants receiving emollient. The Cochrane review concluded there is currently no clear evidence that emollients prevent eczema.
For infants without a family history of eczema or established dry skin, routine moisturiser use is not necessary. For infants who develop dry or eczema-prone skin, a simple, fragrance-free emollient (such as Diprobase, Doublebase, or QV cream) is appropriate, with guidance from a GP or health visitor if eczema is suspected.
What to Avoid
Olive oil, coconut oil, and sunflower oil are sometimes used as "natural" baby moisturisers. Evidence, including a trial by Danby et al. (2013), found that olive oil specifically damages the skin barrier in infants, increasing transepidermal water loss. Sunflower oil was neutral or mildly beneficial in the same study. The general guidance is to avoid undiluted cooking oils on newborn skin.
Talcum powder should not be used around babies because of aspiration risk.
Products containing sodium lauryl sulphate (SLS), preservatives, fragrances, and essential oils should be avoided on newborn skin.
Bathing Frequency
NICE CG37 recommends bathing a newborn two to three times per week, not daily — daily bathing dries the skin by removing natural oils and disrupting the developing barrier. Top-and-tail washing on non-bath days maintains hygiene without the drying effect of daily immersion.
Water temperature for a baby bath should be about 37 to 38°C (comfortably warm to the elbow). Always place baby in the bath facing upward, supporting the head, and never leave an infant unsupported in or near water.
Key Takeaways
Newborn skin is structurally and functionally distinct from adult skin: it is thinner, has a higher water content, a less developed skin barrier, and greater absorption of topically applied substances. NICE CG37 guidance recommends using only water for bathing newborns in the first month, avoiding perfumed products, and leaving the vernix caseosa (the white waxy coating present at birth) to absorb naturally. Moisturiser use in the first weeks of life has been studied in the context of eczema prevention; a Cochrane review (van Zuuren et al., 2017) found no clear evidence that routine moisturiser use prevents eczema. In children with a family history of eczema, specific guidance from a dermatologist is advisable.
