***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Defects in skin barrier function are associated with an increase risk of eczema and atopic sensitisation . Ceramide-dominant triple lipid mixture may improve and maintain the infant skin barrier function , and if shown to be safe and feasible , may therefore offer an effective approach to reduce the incidence of eczema and subsequent atopic sensitisation . We sort to assess the safety and compliance with daily application of a ceramide-dominant triple lipid formula ( EpiCeram ™ ) commencing in the neonatal period for the prevention of eczema . Methods Ten infants ( 0 - 4 weeks of age ) with a family history of allergic disease were recruited into an open-label , phase one trial of daily application of EpiCeram ™ for six weeks . The primary outcomes were rate of compliance and adverse events . Data on development of eczema , and physiological properties of the skin ( transepidermal water loss , hydration , and surface pH ) were also measured . Results Eighty percent ( 8/10 ) of mothers applied the study cream on 80 % or more of days during the six week intervention period . Though a number of adverse events unrelated to study product were reported , there were no adverse skin reactions to the study cream . Conclusions These preliminary results support the safety and parental compliance with daily applications of a ceramide-dominant formula for the prevention of eczema , providing the necessary ground work for a r and omised clinical trial to evaluate EpiCeram ™ for the prevention of eczema . Trial registration The study was listed at the Australian/New Zeal and Clinical Trial Registry ( ANZCTR ) : reg . no. ACTRN12609000727246 Background Some national guidelines recommend the use of water alone for napkin cleansing . Yet , there is a readiness , amongst many parents , to use baby wipes . Evidence from r and omised controlled trials , of the effect of baby wipes on newborn skin integrity is lacking . We conducted a study to examine the hypothesis that the use of a specifically formulated cleansing wipe on the napkin area of newborn infants ( < 1 month ) has an equivalent effect on skin hydration when compared with using cotton wool and water ( usual care ) . Methods A prospect i ve , assessor-blinded , r and omised controlled equivalence trial was conducted during 2010 . Healthy , term babies ( n = 280 ) , recruited within 48 hours of birth , were r and omly assigned to have their napkin area cleansed with an alcohol-free baby wipe ( 140 babies )  or cotton wool and water ( 140 babies ) . Primary outcome was change in hydration from within 48 hours of birth to 4 weeks post-birth . Secondary outcomes comprised changes in trans-epidermal water loss , skin surface pH and erythema , presence of microbial skin contaminants/irritants at 4 weeks and napkin dermatitis reported by midwife at 4 weeks and mother during the 4 weeks . Results Complete hydration data were obtained for 254 ( 90.7 % ) babies . Wipes were shown to be equivalent to water and cotton wool in terms of skin hydration ( intention-to-treat analysis : wipes 65.4 ( SD 12.4 ) vs. water 63.5 ( 14.2 ) , p = 0.47 , 95 % CI -2.5 to 4.2 ; per protocol analysis : wipes 64.6 ( 12.4 ) vs. water 63.6 ( 14.3 ) , p = 0.53 , 95 % CI -2.4 to 4.2 ) . No significant differences were found in the secondary outcomes , except for maternal-reported napkin dermatitis , which was higher in the water group ( p = 0.025 for complete responses ) . Conclusions Baby wipes had an equivalent effect on skin hydration when compared with cotton wool and water . We found no evidence of any adverse effects of using these wipes . These findings offer reassurance to parents who choose to use baby wipes and to health professionals who support their use . Trial registration Current Controlled Trials IS RCT Background The vulnerability of newborn babies ' skin creates the potential for a number of skin problems . Despite this , there remains a dearth of good quality evidence to inform practice . Published studies comparing water with a skin-cleansing product have not provided adequate data to inform an adequately powered trial . Nor have they distinguished between babies with and without a predisposition to atopic eczema . We conducted a pilot study as a prequel to design ing an optimum trial to investigate whether bathing with a specific cleansing product is superior to bathing with water alone . The aims were to produce baseline data which would inform decisions for the main trial design ( i.e. population , primary outcome , sample size calculation ) and to optimize the robustness of trial processes within the study setting . Methods 100 healthy , full term neonates aged < 24 hours were r and omly assigned to bathing with water and cotton wool ( W ) or with a cleaning product ( CP ) . A minimum of bathing 3 times per week was advocated . Groups were stratified according to family history of atopic eczema . Transepidermal water loss ( TEWL ) , stratum corneum hydration and skin surface pH were measured within 24 hours of birth and at 4 and 8 weeks post birth . Measurements were taken on the thigh , forearm and abdomen . Women also completed question naires and diaries to record bathing practice s and medical treatments . Results Forty nine babies were r and omized to cleansing product , 51 to water . The 95 % confidence intervals ( CI ) for the average TEWL measurement at each time point were : whole sample at baseline : 10.8 g/m2/h to 11.7 g/m2/h ; CP group 4 weeks : 10.9 g/m2/h to 13.3 g/m2/h ; 8 weeks : 11.4 g/m2/h to 12.9 g/m2/h ; W group 4 weeks:10.9 g/m2/h to 12.2 g/m2/h ; 8 weeks : 11.4 g/m2/h to 12.9 g/m2/h . Conclusion This pilot study provided valuable baseline data and important information on trial processes . The decision to proceed with a superiority trial , for example , was inconsistent with our data ; therefore a non-inferiority trial is recommended . Trial registration IS RCT Purpose To assess the tolerance of a baby cleanser and lotion ( both lightly fragranced ) on healthy , full-term neonates . Material s and methods Twenty-six infant – mother pairs were enrolled in a 6-week , nonr and omized , controlled-use study that took place in the routine setting of a pediatric clinic and mothers ’ homes . During study weeks 1 to 6 , neonates were bathed by their mother with water and a test cleanser ( JOHNSON ’S ® HEAD-TO-TOE ® Baby Wash ) . During study weeks 1 to 3 , mothers also applied test lotion ( JOHNSON ’S ® Baby Lotion ) to the babies ’ skin immediately after bathing and one to three times/day on bathing and non-bathing days . During study weeks 4 to 6 , no lotion was applied . At baseline and weeks 3 and 6 , the infants ’ pediatrician or mother or both performed visual skin assessment s. Results Twenty-three infant – mother pairs completed the study . The mean age of neonates at enrolment was 17.4 days ( range , 13–28 days ) . Pediatrician observations found no clinical signs of irritation , erythema , or dryness with any significant difference in scores of these parameters compared with baseline throughout the study . Assessment of skin softness , smoothness , dryness , and overall skin condition was very good at baseline and remained so with minimal changes throughout the study . Mothers reported improvements versus baseline ( P ≤ 0.05 ) in overall skin appearance , moisturization , softness , and smoothness on the arms and legs at weeks 3 and 6 . A total of four ( 15.4 % ) subjects experienced adverse events . For three of the subjects , the investigator suspected that the adverse events were unrelated to either of the test products . In one participant , the cause of the adverse event could not be determined . Conclusion The use of a lightly fragranced nonstinging baby cleanser , with or without a lightly fragranced baby lotion , was well tolerated by newborns and result ed in observable skin benefits per the pediatricians ’ and mothers ’ assessment AIM Physiologic post-partum skin adaptation to the relative dry extra-uterine environment is a dynamic process which begins immediately after birth . Considering the differences from adult skin , the neonatal skin is more prone to damage by environmental factors ; therefore , skin care regimens should be age adapted to ensure a good epidermal maturation . The effects of two different skin care practice s were evaluated by transepidermal water loss ( TEWL ) measurement in 94 newborns aged ≤ 10 days : group 1 ( G1 ) , newborns washed only with a cotton washcloth moistened with water ; group 2 ( G2 ) , newborns  washed with liquid baby cleansers and hydrated with moisturizers . These recordings were compared to TEWL baseline values of the same neonates and to adults ' values . METHODS A prospect i ve study was conducted in healthy full-term newborns , measuring TEWL with TEWAMETER ® TM300 . The areas tested were the volar forearm and the popliteal fossa . RESULTS In G1 ( 52 subjects ) , TEWL mean values were 6.65 ± 2.81 SD ( g/m2/h ) at volar forearm and 7.49 ± 2.47 SD ( g/m2/h ) at popliteal fossa . In G2 ( 42 subjects ) , TEWL mean values were 8.83 ± 3.05 SD ( g/m2/h ) at volar forearm and 