Chapter 5 – Hair Care

Even when it comes to hair, not all babies are the same. Some are born with lots of hair, others with just a fine fuzz.

During the first six months of gestation, the fetus develops hair follicles and, between the sixth and seventh month, is covered with a fine fuzz called lanugo, which usually disappears by the end of the eighth month. The appearance of this lanugo is due to the high levels of circulating estrogen. For this reason, after birth, when placental steroid levels drop, it’s not unusual for a progressive loss of residual hair and fuzz to occur.

Within a few months, the initial fuzz gives way to real hair, which is generally abundant and particularly soft, often with a low hairline on the forehead. It’s not uncommon for babies to lose a noticeable amount of hair on the back of the head. This was traditionally believed to be caused by the baby’s sleeping position in the crib and friction between the head and the mattress. However, this belief was challenged by a study conducted by a group of researchers in 2012. The scientists evaluated the incidence of occipital alopecia in a group of 301 newborns, at birth and at three months of age (8).

All babies in the study slept on their backs, as recommended by the American Academy of Pediatrics. Among these infants, the incidence of occipital alopecia was 11.88%—not significantly different from data collected between 1985 and 1995, when babies were put to sleep randomly, without attention to sleep position. Therefore, alopecia is not caused by friction, but rather by the fact that hair growth in the occipital region is delayed compared to the frontal-parietal-temporal areas, which develop in utero before birth. It affects all babies; sometimes it’s just less noticeable because there is already a relatively dense amount of growing hair in that area.

There is no need to worry—just keep the scalp clean to encourage healthy hair growth.

Washing a baby’s head is very important for general hygiene, but especially to help reduce sebum production, which can cause cradle cap. However, it should be done with care.

First of all, no cleansing products should be used until at least four months of age. Warm water and a soft sponge are sufficient. When washing, use slow and gentle movements, bearing in mind that a baby’s head is very delicate and still has soft spots. These areas should be gently dabbed and lightly rubbed.

After washing, the hair should be dried by patting the head several times with a soft towel, avoiding excessive pressure, especially around the soft spots. If the baby has little hair, it can be left to air dry.

Using a hairdryer is not recommended during the first few months, as it may frighten the baby or burn their delicate skin. Later on, if the baby tolerates it, it may be used carefully, at low temperature and from a safe distance.

After four months, you can start using a pediatric shampoo (which can be the same used for the body), starting with small amounts. The product should be based on natural ingredients, free of silicones and preservatives, produce minimal foam during washing, and rinse off easily.

It’s not uncommon for newborns and small children to resist having their hair washed. The right strategy can help make shampoo time a pleasant experience. For example, gently tilting the baby forward, gradually wetting their hair, and speaking calmly and reassuringly can help ease the process.

In some cases, it may help to continue with the sponge-and-dab method. For older babies, especially those who strongly resist, you can even use special visors that shield the face from water and shampoo splashes.

In any case, turning hair washing into a pleasant ritual—like gently brushing their hair before shampooing, playing music, or creating funny hairstyles—can usually overcome resistance and transform the experience into a true wellness moment.