{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:16:49Z","timestamp":1788520609525,"version":"build-2803163510"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR203170"],"award-info":[{"award-number":["NIHR203170"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000276","name":"Department of Health and Social Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bathing, even in tap water, alters skin physiology. Frequent infant bathing may increase the risk of eczema developing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To undertake a randomized controlled feasibility trial of an intervention to reduce infant bathing frequency and intensity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In total, 105 pregnant women (aged \u2265 16\u2005years) with a family history of atopy and carrying a healthy singleton fetus (54 male, 51 female) were randomized in a 1 : 1 ratio during pregnancy or postnatally prior to their infant\u2019s first bath. Caregivers in the intervention group were asked to reduce how often they bathed their infants (no more than once a week for the first 6\u2005months of age) and to reduce the intensity of the bathing (keeping baths short, ensuring the water was not too hot and washing in \u2018plain\u2019 water being usually sufficient). The control group received the routine postnatal infant care advice offered by their maternity unit. The primary feasibility outcome was the proportion of eligible families willing to be randomized to the intervention. The secondary clinical outcome was a blinded assessment of infant eczema at 6\u2005months of age, using an adaptation of the UK Working Party Diagnostic Criteria for Atopic Dermatitis. The trial was registered with the ISRCTN Registry on 24 July 2023 (ISRCTN51491794).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Altogether, 261 pregnant women were screened, of whom 21 were ineligible. Of the 240 women included, 105 (43.8%) were randomized to the intervention (n = 52) and control (n = 53) groups. Adherence to the intervention was high, with 80% (n = 35\/44) of caregivers in the intervention arm bathing their infant once a week or less compared with 29% (n = 14\/49) in the control group. In the intervention group, 95% (n = 38\/40) of caregivers agreed or strongly agreed that the intervention was acceptable. There was minimal contamination of the control group as a result of awareness of the trial\u2019s purpose and accessing the intervention (n = 1\/46). Follow-up was high, with 88.6% (n = 93\/105) of families completing the final 6-month questionnaire and 81.9% (n = 86\/105) attending the final visit. Eczema outcomes occurred less frequently in the intervention arm compared with the control arm, respectively: visible eczema 16% (n = 6\/38) vs. 29% (n = 14\/48); parent-reported eczema 9% (n = 4\/44) vs. 12% (n = 6\/49); and doctor-diagnosed parent-reported eczema 9% (n = 3\/44) vs. 10% (n = 5\/49). No noteworthy adverse effects of the intervention were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings support the feasibility of randomizing infants during pregnancy to a reduced frequency and intensity bathing intervention for eczema prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjd\/ljag248","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:57:17Z","timestamp":1782302237000},"page":"421-430","source":"Crossref","is-referenced-by-count":0,"title":["Randomized controlled feasibility trial of an intervention to reduce infant bathing"],"prefix":"10.1093","volume":"195","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9272-2585","authenticated-orcid":false,"given":"Michael R","family":"Perkin","sequence":"first","affiliation":[{"name":"Department of Population Health & Policy, City St George\u2019s University of London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0995-7955","authenticated-orcid":false,"given":"Michael","family":"Ussher","sequence":"additional","affiliation":[{"name":"Department of Population Health & Policy, City St George\u2019s University of London , London ,","place":["UK"]},{"name":"Institute of Social Marketing and Health, University of Stirling , Stirling ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6934-1925","authenticated-orcid":false,"given":"Lucy P","family":"Goldsmith","sequence":"additional","affiliation":[{"name":"NIHR Policy Research Unit in Mental Health, Division of Psychiatry, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4884-6286","authenticated-orcid":false,"given":"Carsten","family":"Flohr","sequence":"additional","affiliation":[{"name":"Unit for Paediatric and Population-Based Dermatology Research, St John\u2019s Institute of Dermatology, Guy\u2019s & St Thomas\u2019 NHS Foundation Trust and King\u2019s College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0370-3695","authenticated-orcid":false,"given":"Amanda","family":"Roberts","sequence":"additional","affiliation":[{"name":"Nottingham Support Group for Carers of Children with Eczema , Nottingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0080-1065","authenticated-orcid":false,"given":"Victoria","family":"Cornelius","sequence":"additional","affiliation":[{"name":"Imperial Clinical Trials Unit, School of Public Health, Imperial College , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3450-5210","authenticated-orcid":false,"given":"Charlotte","family":"Wahlich","sequence":"additional","affiliation":[{"name":"Department of Population Health & Policy, City St George\u2019s