26. November 2018
The controversy over baby wipes

What do baby wipes have to do with food allergies? Not much at first. But in spring 2018, headlines appeared claiming that ‘baby wipes cause food allergies.’ Although there is no proven connection, there are still good reasons to take care when using them on baby’s skin.

Nearly every baby changing bag has them. They’re always at hand, easily disposed of after use and ever so convenient. We’re talking about packaged baby wipes. They are often described on the package as ‘perfume-free’ or ‘sensitive’. These wipes may be perfume free, but they still contain preservatives. Are they harmful to children?

Water is not necessarily better

British researcher Alison Cooke compiled over 3,000 studies in order to find out which skin care is at the very least not harmful to babies up to six months of age.
Cooke is a lecturer in Manchester. She has worked for many years as a midwife and now provides training to young midwives.
In terms of skin care, the advice given by midwives to new parents is scientifically questionable, says Cooke. Just under 30 of the 3,000 studies were methodologically sound enough to produce an overall conclusion. “The skincare advice given by medical professionals may have contributed to the increase of atopic dermatitis in children in the UK”, she wrote.

When comparing ‘old-fashioned’ wet washcloths and baby wipes, special baby products performed just as well as washing with water only. The researcher found no advantage to caring for baby’s skin with water and a mild soap – although the British National Institute for Health and Care Excellence (NICE) recommends this combination. “This recommendation should be changed”, says Cooke.

What can be used on baby’s skin?

Most parents already know that less is more when it comes to caring for their baby’s skin. Bathing is better than washing. Around ten years ago, the dermatologists at Charité in Berlin provided data to support this.

But there isn’t always a bathtub when you need one.

Joan Cook-Mills, an American allergy researcher, and her team recently investigated the conditions under which certain cleaning substances can cause problems. Babies whose skin displays certain hereditary changes and comes into contact with certain active cleaning substances, in addition to house dust and food allergens, tend to develop food allergies and atopic dermatitis.

The researchers only tested the active cleaning substance sodium dodecyl sulfate (SDS). The substance is found in products such as household cleaners and toothpaste, but is rarely used in cosmetics. It disrupts the protective skin barrier. This skin barrier is constructed like a wall: corneocytes are the ‘building blocks’ and the mortar between them consists of many different fats and proteins, which seal up the wall. Certain proteins and fatty acids also protect against pathogens. SDS destroys these proteins. 

Baby wipes don’t cause food allergies

The speculations in some headlines that baby wipes cause food allergies are simply not true. “I had hoped that no one would draw this conclusion”, says Cook-Mills, who directed the study.

But another finding did emerge from the study:

If

  1. in hereditarily predisposed children
  2. the skin barrier is weakened by certain active cleaning substances, and
  3. they come into contact with environmental allergens such as house dust and
  4. food allergens,

this could lead to food allergies. It can also happen even if they have never eaten any of those particular foods. Therefore several factors must be present at the same time.

Studies have not yet been conducted as to which other active cleaning substances, apart from SDS, may be problematic.

Stop using baby wipes?

The studies did not provide any evidence that parents should stop using baby wipes. In a comment on her study, Cook-Mills draws other practical conclusions: “Wash your hands before touching the baby. This will reduce the baby’s exposure to food allergens. Don’t use too many baby wipes – they contain active cleaning substances that stay on the skin. Rinse them off with plain water, just like people did in the old days.”

Sources

Cooke A et al. Skin care for healthy babies at term: A systematic review of the evidence. Midwifery. 2018;56:29-43.

Flohr C, Mann J. New insights into the epidemiology of childhood atopic dermatitis. Allergy. 2014;69:3–16.

Garcia Bartels N et al. Influence of bathing or washing on skin barrier function in newborns during the first four weeks of life. Skin Pharmacol Physiol. 2009;22(5):248-57.

Walker MT et al. Mechanism for initiation of food allergy: Dependence on skin barrier mutations and environmental allergen costimulation. Allergy Clin Immunol. 2018;141(5):1711-25. Bei dieser Studie war die im Text genannte Joan Cook-Mills Letztautorin, also die Ideengeberin der Studie. Wer die Experiemente maßgeblich durchgeführt hat steht meist am Anfang und wird in den Quellen zuerst genannt, in diesem Fall Cook-Mills Mitarbeiter Matthew Walker.

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