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European Journal of Pediatrics

, Volume 178, Issue 10, pp 1545–1558 | Cite as

Recommendation for hygiene and topical in neonatology from the French Neonatal Society

  • Laurent RenesmeEmail author
  • A. Allen
  • F. Audeoud
  • C. Bouvard
  • A. Brandicourt
  • C. Casper
  • L. Cayemaex
  • H. Denoual
  • M. A. Duboz
  • A. Evrard
  • C. Fichtner
  • C. J. Fischer-Fumeaux
  • L. Girard
  • F. Gonnaud
  • D. Haumont
  • P. Hüppi
  • N. Knezovic
  • E. Laprugne-Garcia
  • S. Legouais
  • F. Mons
  • V. Pelofy
  • J. C. Picaud
  • V. Pierrat
  • P. Pladys
  • A. Reynaud
  • G. Souet
  • G. Thiriez
  • P. Tourneux
  • M. Touzet
  • P. Truffert
  • C. Zaoui
  • E. Zana-Taieb
  • C. Zores
  • J. Sizun
  • P. Kuhn
Original Article

Abstract

We sought to establish guidelines for hygiene care in newborns based on a systematic review of the literature and grading of evidence using the Groupe de Réflexion et d’Evaluation de l’Environement des Nouveau-nés (GREEN) methodology. We examined 45 articles and 4 reports from safety agencies. These studies recommend a tub bath (rather than a sponge bath) for full-term infants and a swaddle bath for preterm newborns. They also recommend against daily cleansing of preterm infants. The literature emphasized that hygiene care must consider the clinical state of the newborn, including the level of awareness and behavioral responses. Hospitalized newborns treated with topical agents may also experience high exposure to potentially harmful excipients of interest. Caregivers should therefore be aware of the excipients present in the different products they use. In high-resource countries, the available data do not support the use of protective topical agents for preterm infants.

Conclusions: We recommend individualization of hygiene care for newborns. There is increasing concern regarding the safety of excipients in topical agents that are used in neonatology. A multidisciplinary approach should be used to identify an approach that requires lower levels of excipients and alternative excipients.

What is known:

Hygiene care is one of the most basic and widespread types of care received by healthy and sick newborns worldwide.

• There is no current guideline on hygiene for preterm or hospitalized term newborn.

What is new:

The French Group of Reflection and Evaluation of the environment of Newborns (GREEN) provided here guidelines based on the current body of evidence.

• Caregivers should be aware of the many issues related to hygiene care of newborns including newborns’ behavioral responses to hygiene care, exposition to excipients of interest, and the potential risk of protective topical agents in a preterm infant. provided here guidelines based on the current body of evidence.

• Caregivers should be aware of the many issues related to hygiene care of newborns including newborns’ possible behavioral responses to hygiene care, exposition to excipients of interest and the potential risk of protective topical agents in a preterm infant.

Keywords

Excipient of interest Hygiene Newborn Preterm Topical 

Abbreviations

LE

Level of evidence

TEWL

Transepidermal water loss

Notes

Authors’ contribution

L. Renesme selected and reviewed the articles, and wrote, drafted, and reviewed the manuscript. The members of the GREEN committee listed in the appendix participated in the assignment of level of evidence and reviewed the manuscript.

Compliance with ethical statement

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Laurent Renesme
    • 1
    Email author
  • A. Allen
    • 2
  • F. Audeoud
    • 3
  • C. Bouvard
    • 4
  • A. Brandicourt
    • 5
  • C. Casper
    • 6
  • L. Cayemaex
    • 7
  • H. Denoual
    • 8
  • M. A. Duboz
    • 9
  • A. Evrard
    • 10
  • C. Fichtner
    • 11
  • C. J. Fischer-Fumeaux
    • 12
  • L. Girard
    • 13
  • F. Gonnaud
    • 14
  • D. Haumont
    • 15
  • P. Hüppi
    • 16
  • N. Knezovic
    • 17
  • E. Laprugne-Garcia
    • 14
  • S. Legouais
    • 13
  • F. Mons
    • 18
  • V. Pelofy
    • 6
  • J. C. Picaud
    • 14
  • V. Pierrat
    • 19
  • P. Pladys
    • 20
  • A. Reynaud
    • 4
  • G. Souet
    • 21
  • G. Thiriez
    • 9
  • P. Tourneux
    • 22
  • M. Touzet
    • 2
  • P. Truffert
    • 19
  • C. Zaoui
    • 23
  • E. Zana-Taieb
    • 2
  • C. Zores
    • 17
  • J. Sizun
    • 24
  • P. Kuhn
    • 17
  1. 1.Unité de Néonatalogie Soins Intensifs-Pédiatrie de Maternité, Centre Aliénor d’AquitaineCentre Hospitalier Universitaire de BordeauxBordeauxFrance
  2. 2.Port Royal Assitance Publique Hôpitaux de ParisParisFrance
  3. 3.Centre Hospitalier Universitaire de GrenobleGrenobleFrance
  4. 4.Association SOS PrémaBoulogne-BillancourtFrance
  5. 5.Centre Hospitalier Sud FrancilienCorbeil-EssonnesFrance
  6. 6.Centre Hospitalier Universitaire de ToulouseToulouseFrance
  7. 7.Centre Hospitalier Inter-Communal de CréteilCréteilFrance
  8. 8.Centre Hospitalier du MansLe MansFrance
  9. 9.Centre Hospitalier Universitaire de BesançonBesançonFrance
  10. 10.Comité Inter-Associatif de la NaissanceParisFrance
  11. 11.Centre Hospitalier Universitaire de Saint EtienneSaint EtienneFrance
  12. 12.Centre Hospitalier Universitaire Vaudois LausanneLausanneSwitzerland
  13. 13.Association Co-NaîtrePertuisFrance
  14. 14.Centre Hospitalier Universitaire de LyonLyonFrance
  15. 15.Hôpital Saint-Pierre BruxellesBrusselsBelgium
  16. 16.Centre Hospitalier Universitaire de GenèveGenèveSwitzerland
  17. 17.Centre Hospitalier Universitaire de StrasbourgStrasbourgFrance
  18. 18.Centre Hospitalier Universitaire de LimogesLimogesFrance
  19. 19.Centre Hospitalier Régional Universitaire de LilleLilleFrance
  20. 20.Centre Hospitalier Universitaire de RennesRennesFrance
  21. 21.Agence Régionale de Santé CentreOrleansFrance
  22. 22.Centre Hospitalier Universitaire d’AmiensAmiensFrance
  23. 23.Centre Hospitalier Général de ValenciennesValenciennesFrance
  24. 24.Centre Hospitalier Universitaire de BrestBrestFrance

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