the benefits of vernix

Let me preface this blog by saying that when I present information such as this it is not my intention to get you to follow the advice that I am giving. I am merely trying to give you information that I was not privy to when I became pregnant with my first child. And who knows if I would have followed these suggestions if I had known.

I will say though that Manny was immediately washed after he was born. He has grown into completely healthy 3 year old. He suffered no major illnesses as an infant. Christian wasn't bathed immediately, but he was bathed within the first 24 hours, and he is a completely healthy 13 month old. However I do think it's important to know that there are benefits to delaying a newborns first bath. After reading the information, you make the decision that is best for you.

When a baby is born he is covered in a waxy white substance (some say it also looks like cheese). This substance is called vernix caseosa.

Vernix is secereted by babies sebaceous glands while in utero. It is thought to protect the baby's skin from amniotic fluid. Without this protection baby's skin would become wrinkly (think about how your skin looks after you get out of a pool or bath). It is also thought that vernix has antibacterial properties to protect baby from infections while inside the uterus.

At the time of birth one of the standard procedures followed by hospitals is to immediately bathe a newborn. Unfortunately - it is believed by some - that this procedure does more harm than good. Several studies have shown that leaving vernix on a newborn for several days (some suggest until a good breastfeeding routine has been established) could protect him from bacteria in his new surroundings.

"Antimicrobial Properties of Amniotic Fluid and Vernix Caseosa Are Similar to Those Found in Breastmilk

Akinbi, H. T., Narendran, V., Pass, A. K., Markart, P., & Hoath, S. B. (2004). Host defense proteins in vernix caseosa and amniotic fluid. American Journal of Obstetrics and Gynecology, 191 (6), 2090-2096. [Abstract]

Summary: In this study, researchers analyzed samples of amniotic fluid and vernix caseosa (vernix) from healthy, term gestations to determine the immune properties of these substances. Participants were pregnant women admitted for elective cesarean section after 37 weeks gestation with no prior labor and no signs of chorioamnionitis (intrauterine infection). Women with a history of prenatal fever or premature rupture of membranes, or who received steroids prenatally or antibiotics during delivery were excluded, as were women whose babies passed meconium in utero, had congenital malformations, or required prolonged resuscitation after birth. Amniotic fluid was obtained by amniocentesis to determine fetal lung maturity prior to elective delivery. Vernix was gently scraped from the newborn's skin with a sterile implement immediately following delivery. There were 10 samples of amniotic fluid and 25 samples of vernix obtained.

Tests (Western analysis and immunochemistry) revealed that lysozyme, lactoferrin, human neutrophil peptides 1-3 and secretory leukocyte protease inhibitor were present in the amniotic fluid samples and in organized granules embedded in the vernix samples. These immune substances were tested using antimicrobial growth inhibition assays and found to be effective in inhibiting the growth of common perinatal pathogens, including group B Streptococcus, K pneumoniae, L monocytogenes, C albicans, and E coli.

The authors point out that the innate immune proteins found in vernix and amniotic fluid are similar to those found in breast milk. As the baby prepares for extrauterine life, pulmonary surfactant (a substance produced by the maturing fetal lungs) increases in the amniotic fluid, resulting in the detachment of vernix from the skin. The vernix mixes with the amniotic fluid and is swallowed by the growing fetus. Given the antimicrobial properties of this mixture, the authors conclude that there is therefore "considerable functional and structural synergism between the prenatal biology of vernix caseosa and the postnatal biology of breast milk." They also suggest that better understanding of these innate host defenses may prove useful in preventing and treating intrauterine infection.

Significance for Normal Birth: It is well understood that routine artificial rupture of membranes increases the likelihood of intrauterine infection because it eliminates the physical barrier (the amniotic sac) between the baby and the mother's vaginal flora. This study suggests an additional mechanism for the prevention of infection when the membranes remain intact: a baby that is bathed in amniotic fluid benefits from antimicrobial proteins that are found in the fluid and in vernix caseosa.

The results of this study also call into question the routine use of some newborn procedures. Early bathing of the baby removes vernix, which contains antimicrobial proteins that are active against group B streptococcus and E. coli. Delaying the bath and keeping the newborn together with his or her mother until breastfeeding is established may prevent some cases of devastating infections caused by these bacteria. The fact that preterm babies tend to have more vernix than babies born at or after 40 weeks might mean that healthy, stable preterm babies derive even greater benefit from staying with their mothers during the immediate newborn period.

Finally, this study illustrates how the normal physiology of pregnancy and fetal development is part of a continuum that extends beyond birth to the newborn period. The immunologic similarities between amniotic fluid, vernix and breast milk provide further evidence that successful initiation of breastfeeding is a critical part of the process of normal birth."

Another study:

Is vernix caseosa a protective material to the newborn? A biochemical approach.

Baker SM, Balo NN, Abdel Aziz FT.

Department of Nursing, Al-Arab Medical University, Faculty of Medicine, Benghazi, Libya.

Twenty random samples of vernix caseosa were collected from immediately born neonates, in Jamahiriya Hospital, Benghazi. Biochemical studies of these samples revealed presence of lipids (62.5%), proteins (36%) and carbohydrate (1.5%). Also we could observe inhibition of staph. aureus and klebsiella growth on nutrient agar by this vernix. This observation could be explained either by its higher asparagine content or by its elevated lipid component. In addition tripalmitin was found to be the major lipid constituent, responsible for its hydrophobic property. So we recommend leaving this vernix layer on newborn skin until spontaneous drying.

A novel role for vernix caseosa as a skin cleanser.

Moraille R, Pickens WL, Visscher MO, Hoath SB.

Division of Neonatology and Skin Sciences Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.

OBJECTIVES: Skin cleansing is a complex process involving endogenous and exogenous mechanisms. This study examines the role of vernix caseosa in the process of skin cleansing in the perinatal period.

METHODS: Vernix was evaluated as an exogenously applied skin cleanser using digitized image analysis which quantified residual carbon particles following a standardized cleansing assay. In addition, the detachment of vernix from human cadaveric skin and Gore-Tex supports was investigated following timed exposures to a variety of commonly used commercial surfactants. Detachment was quantified spectrophotometrically as increased turbidity at 650 nm.

RESULTS: Image analysis showed that exogenous application of vernix exhibited a cleansing capability comparable or superior to standard skin cleansers. Dose-dependent increases in solution turbidity (vernix detachment) were seen following exposure of vernix-covered Gore-Tex vehicles to sodium laureth sulfate, sodium lauryl sulfate, and cocamidopropyl betaine solutions. Similar results were seen with cadaveric skin.

CONCLUSIONS: These results demonstrate a role for vernix caseosa as a skin cleanser. Previous views of vernix as a soil or skin contaminant at birth need to be reevaluated.