Safety of Neonatal Skin Cleansing in Rural Nepal

Overview

Journal Indian Pediatr

Specialty Pediatrics

Date 2006 Mar 11

PMID 16528107

Citations 5

Authors

Luke C Mullany

Gary L Darmstadt

Subarna K Khatry

Steve C LeClerq

James M Tielsch

Affiliations

Soon will be listed here.

Abstract

Objective: A high proportion of deaths during the neonatal period are attributed to infections. Neonatal skin plays an important role in protecting the newborn from invasive pathogens. In preparation for a study of newborn skin cleansing with chlorhexidine in Nepal, we evaluated the feasibility, acceptability, and safety of the newborn cleansing procedure.

Study Design/setting: Observational pilot study of full-body cleansing of newborns in rural Nepal.

Methods: Thirty two newborn infants were wiped with commercially available non-antiseptic baby wipes. Pre and post-procedure axillary temperatures were recorded to estimate the impact of cleansing on body temperature. Skin aggravation, residual moisture, removal of vernix, and maternal satisfaction were assessed qualitatively.

Results: Body temperature of newborns decreased an average of 0.40 C (95% CI: 0.31 to 0.49 C, p < 0.0001) during the procedure. There was no evidence of skin aggravation, injury or removal of vernix, and mothers expressed satisfaction with the procedure. The procedure was simple and project workers were easily trained.

Conclusion: Care must be taken to promptly wrap infants after skin cleansing procedures as slight temperature decrease was noted after the procedure. These pilot data indicate, however, that gentle cleansing of newborn skin poses minimal risk to infants. This procedure is safe and appropriate precautions can be taken to deliver safe skin antisepsis with chlorhexidine to infants in the community.

Citing Articles

Incidence and seasonality of hypothermia among newborns in southern Nepal.

Mullany L, Katz J, Khatry S, LeClerq S, Darmstadt G, Tielsch J Arch Pediatr Adolesc Med. 2010; 164(1):71-7.

PMID: 20048245 PMC: 4546825. DOI: 10.1001/archpediatrics.2009.239.

A randomized controlled trial of the impact of chlorhexidine skin cleansing on bacterial colonization of hospital-born infants in Nepal.

Mullany L, Khatry S, Sherchand J, LeClerq S, Darmstadt G, Katz J Pediatr Infect Dis J. 2008; 27(6):505-11.

PMID: 18449064 PMC: 2562933. DOI: 10.1097/INF.0b013e31816791a2.

The use of chlorhexidine to reduce maternal and neonatal mortality and morbidity in low-resource settings.

McClure E, Goldenberg R, Brandes N, Darmstadt G, Wright L, Armbruster D Int J Gynaecol Obstet. 2007; 97(2):89-94.

PMID: 17399714 PMC: 2727736. DOI: 10.1016/j.ijgo.2007.01.014.

Impact of newborn skin-cleansing with chlorhexidine on neonatal mortality in southern Nepal: a community-based, cluster-randomized trial.

Tielsch J, Darmstadt G, Mullany L, Khatry S, Katz J, LeClerq S Pediatrics. 2007; 119(2):e330-40.

PMID: 17210728 PMC: 2364722. DOI: 10.1542/peds.2006-1192.

Safety and impact of chlorhexidine antisepsis interventions for improving neonatal health in developing countries.

Mullany L, Darmstadt G, Tielsch J Pediatr Infect Dis J. 2006; 25(8):665-75.

PMID: 16874163 PMC: 2386993. DOI: 10.1097/01.inf.0000223489.02791.70.

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