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Renesme L, Allen A, Audeoud F, Bouvard C, Brandicourt A, Casper C, Cayemaex L, Denoual H, Duboz MA, Evrard A, Fichtner C, Fischer-Fumeaux CJ, Girard L, Gonnaud F, Haumont D, Hüppi P, Knezovic N, Laprugne-Garcia E, Legouais S, Mons F, Pelofy V, Picaud JC, Pierrat V, Pladys P, Reynaud A, Souet G, Thiriez G, Tourneux P, Touzet M, Truffert P, Zaoui C, Zana-Taieb E, Zores C, Sizun J, Kuhn P. Recommendation for hygiene and topical in neonatology from the French Neonatal Society. Eur J Pediatr 2019; 178:1545-1558. [PMID: 31463766 DOI: 10.1007/s00431-019-03451-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 07/10/2019] [Accepted: 08/09/2019] [Indexed: 11/24/2022]
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.
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Affiliation(s)
- Laurent Renesme
- Unité de Néonatalogie Soins Intensifs-Pédiatrie de Maternité, Centre Aliénor d'Aquitaine, Centre Hospitalier Universitaire de Bordeaux, Place Amélie Raba Léon, 33000, Bordeaux, France.
| | - A Allen
- Port Royal Assitance Publique Hôpitaux de Paris, Paris, France
| | - F Audeoud
- Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | - C Bouvard
- Association SOS Préma, Boulogne-Billancourt, France
| | - A Brandicourt
- Centre Hospitalier Sud Francilien, Corbeil-Essonnes, France
| | - C Casper
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - L Cayemaex
- Centre Hospitalier Inter-Communal de Créteil, Créteil, France
| | - H Denoual
- Centre Hospitalier du Mans, Le Mans, France
| | - M A Duboz
- Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - A Evrard
- Comité Inter-Associatif de la Naissance, Paris, France
| | - C Fichtner
- Centre Hospitalier Universitaire de Saint Etienne, Saint Etienne, France
| | | | - L Girard
- Association Co-Naître, Pertuis, France
| | - F Gonnaud
- Centre Hospitalier Universitaire de Lyon, Lyon, France
| | - D Haumont
- Hôpital Saint-Pierre Bruxelles, Brussels, Belgium
| | - P Hüppi
- Centre Hospitalier Universitaire de Genève, Genève, Switzerland
| | - N Knezovic
- Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | | | | | - F Mons
- Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - V Pelofy
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - J C Picaud
- Centre Hospitalier Universitaire de Lyon, Lyon, France
| | - V Pierrat
- Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - P Pladys
- Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - A Reynaud
- Association SOS Préma, Boulogne-Billancourt, France
| | - G Souet
- Agence Régionale de Santé Centre, Orleans, France
| | - G Thiriez
- Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - P Tourneux
- Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | - M Touzet
- Port Royal Assitance Publique Hôpitaux de Paris, Paris, France
| | - P Truffert
- Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - C Zaoui
- Centre Hospitalier Général de Valenciennes, Valenciennes, France
| | - E Zana-Taieb
- Port Royal Assitance Publique Hôpitaux de Paris, Paris, France
| | - C Zores
- Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - J Sizun
- Centre Hospitalier Universitaire de Brest, Brest, France
| | - P Kuhn
- Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
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