It’s difficult being a parent at the best of times, but now with the overload of data and the conflicting or inaccurate information brought by the Internet and social media, it’s now even harder. We all want to ensure that we do the best by our children but it can sometimes get a bit confusing!
Which massage oil to use, if any, on baby’s skin is one of those topics that causes much debate and confusion. The scientific research undertaken by academics in this area gives no firm answers either. In this blog post, I will challenge some of the myths that are emerging in this area, and explain why Bambino&i have chosen the massage oils that we use.
The role of massage oil
When practising baby massage, the use of oil is important as it allows the hands to glide over the skin without causing friction and discomfort – although this isn’t the only reason to use it. The use of oil can also hydrate and nourish baby’s skin and some oils even have antibacterial properties that can help against infection.
What oils are safe to use?
There are lots of different oils that can be used for baby massage. However, the oils that have been subject to the most research are olive oil and sunflower seed oil, as these are the most commonly used and the ones widely recommended by midwives and healthcare professionals.
The ongoing olive oil and sunflower seed oil debate
One of the main pieces of research on the use of massage oils that seems to have caught people’s attention comes from research carried out by academics at Manchester University.1 This research was funded by the pharmaceutical company, Johnson & Johnson. The ‘inaccurate’ message that people appear to have taken from it is that both olive and sunflower oil should not be used on baby’s skin as it damages the skin barrier, which can lead to atopic eczema (a condition that causes the skin to become itchy, red, dry and cracked).
Earlier research had concluded that the topical application of olive oil significantly damages the skin barrier. 2 Thus, healthcare professionals and massage instructors have been discouraging its use on infants’ skin for quite some time. However, sunflower seed oil continues to be one of the most commonly recommended oils by massage instructors and so the research by Manchester University caused slight alarm and confusion. It also caused concern for me, as I was planning to include sunflower seed oil in my baby massage kits. However, after reading the full report and other research papers, I decided to continue to provide sunflower seed oil and these are the reasons why:
- Research carried out in 2013 found that the use of sunflower seed oil preserved the skin barrier integrity and improved hydration.3
- Recent research published in 2017 supports the use of sunflower seed oil, showing that the use of sunflower oil on baby’s skin three times a week from birth did not cause harm to the skin barrier function adaptation in healthy-term infants during the first five weeks of life.4
- Other research suggests that sunflower seed oil is beneficial in pre-term baby health and enhances skin barrier functioning.6,7,8 Due to its anti-microbial action, it can also have a very positive effect on baby’s health where infection is a risk.
- Sunflower seed oil is full of vitamins, and has antibacterial, regenerating, restructuring and moisturising properties.9, 10
- Studies have found that the skin is better hydrated when using oils.
- The research carried out by Manchester University11 was based on applying the oil twice a day for four weeks on an infant from 48 hours old. This is far more frequent than would normally be the case. When practising baby massage, particularly in the early days, it is highly unlikely that you will be doing this two times a day, every day. In fact, massage is something that should be built up gradually, allowing you and your baby time to learn to give and receive massage.
- The research carried out by Manchester University12 found that the lipid structure of the skin barrier appeared to have been altered in those babies upon whom the oils (olive and sunflower seed) were applied. However, they acknowledge that the clinical importance of this and the possible link to atopic eczema was unknown. They went on to say that they “cannot draw firm conclusions about the long-term effects” of applying these topical oils and that the “results were not powered to identify the optimal treatment for baby dry skin or massage; findings should therefore be interpreted with caution.” Their concluding sentence states that “until there is evidence that the use of these oils improves the skin barrier function, caution should be exercised when recommending oils on newborn baby skin”. I feel that it is important to emphasise an important point in their conclusion: they do not find that the use of these oils damages or otherwise harms baby’s skin barrier, thus increasing the risk of eczema, but they cannot prove that the use of these oils improves baby’s skin barrier function either. There is an important difference. When we engage in baby massage, the primary aim is to generate the many positive physical and emotional benefits for you and your baby. If oils can improve skin barrier function whilst doing this, then perfect! If they cannot be proven to improve skin barrier function, then provided that they are shown to do no harm to baby’s skin, then we will continue to recommend use of sunflower seed oil.
The use of other vegetable oils such as grape seed, sweet almond and coconut oils are also widely recommended by massage instructors. Coconut Oil in particular has grown massively in popularity owing to its ability to help hydrate and nourish the skin whilst also smelling lovely! Although it must be noted that these oils have unfortunately not undergone a great deal of research. We therefore do not have a clear and detailed picture of their potential effects.