University of London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2847-3573","authenticated-orcid":false,"given":"Kathryn","family":"Willis","sequence":"additional","affiliation":[{"name":"St George\u2019s Emergency Department Collaborative Research Group, St George\u2019s University Hospitals NHS Foundation Trust , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2618-9257","authenticated-orcid":false,"given":"Umar A R","family":"Chaudhry","sequence":"additional","affiliation":[{"name":"Department of Population Health & Policy, City St George\u2019s University of London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2174-7229","authenticated-orcid":false,"given":"Selma","family":"Audi","sequence":"additional","affiliation":[{"name":"Department of Population Health & Policy, City St George\u2019s University of London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4913-7580","authenticated-orcid":false,"given":"Robert J","family":"Boyle","sequence":"additional","affiliation":[{"name":"Mohn Centre for Children\u2019s Health and Wellbeing, School of Public Health, Imperial College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"2026090406311287300_ljag248-B1","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1111\/cea.13784","article-title":"The epidemiology of eczema in children and adults in England: a population-based study using primary care data","volume":"51","author":"de Lusignan","year":"2021","journal-title":"Clin Exp Allergy"},{"key":"2026090406311287300_ljag248-B2","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1111\/cea.14276","article-title":"Trends in eczema prevalence in children and adolescents: a Global Asthma Network phase one study","volume":"53","author":"Langan","year":"2023","journal-title":"Clin Exp Allergy"},{"key":"2026090406311287300_ljag248-B3","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1542\/peds.2004-0374","article-title":"Effects of atopic dermatitis on young American children and their families","volume":"114","author":"Chamlin","year":"2004","journal-title":"Pediatrics"},{"key":"2026090406311287300_ljag248-B4","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1111\/j.1365-2133.2010.10068.x","article-title":"Filaggrin loss-of-function mutations are associated with early-onset eczema, eczema severity and transepidermal water loss at 3\u2005months of age","volume":"163","author":"Flohr","year":"2010","journal-title":"Br J Dermatol"},{"key":"2026090406311287300_ljag248-B5","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1038\/ng2020","article-title":"Comprehensive analysis of the gene encoding filaggrin uncovers prevalent and rare mutations in ichthyosis vulgaris and atopic eczema","volume":"39","author":"Sandilands","year":"2007","journal-title":"Nat Genet"},{"key":"2026090406311287300_ljag248-B6","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013534.pub3","article-title":"Skin care interventions in infants for preventing eczema and food allergy","author":"Kelleher","year":"2022","journal-title":"Cochrane Database Syst Rev"},{"key":"2026090406311287300_ljag248-B7","first-page":"258","article-title":"Effects of soap and detergents on skin surface pH, stratum corneum hydration and fat content in infants","volume":"195","author":"Gfatter","year":"1997","journal-title":"Dermatology"},{"issue":"3, Supplement","key":"2026090406311287300_ljag248-B8","doi-asserted-by":"crossref","first-page":"S123","DOI":"10.1016\/S0091-6749(99)70054-0","article-title":"Update on therapy of atopic dermatitis","volume":"104","author":"Hanifin","year":"1999","journal-title":"J Allergy Clin Immunol"},{"key":"2026090406311287300_ljag248-B9","volume-title":"Clean: An Unsanitised History of Washing","author":"Ashenburg","year":"2011"},{"key":"2026090406311287300_ljag248-B10","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/cea.14407","article-title":"Routine infant skincare advice in the UK: a cross-sectional survey","volume":"54","author":"Goldsmith","year":"2024","journal-title":"Clin Exp Allergy"},{"key":"2026090406311287300_ljag248-B11","author":"Scanlan"},{"key":"2026090406311287300_ljag248-B12"},{"key":"2026090406311287300_ljag248-B13","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1016\/j.jaci.2015.12.1322","article-title":"Enquiring About Tolerance (EAT) study: feasibility of an early allergenic food introduction regimen","volume":"137","author":"Perkin","year":"2016","journal-title":"J Allergy Clin Immunol"},{"key":"2026090406311287300_ljag248-B14","doi-asserted-by":"crossref","first-page":"2820","DOI":"10.1016\/j.jaip.2020.04.043","article-title":"Bathing frequency is associated with skin barrier dysfunction and atopic dermatitis at three months of age","volume":"8","author":"Marrs","year":"2020","journal-title":"J Allergy Clin Immunol Pract"},{"key":"2026090406311287300_ljag248-B15","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.jaci.2016.03.031","article-title":"Association between domestic water hardness, chlorine, and atopic dermatitis risk in early life: a population-based cross-sectional study","volume":"138","author":"Perkin","year":"2016","journal-title":"J Allergy Clin Immunol"},{"key":"2026090406311287300_ljag248-B16","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1111\/cea.14071","article-title":"Randomized controlled pilot trial with ion-exchange water softeners to prevent eczema (SOFTER trial)","volume":"52","author":"Jabbar-Lopez","year":"2022","journal-title":"Clin Exp