Newborn Skin Care Practices and Their Impact on the Skin Microbiome

What is the skin microbiome?

The skin microbiome consists of around a million bacteria, fungi, viruses, and other microorganisms per square centimeter of skin surface. These microorganisms contribute to various functions, including protecting against pathogens, regulating skin pH, and aiding in the development of the immune system.¹ In newborns, the skin microbiome is particularly important as it lays the foundation for microbial colonisation and can influence health outcomes throughout life. Research on the importance of a diverse microbiome is still in its infancy, but there are correlational links to both gut and skin microbiome changes and the impacts on health and wellbeing throughout the life course. ²

The initial colonisation of the skin microbiome occurs during pregnancy with changes seen in families where pets are present, and also whether antibiotics have been taken too.³ The colonisation continues at birth, influenced by several factors, including the mode of birth (vaginal birth or caesarean birth), gestation of birth, genetics, maternal microbiome, and environmental exposures.^2,4 When babies are born vaginally, the microbiome is acquired from their mother’s vaginal flora, which is rich in Lactobacillus spp. and other beneficial bacteria. In contrast, babies born by caesarean birth may be colonised by skin and environmental microbes, leading to differences in microbial diversity and composition.⁵

Skin to skin at birth with the mother or second parent has also been shown to promote healthy skin microbiome development.^5,6 Continued skin to skin in the postnatal period has continued benefits for the skin microbiome.⁷ In addition, kangaroo care which is the practice of skin to skin with preterm babies also has positive benefits for the skin microbiome.⁸ The act of breastfeeding transfers beneficial bacteria from the mother's skin and milk to the infant, further enriching their microbial community.⁸

Microbial diversity is essential for a healthy skin microbiome. A diverse microbiome can enhance the skin's ability to fend off pathogens, regulate inflammation, and support immune function.⁹ For newborns, establishing a robust microbial community early in life is crucial as it sets the stage for immune development and skin health. Encouraging these practices provides newborns with exposure to a diverse range of microorganisms, which can promote a balanced microbiome.¹⁰

Vernix

Vernix caseosa, often referred to simply as vernix, is a waxy, white substance that coats the skin of newborns at birth. Composed of water, lipids, and proteins, vernix serves several important functions. It acts as a protective barrier against amniotic fluid, preventing skin damage and aiding in hydration during gestation. Additionally, vernix has antibacterial properties that help protect the newborn's skin from infection.^11,12

Historically, vernix was often removed both initially at birth by cleaning the baby initially, following by bathing the baby in the first day. Now immediate skin to skin is recommended where safe to undertake. Research suggests that vernix may also play a role in thermoregulation, reducing heat loss after birth.¹³ While it typically begins to shed shortly after birth, many healthcare professionals recommend leaving vernix on the baby’s skin for a while to maximise its protective benefits.¹¹

Bathing

Moisturisation

At present, the research is mixed on the use of emollients on the newborn skin microbiome.³ The only study to date which has shown benefits of moisturisation on newborn skin with commercialised baby bathing products was funded and conducted by the individual company with large bias involved.¹⁶ Currently the recommendation remains to avoid any moisturising products on newborn skin unless advised on an individual basis by a healthcare professional should concerns arise. ¹⁵

Protecting the Skin Barrier

The skin barrier serves as the first line of defence against pathogens and environmental irritants. Care practices that promote skin barrier integrity are essential for maintaining a healthy skin microbiome. Parents should avoid using fragranced wipes or cleansers for the first month as these can disrupt the microbiome and compromise the barrier function.¹⁷ When the baby is over a month old parents can choose to use a gentle cleanser in bathing products. It is advisable to use mild, fragrance-free, and pH-balanced cleansers specifically formulated for infants.¹⁸

Clothing and Environmental Factors 

The choice of clothing and exposure to environmental factors can also influence the skin microbiome. Newborns should be dressed in breathable, soft fabrics to minimize irritation and allow for proper microbial colonisation.¹⁸ Overheating or excessive moisture can create an environment conducive to harmful bacteria. Maintaining a controlled environment with appropriate humidity and temperature can support the health of the newborn's skin and microbiome. ^{18,19, 20,21}

Discussion

The practices outlined above have a profound impact on the development and composition of the newborn's skin microbiome. Research has shown that maintaining a diverse and balanced microbiome is associated with a lower risk of allergic diseases, eczema, and other skin conditions.^22,23 Conversely, practices that disrupt the microbiome can lead to dysbiosis, characterized by an imbalance in microbial communities, which has been linked to various health issues.²³ Practices that encourage microbial diversity, such as delayed bathing and gentle cleansing, have been associated with a lower incidence of allergic conditions and skin disorders.²¹

In conclusion, newborn skin care practices influence the development of the skin microbiome, which is vital for the infant's health and immune system development. By adopting gentler, microbiome-friendly practices, parents can help establish a diverse microbiome on their newborn's skin, laying the groundwork for long-term health benefits. As research continues to unveil the complexities of the skin microbiome, awareness and education surrounding newborn skin care will be essential in promoting not only skin health but overall well-being in children.

This scientific article has been authored by an expert who received compensation from MAM. Published in October 2025.