Determining appropriate use in NICU/PICU: An evaluation of a neonate suitable no-rinse cleanser

Selecting skin care products which are appropriate for use in pediatric and neonatal intensive care units (PICU/NICU) is challenging for health care practioners and skin care formulary committees. Selection is further complicated by the limited ingredient-safety research available for this patient population.   In present, one of the guiding resources is the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) publication, Neonatal Skin Care (2^nd edition): Evidence-Based Clinical Practice Guideline. The Neonatal Skin Care guidelines include recommendations on product selection for use on neonates¹. The aim of the present research was to utilize the Neonatal Skin Care guidelines, ingredient-safety research and in-vitro/in-vivo lab testing to develop a no-rinse bathing cleanser formulated for use in the NICU/PICU. Through the formula development process, NICU Medical Doctors reviewed the ingredient list and provided concerns and endorsements of the surfactants and preservatives contained.  Cosmetic ingredient experts were also hired for recommendation and research on the safest ingredients available for use based on historical adverse response data.  Thereafter, bio-safety labs tested the formula to validate product safety and efficacy. The tests conducted include: skin sensitizing and irritation testing, ocular irritation testing, preservative efficacy and cleansing efficacy testing. The result is an exceptionally mild product formula designed specifically for use with neonates and pediatrics in the clinical-setting.  Through the investigation and development of a neonate-suitable cleanser, the authors aim to validate the current formula for use in the neonate patient population as well as suggest a standard of resources and processes used for future neonate-suitable skin care product development.