Keep reading for the basics of caring for baby's skin, the first bath, the first diaper change (and poop!), bathing and diaper change hygiene, and how to treat diaper rash when there are signs.
Diaper creams and jellies and powders are on baby registries and must-have lists on the internet, but I've realized that many people don't really know what they're using them for and when they're appropriate. And when it comes to baby skin, less is definitely more. Here are the keys to my approach to caring for your newborn's skin and diaper area:
Don't over-wipe or wash
Keep skin clean and dry
Fresh air is your friend
Avoid fragrances & extras - keep it simple
How to care for baby's skin:
When a baby is born, they're often covered in birth stuff - poop (yours and/or baby's 😃), blood, amniotic fluid - but underneath they have a layer of something called vernix. It's a thick, whiteish substance that is sometimes plentiful and covering baby's whole body, or there's less of it in more concentrated places. Vernix is present later in pregnancy and functions to protects the baby's developing skin when inside the womb. We know that it is antimicrobial, helps regulate temperature, and protects the skin from moisture loss and possible infection (which is important as the skin adjusts to life on the outside). And we're learning more and more about the critical nature of baby skin immediately post birth - it's colonized with beneficial bacteria (significantly moreso after vaginal birth vs. surgical birth) that plays a key role in establishing baby's microbiome.
For all of these reasons, I highly encourage everyone to include loud and clear in their birth plans and with their providers:
DO NOT BATHE MY NEWBORN
With baby in your arms, your birth team is able to take a warm wet cloth to wipe off any non-vernix gunk. But otherwise, you'll be able to gently massage the vernix into their skin, snuggle them up, and just do nothing when it comes to bathing. For quite a while, actually.
The first diaper after birth
One of the critical things on my hospital bag checklist is a small container of olive oil. After baby is born and you've had some time together, before you put their first diaper on, slather on a layer of oil. The first couple of poops are made up of something fairly shocking called meconium. It's what gets cleared out of baby's digestive tract, and it's a blackish, grayish, greenish sticky tar like consistency that can be hard to clean from baby's skin. It's a very normal part of being born, but if you're not ready for it, it can be surprising AND quite hard to clean. The layer of oil for the first few days (until the poop consistency changes) helps with cleaning their skin more gently.
Bathing your baby
Your baby is not dirty, and in most situations, your baby won't get dirty for quite some time... likely a few months at least. There are exceptions, of course, but generally speaking, you can simply use warm water and washcloths or a soap-free bath to keep your baby clean. I highly suggest avoiding using anything with detergents, fragrances, or harsh chemicals on baby's skin. Remember, the skin is a living organ and has its own microbiome keeping it clean and safe, and we would be best not disrupting it.
If your baby has cradle cap or build up on the scalp, you can soften the area with some olive or other gentle oil and then use a cradle cap brush and comb like this one. After rinsing and drying, I'd use a bit of hypochlorous acid spray on the scalp.
Diaper Change Hygiene
The basics of keeping the diaper area healthy:
Keep dry
Treat as sensitive skin - reduce/avoid rubbing
Avoid using products unless necessary
When baby is very little, if you have help around, I recommend using reusable wipes wet with just warm water to clean baby during diaper changes. You just put the used ones in a wet bag and launder normally. These are great to have for many years - for diaper changes/outfit messes on the go, storing wet swim gear, etc.
And if you have a messy enough poop or if the sink is close by, take them to rinse their diaper area under warm water to get them clean (again, no soap is even necessary). Infant poop isn't gross, only has a faint smell (can be a little smellier with formula), and is liquid.
Regular wipes are totally fine and I always keep a pack by my bed postpartum for changes (I have used these for all my babies). But treating the baby's skin as gently as possible helps a lot in the long run.
I have used the fancy Coterie diapers, but I eventually went back to my favorite brand I used for many years before. They work well and are great for sensitive skin. You can sign up for a subscription on their website directly, too.
For daily maintenance, you really don't need any products.
How to treat diaper rash once there are signs:
When baby is likely going to be awake/happy for a window of time (don't start this process when they're hungry/tired/cranky!) carefully wash the diaper area with warm water. Optionally, you can rinse with gentle, fragrance free soap as well. Allow baby to air dry fully on a towel. Make sure you're in a warm enough room and bring something for them to play with/chew on. Yes, they might pee. You can pat them dry and wash the towel. Diaper free time is the most important thing here.
Spray the area generously with a skin-safe concentration of hypochlorous acid. Again, allow it to dry completely.
Spend as much time diaper free and dry as possible and repeat this process when you can. When baby poops (before they're eating solids and the poop is drain safe), if possible, rinse them under warm water instead of using wipes.
When putting the diaper on overnight, you can do the steps above and then apply a non-petroleum jelly generously to dry skin before putting the diaper on. The point of this product is to add a barrier between the dry skin and the wetness.
Make sure you’re using sensitive skin friendly diapers and change more often than usual until the redness subsides. If there are any signs of infection or severe discomfort seek medical attention.
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