Allergy"},{"key":"2026090406311287300_ljag248-B17","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.jid.2017.08.037","article-title":"The effect of water hardness on surfactant deposition after washing and subsequent skin irritation in atopic dermatitis patients and healthy control subjects","volume":"138","author":"Danby","year":"2018","journal-title":"J Invest Dermatol"},{"key":"2026090406311287300_ljag248-B18","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1016\/S0140-6736(19)32983-6","article-title":"Skin emollient and early complementary feeding to prevent infant atopic dermatitis (PreventADALL): a factorial, multicenter, cluster-randomised trial","volume":"395","author":"Skjerven","year":"2020","journal-title":"Lancet"},{"key":"2026090406311287300_ljag248-B19","doi-asserted-by":"crossref","first-page":"298335","DOI":"10.1371\/journal.pone.0298335","article-title":"Development of an intervention for reducing infant bathing frequency","volume":"19","author":"Goldsmith","year":"2024","journal-title":"PLOS ONE"},{"key":"2026090406311287300_ljag248-B20","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1111\/cea.14464","article-title":"BabyBathe study protocol: a randomised controlled feasibility trial to change baby bathing practice during the first months of life","volume":"54","author":"Perkin","year":"2024","journal-title":"Clin Exp Allergy"},{"key":"2026090406311287300_ljag248-B21","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap) \u2013 a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"2026090406311287300_ljag248-B22","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners","volume":"95","author":"Harris","year":"2019","journal-title":"J Biomed Inform"},{"key":"2026090406311287300_ljag248-B23","doi-asserted-by":"crossref","DOI":"10.1093\/jamiaopen\/ooac047","article-title":"MyCap: a flexible and configurable platform for mobilizing the participant voice","volume":"5","author":"Harris","year":"2022","journal-title":"JAMIA Open"},{"key":"2026090406311287300_ljag248-B24","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1111\/j.1365-2133.1994.tb08530.x","article-title":"The U.K. Working Party's Diagnostic Criteria for Atopic Dermatitis. I. Derivation of a minimum set of discriminators for atopic dermatitis","volume":"131","author":"Williams","year":"1994","journal-title":"Br J Dermatol"},{"key":"2026090406311287300_ljag248-B25","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1111\/j.1365-2133.1996.tb03599.x","article-title":"Validation of the U.K. diagnostic criteria for atopic dermatitis in a population setting. U.K. Diagnostic Criteria for the Atopic Dermatitis Working Party","volume":"135","author":"Williams","year":"1996","journal-title":"Br J Dermatol"},{"key":"2026090406311287300_ljag248-B26","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1111\/j.1365-2133.1995.tb06930.x","article-title":"A protocol for recording the sign of flexural dermatitis in children","volume":"133","author":"Williams","year":"1995","journal-title":"Br J Dermatol"},{"key":"2026090406311287300_ljag248-B27","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1111\/1346-8138.14080","article-title":"Effects of moisturizing skincare on skin barrier function and the prevention of skin problems in 3-month-old infants: a randomized controlled trial","volume":"45","author":"Yonezawa","year":"2018","journal-title":"J Dermatol"},{"key":"2026090406311287300_ljag248-B28","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1016\/j.jaci.2014.08.005","article-title":"Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention","volume":"134","author":"Simpson","year":"2014","journal-title":"J Allergy Clin Immunol"},{"key":"2026090406311287300_ljag248-B29","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1016\/S0140-6736(19)32984-8","article-title":"Daily emollient during infancy for prevention of eczema: the BEEP randomised controlled trial","volume":"395","author":"Chalmers","year":"2020","journal-title":"Lancet"},{"key":"2026090406311287300_ljag248-B30","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1111\/j.1365-2222.2004.1935.x","article-title":"Burden of allergic disease in the UK: secondary analyses of national databases","volume":"34","author":"Gupta","year":"2004","journal-title":"Clin Exp Allergy"},{"key":"2026090406311287300_ljag248-B31","doi-asserted-by":"crossref","first-page":"105","DOI":"10.2165\/00019053-200321020-00003","article-title":"Cost of illness of atopic dermatitis in children","volume":"21","author":"Kemp","year":"2003","journal-title":"Pharmacoeconomics"}],"container-title":["British Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjd\/advance-article-pdf\/doi\/10.1093\/bjd\/ljag248\/68625739\/ljag248.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjd\/article-pdf\/195\/3\/421\/68625739\/ljag248.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjd\/article-pdf\/195\/3\/421\/68625739\/ljag248.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T10:31:25Z","timestamp":1788517885000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjd\/article\/195\/3\/421\/8718858"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,26]]},"references-count":31,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,6,26]]},"published-print":{"date-parts":[[2026,8,18]]}},"URL":"https:\/\/doi.org\/10.1093\/bjd\/ljag248","relation":{},"ISSN":["0007-0963","1365-2133"],"issn-type":[{"value":"0007-0963","type":"print"},{"value":"1365-2133","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,6,26]]}}}