***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: OBJECTIVE . Skin barrier therapy during the neonatal period , when the skin barrier is most highly compromised and the risk of death is greatest , has been shown to have a number of potential benefits , including reduced risk of nosocomial sepsis . Topical application of emollients that augment skin barrier function was evaluated as a strategy for improving survival rates among hospitalized preterm infants in Bangladesh . METHODS . A prospect i ve , r and omized , controlled , clinical trial was conducted in the special care nursery at Dhaka Shishu ( Children ) Hospital , the largest tertiary care children 's hospital in Bangladesh . Preterm infants ( gestational age : ≤33 weeks ; N = 497 ) received daily topical applications of sunflower seed oil or Aquaphor ointment . Neonatal mortality rates were compared in an intent-to-treat analysis with a control group that did not receive emollient therapy . RESULTS . Treatment with sunflower seed oil result ed in a statistically significant 26 % reduction in mortality rates , compared with infants not receiving topical emollient therapy . Aquaphor therapy also significantly reduced mortality rates , by 32 % . CONCLUSIONS . Topical therapy with skin barrier-enhancing emollients  improved survival rates among preterm hospitalized infants in Bangladesh . This study provides strong evidence for the implementation of topical therapy for high-risk preterm neonates in developing countries 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 and Objectives : After birth , skin barrier function is in state of flux and at risk of dysfunction . In a prospect i ve clinical study , we compared the effects of 2 st and ard cleansing procedures on skin barrier function in newborns . Methods : Fifty-seven healthy full-term neonates aged ≤48 h were r and omly assigned to either a bathing group ( group B ; n = 29 ) , who were bathed with clear water twice weekly , or to a washing group ( group W ; n = 28 ) , who were washed with a washcloth moistened with clear water twice weekly  . Transepidermal water loss ( TEWL ) , skin pH , stratum corneum hydration ( SCH ) and sebum production were measured at days 2 , 7 and 28 of life on the forehead , abdomen , upper leg and buttock . Results : Group B showed significantly lower TEWL on the buttock and higher SCH on the abdomen and forehead compared to group W at day 28 . Conclusions : Both skin care regimens do not harm the adaptation of the skin barrier in healthy neonates within the first 4 weeks of life . Skin barrier function differentiates after birth in a regionally specific fashion AIM The objective of this study was to evaluate the effects of  preterm infant bathing periods  on skin condition and axillary skin colonization . BACKGROUND Reducing the frequency of bathing in preterm infants is beneficial in reducing the risk of hypothermia and exposure to stress from frequent nursing contacts . METHODS The subjects of this study were observed at The V hospital at the C University in South Korea between December 2012 and August 2013 . A total of 32 preterm infants were included and were r and omly assigned to two different bathing intervals ; every four days ( n=16 ) and the other every two days ( n=16 ) bathing groups . A neonatal skin conditions were assessed on a daily basis , whereas , axillary skin colonization was measured every eight days before bathing . Data was analyzed via the SPSS program with a non-inferiority test , t-test , chi-square test , Fisher 's exact test , and paired t-test . RESULTS Mean differences of skin condition between the four-day bathing and two-day bathing groups were 0.065 and the 97.5 % one-sided confidence limit was 0.196 ( less than the non-inferiority margin , 0.3 ) . There were no statistically significant differences in skin condition and axillary skin colonization between the two groups ( p>0.05 ) . CONCLUSION The interval of bathing for preterm infants can be changed from every two days to every four days without increasing the incidence of skin condition problems or axillary skin colonization . Less-frequent bathing may decrease the chance of physiological instability caused by the caring process , while providing them with a better environment for growth and development INTRODUCTION Maintaining body temperature and reducing stress are important challenges in bathing preterm infants .  Swaddle bathing , which includes in itself the principles of developmental care , can be used as a low-stress and appropriate bathing method for premature infants . Given the limitations of the research es carried out on this bathing method , the present study was conducted with the aim of comparing the effects of swaddled and conventional bathing methods on body temperature and crying duration in premature infants . METHODS In this r and omized clinical trial study , 50 premature infants hospitalized in Neonatal Intensive Care Unit ( NICU ) who were eligible for the study were divided by r and om allocation into two experimental and control groups . The infants in the experimental group were bathed using the swaddle bathing method and the infants in the control group were bathed using the conventional bathing method .  Body temperature was measured 10 minutes before and 10 minutes after the bath . To record the crying , the infants ' faces were filmed during the bath . The data were analyzed using chi-squared test , independent t-test , paired t-test and Mann-Whitney U test . RESULTS The mean temperature loss was significantly less in the swaddle-bathed newborns compared to the conventionally-bathed newborns . Furthermore , crying time was significantly less in the experimental group than in the control group . CONCLUSION Given the positive effect of swaddled bathing in maintaining body temperature and reducing stress , it can be used as an appropriate bathing method in NICU 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 Objectives To examine the hypothesis that the use of a wash product formulated for newborn ( < 1 month of age ) bathing is not inferior ( no worse ) to bathing with water only . Design Assessor-blinded , r and omized , controlled , noninferiority trial . Setting A teaching hospital in the Northwest of Engl and and in participants ’ homes . Participants Three-hundred- and -seven healthy , term infants recruited within 48 hours of birth . Method We compared bathing with a wash product ( n = 159 ) to bathing with water alone ( n = 148 ) . The primary outcome was transepidermal water loss ( TEWL ) at 14 days postbirth ; the predefined difference deemed to be unimportant was 1.2 . Secondary outcomes comprised changes in stratum corneum hydration , skin surface pH , clinical observations of the skin , and maternal views . Results Complete TEWL data were obtained for 242 ( 78.8 % ) infants . Wash was noninferior to water alone in terms of TEWL ( intention-to-treat analysis : 95 % confidence interval [ CI ] for difference [ wash – water , adjusted for family history of eczema , neonate state , and baseline ] −1.24 , 1.07 ; per protocol analysis : 95 % CI −1.42 , 1.09 ) . No significant differences were found in secondary outcomes . Conclusion We were unable to detect any differences between the newborn wash product and water . These findings provide reassurance to parents who choose to use the test newborn wash product or other technically equivalent cleansers and provide the evidence for health care professionals to support parental choice To date , appropriate skin therapy for premature infants has not been clearly defined . Emollient creams are often used without solid evidence for a benefit to the neonate . The aim of the current study was to investigate the cutaneous effects of two different topical ointment therapies . Between October 2004 and November 2006 we prospect ively enrolled 173 infants between 25 and 36 weeks of gestation admitted to a neonatal intensive care unit . Infants were r and omly assigned to daily topical treatment with water-in-oil emollient cream ( Bepanthen ) , olive oil cream ( 70 % lanolin , 30 % olive oil ) , or to a control group . Each ne 
    Output:
    
In high-re source countries , the available data do not support the use of protective topical agents for preterm infants .