Clinicians' recommendations on neonatal bathing and skin care in the context of atopic dermatitis prevention: AnEAACItask force report

Abstract

Background The skin is the first line of defense against environmental factors, including pathogens and allergens, and plays a critical role in regulating transepidermal water loss. Newborn skin undergoes significant development and maturation during the first year of life. There is currently no globally harmonized evidence-based consensus specifically addressing neonatal bathing practices for the prevention of atopic dermatitis, despite general recommendations (e.g., from the WHO) regarding timing of the first bath.Methods The EAACI Task Force created and disseminated an online clinical survey among EAACI members. Participants were asked to answer 27 questions regarding their recommendations on neonatal bathing practices and skin care.Results The survey was disseminated to 51,787 individuals, of whom 319 provided eligible responses that we included in the analysis (effective response rate: 0.62%). The most commonly recommended timing for the first bath in term infants was 24-48 h after birth (29.09%). Significant heterogeneity was observed between European and non-European countries as well as within Europe regarding the timing of the first bath, preference bathing method, and recommendation of bathing frequency during the neonatal period and throughout the first year of life for both healthy and those with atopic infants.Conclusion Clinicians' recommendations regarding infant skin care vary considerably across different regions worldwide. Given the pivotal role of early-life skin care in conditions characterized by epithelial barrier dysfunction such as atopic dermatitis, it is essential to conduct further research and establish robust, evidence-based guidelines for bathing practices beginning from the neonatal period.