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Journal of the American Academy of... Aug 2021
Topics: Cost Savings; Diaper Rash; Drug Combinations; Drug Compounding; Humans; Hydrocortisone; Nystatin; Ointments; Zinc Oxide
PubMed: 34092406
DOI: 10.1016/j.jaad.2017.04.1135 -
Pediatric Dermatology Jul 2021Newborn infant skin is functional but immature, and diapering products can play a significant role in infant diapered skin health. Previous work demonstrated a regimen... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND/OBJECTIVE
Newborn infant skin is functional but immature, and diapering products can play a significant role in infant diapered skin health. Previous work demonstrated a regimen consisting of a diaper with an emollient and apertures on the inner liner (topsheet) with an acidic, pH-buffered wipe (Regimen A) lowered newborn skin pH and reduced the enzymatic activity on skin post-stool cleaning versus a regimen without these features (Regimen B). This study extends these findings to determine the impact of Regimen A on diaper area erythema severity over a 2-week use period.
METHODS
This IRB-approved, blinded, randomized, crossover study enrolled newborn infants >7 days and ≤8 weeks. Participants exclusively used two unique diaper and wipe combinations, Regimen A and Regimen B (non-emollient, non-aperture containing topsheet and wipe with limited buffering capacity), each for 14 days and preceded by a 3-day washout regimen.
RESULTS
Diapered skin pH was reduced during Regimen A use to values similar to that of a non-diapered control site (chest), while use of Regimen B was associated with a more alkaline skin pH. Regimen A resulted in significantly fewer severe erythema episodes. At the site of highest erythema, the perianal space, the average erythema score was significantly lower and more newborns were free of erythema while using Regimen A vs. Regimen B (P < .05).
CONCLUSIONS
These findings demonstrate that diapering products can have a significant impact on newborn skin. They reinforce the need to support the physiological normalization of skin pH and protection from skin irritation and damage.
Topics: Cross-Over Studies; Diaper Rash; Erythema; Humans; Hydrogen-Ion Concentration; Infant; Infant, Newborn; Skin; Skin Care
PubMed: 34060142
DOI: 10.1111/pde.14602 -
Beneficial Microbes Aug 2021The gut microbiome during infancy is directly involved in the digestion of human milk, development of the immune system, and long-term health outcomes. Gut dysbiosis in...
The gut microbiome during infancy is directly involved in the digestion of human milk, development of the immune system, and long-term health outcomes. Gut dysbiosis in early life has been linked to multiple short-term ailments, from diaper dermatitis and poor stooling habits, to poor sleep and fussiness, with mixed results in the scientific literature on the efficacy of probiotics for symptom resolution. Despite the growing interest in probiotics for consumer use, observed symptomatic relief is rarely documented. This study aims to evaluate observed symptomatic relief from at-home use of activated EVC001 in infants. Consumer feedback was collected over a 2-year period via a 30-day post-purchase online survey of EVC001 (Evivo) customers. Outcome measures included observed changes in diaper rash, symptoms of colic, and sleep behaviours in infants fed EVC001. A total of 1,621 respondents completed the survey. Before purchasing EVC001, the majority of respondents visited the product website, researched infant probiotics online, or consulted with their doctor or other healthcare professional. Of the participants whose infants had ever experienced diaper rash, 72% (n=448) reported improvements, and 57% of those reported complete resolution of this problem. Of those who responded to questions about gassiness/fussiness, naptime sleep, and night-time sleep behaviours, 63% (n=984), 33% (n=520), and 52% (n=806) reported resolution or improvements, respectively. Although clinical data regarding probiotic use are often inconclusive for symptom resolution, home use of EVC001 in infants improved diaper rash, gassiness/fussiness, and sleep quality within the first week of use in a significant number of respondents who engaged in a voluntary post-purchase survey. These outcomes may be a result of the unique genetic capacity of EVC001 to colonise the infant gut highlighting the importance of strain selection in evaluating the effects of probiotic products.
Topics: Bifidobacterium; Bifidobacterium longum subspecies infantis; Colic; Diaper Rash; Humans; Infant; Probiotics; Sleep
PubMed: 34057053
DOI: 10.3920/BM2020.0229 -
Advances in Neonatal Care : Official... Feb 2022Infants with neonatal abstinence syndrome (NAS) are at an increased risk for diaper dermatitis, which can cause skin breakdown and lead to significant pain and potential...