You may have already heard that the use of cold-pressed oils for massage is preferable. But what is cold-pressed and why is it preferable? The natural oils that are used for massage are extracted from seeds, fruits, vegetables and nuts. There are two methods of extracting this oil (1) the cold-press process and (2) the hot-press process. The cold-press process involves crushing the seeds, fruits, vegetables or nuts and squeezing the oils out, whereas the hot-press process uses heat to advance the oil extraction. The way in which the oil is extracted greatly affects the quality of the oil. Where heat is used, the nutritional content of the oils can be reduced, while the cold-pressed process allows the oil to retain its vitamins, minerals and fatty acids, which can in turn go on to nourish our skin!
Linoleic and oleic acid
Linoleic acid (omega-6) and oleic acid (omega-9) are fatty acids found in oils. Linoleic acid is an essential fatty acid – one that your body cannot produce itself. These fatty acids bring many benefits for our skin and form an important part of our sebum, which is a waxy substance that makes the skin waterproof and lubricated.
However, the ratio of linoleic to oleic acid is very important and can differ for different skin types. For baby massage, it is recommended that you use oils with a higher linoleic acid to oleic acid ratio. A study carried out on adults showed an adverse effect on skin barrier function when olive oil was applied to the skin.13 Olive oil is high in oleic acid, which makes skin more permeable, thus resulting in the loss of moisture from the skin. This can then lead to dryness and eczema.
So how do you know which oil is rich in linoleic acid? It’s hard to know as this information is rarely provided. But, as a general rule, they will have a higher content of polyunsaturated fatty acids than monounsaturated fatty acids.
So, to summarise, here are a few tips to bear in mind when choosing your oil:
- Minimise the use of oil on baby’s skin in their first four weeks. Limit to three times a week.
- Avoid the use of olive oil, mustard oil and peanut oil.
- Always bear in mind that babies are likely to put their hands, feet or anything else they can into their mouth. So whatever oil you decide to use, make sure it is safe for them to eat!
- We would recommend using a pure vegetable oil, which is preferably cold-pressed and organic.
- Choose oils with a higher linoleic acid to oleic acid ratio (i.e. sunflower, coconut, grape seed).
- Try to avoid oils with added parabens, phthalates, synthetic fragrances, petrochemicals, colourants or alcohol SLS/SLESs.
- Massage can also be performed on top of baby’s clothes to avoid the need for always using oil.
- Always carry out a skin patch test before using a new oil on baby. If the skin becomes red or blotchy, try another oil.
1. Cooke A, Cork MJ, Victor S, Campbell M, Danby S, Chittock J, Lavender T. (2015) Olive Oil, Sunflower Oil or no Oil for Baby Dry Skin or Massage: A Pilot, Assessor-blinded, Randomised Controlled Trial (the Oil in Baby Skincare Study). Acta Derm Venereol, eScholoarID: 281521
Online article: http://www.manchester.ac.uk/discover/news/olive-and-sunflower-oil-on-baby-skin-weakens-natural-defences
2. Danby SG, AlEnezi T, Sultan A, Lavender T, Chittock J, Brown K, Cork MJ. (2013) Effect of olive and sunflower seed oil on the adult skin barrier: implications for neonatal skin care. Pediatr Dermatol. 30(1); 42–50.
3. Danby et al. 2013 – see 2
4. Kanti V, Gunther M, Stroux A, Sawatzky S, Henrich W, Abou-Dakn M, Blume-Peytavi U, and Garcia Bartels N. (2017) Influence of sunflower seed oil or baby lotion on the skin barrier function of newborns: A pilot study. J Cosmet Dermatol. 00:1–8. doi:10.1111/jocd.12302.
5. Darmstadt GL, Badrawi N, Law P, Ahmed S, Bashir M, Iskander I, Al Said D, El Kholy A, Husein MH, Alam A, Winch PJ, Gipson R and Santosham M. (2004) Topically applied sunflower seed oil prevents invasive bacterial infections in preterm infants in Egypt. Pediatr Infect Dis J. 23: 719–725.
6. Darmstadt GL and Dinulos JG (2000) Neonatal Skin Care. Pediatric Clinics. 47: 757–782.
7. Darmstadt GL, Mao-Qiang M, Chi E, Saha SK, Ziboh VA, Black RE, Santosham M and Elias PM (2002) Impact of topical oils on the skin barrier: possible implications for neonatal health in developing countries. Acta Paediatr. 91: 546–554.
8. Darmstadt GL, Saha SK, Ahmed AS, Ahmed S, Chowdhury MA, Law PA, Rosenberg RE, Black RE, Santosham M (2008) Effect of skin barrier therapy on neonatal mortality rates in preterm infants in Bangladesh: a randomized, controlled, clinical trial. Pediatrics. 121: 522–529.
9. Danby SG, et al. 2013 – see 2
10. Stoia, Mihaela & Oancea, Simona. (2015) Selected Evidence-Based Health Benefits of Topically Applied Sunflower Oil. Applied Science Reports. 10. 45-49.
11. Cooke et al. 2015 – see 1
12. Cooke et al. 2015 – see 1
13. Danby et al. 2013 – see 2