10.18 ± 3.64 SD ( g/m2/h ) at popliteal fossa . There were statistically significant differences of TEWL mean values between G1 and G2 , newborns and adults , baseline and post-skin care procedures . CONCLUSION Tested skin care regimens could influence the process of functional adaptation of skin , in the early postnatal period . We could hypothesize that daily washing with liquid baby cleansers and moisturizing may delay the natural maturation of skin barrier function Adaptation of skin barrier function and interleukin-1α ( IL-1α ) content in diapered and nondiapered skin are poorly characterized in newborns receiving st and ard skin care . In a monocentric , prospect i ve pilot study 44 healthy , full-term neonates were r and omly assigned to skin care with baby wipes ( n = 21 ) or water-moistened washcloth ( n = 23 ) at each diaper change . Transepidermal water loss ( TEWL ) , skin hydration , skin-pH , IL-1α , and epidermal desquamation were measured on days 2 , 14 , and 28 postpartum . Microbiological colonization was evaluated at baseline and on day 28 . Significantly lower TEWL was found on the buttock in the group using baby wipes compared to water . IL-1α and skin hydration significantly increased and pH decreased independent of skin care regimen . IL-1α was significantly higher in diapered skin compared to nondiapered skin . Although skin care with wipes seems to stabilize TEWL better than using water , the skin condition and microbiological colonization were comparable using both cleansing procedures . Increase of epidermal IL-1α may reflect postnatal skin barrier maturation . These data suggest that neither of the two cleansing procedures harms skin barrier maturation within the first four weeks postpartum . Longer observations on larger population s could provide more insight into postnatal skin barrier maturation Background Hypothermia contributes to neonatal morbidity and mortality in low-income countries , yet little is known about thermal care practice s in rural African setting s. We assessed adoption and community acceptability of recommended thermal care practice s in rural Tanzania . Methods A multi- method qualitative study , enhanced with survey data . For the qualitative component we triangulated birth narrative interviews with focus group discussion s with mothers and traditional birth attendants . Results were then contrasted to related quantitative data . Qualitative analyses sought to identify themes linked to a ) immediately drying and wrapping of the baby ; b ) bathing practice s , including delaying for at least 6 hours and using warm water ; c ) day to day care such as covering the baby ’s head , covering the baby ; and d ) keeping the baby skin-to-skin .  Quantitative data ( n = 22,243 women ) on the thermal care practice s relayed by mothers who had delivered in the last year are reported accordingly . Results 42 % of babies were dried and 27 % wrapped within five minutes of birth mainly due to an awareness that this reduced cold . The main reason for delayed wrapping and drying was not attending to the baby until the placenta was delivered . 45 % of babies born at a health facility and 19 % born at home were bathed six or more hours after birth . The main reason for delayed bathing was health worker advice . The main reason for early bathing believed that the baby is dirty , particularly if the baby had an obvious vernix as this was believed to be sperm . On the other h and , keeping the baby warm and covered day-to-day was considered normal practice . Skin-to-skin care was not a normalised practice , and some respondents wondered if it might be harmful to fragile newborns . Conclusion Most thermal care behaviours needed improving . Many sub-optimal practice s had cultural and symbolic origins . Drying the baby on birth was least symbolically imbued , although resisted by prioritizing of the mothers . Both practical inter 
    Output:
    
FINDINGS from the small numbers of studies with comparable data , there was no evidence of any significant differences between tested wash products and water or tested baby wipes and water .
There was some evidence to suggest that daily use of full-body emollient therapy may help to reduce the risk of atopic eczema in high risk babies with a genetic predisposition to eczema ; however , the use of olive oil or sunflower oil for baby dry skin may adversely affect skin barrier function .
There was no evidence about hair/scalp care or baby massage .
Qualitative research indicates that parents and health professionals believe that water alone is best .