Baby Massage Oils – What’s the best option?
There has been lots of discussion on what is the safest oil for baby massage recently. It is important to be aware that baby massage is practiced in many different cultures around the world and each has its own preference on the oil used, based on history and tradition. Baby’s skin is very delicate so we must ensure that we are using the safest and most gentle option for massage. The main cautions have arisen over what oil to use for massage on newborn skin and also the structure of the skin itself. Oil should not be used for a massage before four weeks and some studies suggest six weeks of age.
There has been some confusion on what is the best oil to use based on conflicting views and some inconsistencies in advice from health professionals, NICE guidelines and other experts in the field (Walker et al. 2005; Meza 2013) Tradition has also played a part in determining the choice of oil used. In India, mustard seed oil was largely used for massage but later was shown to be potentially damaging to the skin.(Darmstadt GL, 2008).
Essential oils-Helpful or harmful?
Essential oils should be avoided on newborn skin for massage as they are very strong. The use of any essential oils on babies and children’s skin should be supervised by a qualified aromatherapist with specifying knowledge in this area. The use of any heavily scented oil may detract from the exchange of parent and baby smell imprinting which is very important for the early bonding process. Using a product with no scent is best to avoid confusion for the baby and to not overload the olfactory system. Some studies have suggested that the addition of some essential oils to products can disrupt the hormonal balance of children and therefore may be best avoided (Fergie, 2010).
Mineral oil is a petroleum-based product that is not absorbed by the skin, rather creates a barrier on the surface. Studies suggest that it can have some benefits in maintaining hydration and reducing infection (Stamatas, 2008) through its properties but it does not allow the skin to “breathe” and it has no nutritional value to the skin as it contains no vitamins. Again it has a strong artificial smell which can mask the natural smell of the parent/baby. It is not advisable to use mineral oil for baby massage.
Olive Oil and Sunflower Oil Debate
Olive oil was often cited as the best option for baby skin especially for conditions such as cradle cap. However, recent studies have now questioned its use. Research has concluded that that oleic acid, which is contained in olive oil, delays skin barrier recovery on damaged skin (Danby et al 2013). It is now widely avoided for use on newborns.
Organic sunflower oil has been the preferred choice of baby massage instructors for the last 5-8 years as it has many properties which make it ideal. It has almost no smell, is full of vitamins, absorbed into the skin easily and if it is ingested by the baby, causes no harmful effects. It is also low in oleic acid and is high linoleum acid which has antibacterial, regenerating, restructuring and moisturising properties (Stoia et al, 2015; Danby et al 2013). Some studies even suggested that sunflower seed oil was very important in preterm baby health and enhanced the skin barrier function.
However, a recent control trial on infant skin at the University of Manchester involving a group of 115 newborn infants indicates sunflower oil delays the development of the crucial skin barrier function, damaging the integrity of the superficial layer of skin, the stratum corneous (Cooke et al. 2015). As a result of the study, Alison Cooke, lecturer in midwifery concluded that;
“If the skin barrier function is a wall with bricks made of cells, then the lipid lamellae is the mortar that holds it together. If it isn’t developed enough then cracks appear which let water out and foreign bodies through…oil prevents this mortar from developing as quickly and this could be linked to the development of conditions such as eczema.”
Interestingly, the skin of the babies who received the oils tended to be better hydrated but the researchers felt that since the implications of the effect on the lipid layer weren’t fully understood, this was not enough of a benefit to outweigh possible harm. Consequently, the study has concluded that they cannot recommend the use of either sunflower or olive oil on babies’ skin and more research is required. (Manchester.ac.uk. 2015)
What is interesting is that the study took place on newborn babies. It would be interesting to see the effects on older babies. Babies attending infant massage classes are usually two-three months old and have traditionally used organic sunflower seed oil. As a result of this study, it would appear that it is prudent to avoid sunflower oil on the skin newborn babies (under 4 weeks) even though some studies suggest that it can be particularly beneficial for preterm babies and newborn skin. There is no evidence that it is harmful to the skin of babies over 4 weeks old.
In replacement of sunflower oil, coconut oil is a good choice. Coconut oil contains oleic acid, the same fatty acid found in olive oil which means it can make skin more permeable but it’s in a relatively low amount (around 5-6% in coconut oil compared to 55% plus in olive oil). Coconut oil is mainly made up of lauric acid (around 48%), as well as caprylic acid (9%) and linoleic acid(1-2%). However, there has not been a full-scale study on the use of coconut oil on a baby’s skin so it is difficult to fully recommend without a full trial. What is clear however is that it would seem safer to use an organic, natural-based product on babies’ skin as opposed to a highly perfumed or processed product.
Use of water or no medium for massage
Recent evidence has suggested that water may not be the optimal skin cleanser for newborns (J Eur Acad Dermatol Venereol. 2009). This provides further confusion for parents. Water alone is a poor cleanser and does not remove fat-soluble substances. It can also affect the pH of the skin and may weaken the skin barrier (Lavender T, Bedwell C, O’Brien E et al 2011). Newborn babies’ skin may be best to be left to settle after birth protected by its layer of vernix. Current advice is to not bathe babies immediately after birth but allow this layer of vernix on the skin to protect the baby. Skin to skin can still take place in many forms to enable the process of bonding to occur. Massage without oil can also be beneficial although the benefits were shown to be reduced. (Sankaranarayanan, 2005).
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