BACKGROUND
Infants with neonatal abstinence syndrome (NAS) are at an increased risk for diaper dermatitis, which can cause skin breakdown and lead to significant pain and potential infection exposure. Skin care protocols in the neonatal intensive care unit (NICU) setting seldom specifically address the needs of this at-risk population, leading to inconsistent skin care management.
PURPOSE
The goal was to support a decrease in the rate of diaper dermatitis for infants with NAS by designing and implementing an evidence-based skin care protocol.
METHODS
A retrospective medical record review was used to examine outcomes of 25 infants preintervention and 8 infants postintervention. The skin care protocol was a bundle of 5 evidence-based interventions: (1) a specific diaper dermatitis assessment tool; (2) frequent diaper changes with superabsorbent diapers; (3) application of petroleum jelly and alcohol-free wipes; (4) infant bathing in pH neutral soap; and (5) application of zinc oxide barrier cream for erythema.
RESULTS
There was an overall 80.5% decrease in diaper dermatitis from pre- to postimplementation (P ≤ .01) as noted when comparing positive cases of diaper dermatitis with negative cases from pre- to postintervention.
IMPLICATIONS FOR PRACTICE
Expanding the skin care protocol to all neonates in the NICU and nursery could aid in maintaining skin integrity and decreasing diaper dermatitis in the NICU. More research is needed following this study for the data to be generalizable to other NICUs. This study offers key takeaways including using a specific diaper dermatitis assessment tool and consistently using the bundle of interventions.
VIDEO ABSTRACT AVAILABLE AT
https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=47.
Topics: Diaper Rash; Humans; Infant; Infant, Newborn; Neonatal Abstinence Syndrome; Retrospective Studies; Skin; Skin Care
PubMed: 34054014
DOI: 10.1097/ANC.0000000000000898 -
Clinical Pediatrics Jul 2021
Topics: Anti-Bacterial Agents; Antifungal Agents; Bacitracin; Blister; Candidiasis; Cephalexin; Diagnosis, Differential; Diaper Rash; Forehead; Humans; Impetigo; Infant, Newborn; Male; Nystatin; Staphylococcal Infections; Staphylococcus aureus; Time
PubMed: 33980051
DOI: 10.1177/00099228211012853 -
Journal of Cosmetic Dermatology Apr 2021Diaper dermatitis (DD) is an acute inflammatory reaction, regardless of the cause, of the diaper-covered area. Topical skin barrier repair cosmetic products are the... (Clinical Trial)
Clinical Trial
BACKGROUND
Diaper dermatitis (DD) is an acute inflammatory reaction, regardless of the cause, of the diaper-covered area. Topical skin barrier repair cosmetic products are the mainstay treatment to cure and/or prevent DD.
AIMS
To assess the efficacy/tolerability of a zinc gluconate-taurine/zinc oxide and panthenol/ glycerin/ Butyrospermum parkii butter barrier cream using clinical evaluation.
METHODS
In this prospective, open-label trial, 20 patients (10 infants/10 adults), with mild/moderate DD enrolled at the Dermatology University Clinic of Catania (Italy) were instructed to apply the cream twice daily for 30 days. Degree of erythema was performed clinically by a 5-point severity scale (from 0 = no erythema to 4 = severe erythema), at baseline, at 15 and 30 days. An Investigator Global Assessment (IGA) using a 6-point scale (from -1 = worsening to 4 = complete response/clear) along with product tolerability was also performed at 15 and 30 days. Statistical analysis was performed using SAS version 9.
RESULTS
At 15 days, a reduction of clinical erythema assessment (CEA) from baseline was observed (mean from 3.2 ± 0.8 to 2.5 ± 0.3; p < 0.06), that although nonsignificant, showed a significant progressive improvement at 30 days (mean from 3.2 ± 0.8 to 1.1 ± 0.9; p < 0.0001) without any age differences.
CONCLUSIONS
Our preliminary results indicate that the tested barrier cream may represent a promising approach in DD rash. It may be used in mild-to-moderate forms in monotherapy without significant side effects or, where required, in association with pharmacological agents. Its long-term use is likely safe.
Topics: Adult; Diaper Rash; Emollients; Humans; Infant; Prospective Studies; Skin; Treatment Outcome; Zinc Oxide
PubMed: 33934478
DOI: 10.1111/jocd.14091 -
CMAJ : Canadian Medical Association... Apr 2021
Topics: Acrodermatitis; Diaper Rash; Diarrhea; Dietary Supplements; Humans; Infant; Male; Zinc
PubMed: 33903138
DOI: 10.1503/cmaj.201181-f