When we talk about organic products for babies, we usually mean full-term newborns, and the rationale is solid. Newborn skin is approximately 30% thinner than adult skin, and the baby product market is full of unnecessary chemicals. But for premature infants, the stakes are categorically higher. Their bodies haven't had the time to build the biological systems that limit chemical absorption in the first place.
Understanding why preemies are more vulnerable isn't just academic. It's the foundation for making better product decisions during one of the most sensitive developmental windows in a human life.
The Skin Barrier Isn't Finished Yet
The stratum corneum, the outermost layer of skin, functions as the body's primary chemical barrier. It's a compact, lipid-rich structure that limits what gets through to the bloodstream. The problem for preemies is that it doesn't fully mature until around 34 weeks of gestation.
In infants born before 28 weeks, the stratum corneum can be virtually absent. There are no complete lipid bilayers (ceramides), minimal organized structure, and high transepidermal water loss as a result. Topical substances, preservatives, fragrances, dyes, even moisturizers, can absorb directly into the bloodstream without the normal filtration that even a full-term newborn's skin provides.
This surface-to-weight ratio compounds the problem. It's not just that preemie skin is more permeable. There's also more of it relative to their body mass than at any other point in their lives. Whatever gets through the skin gets delivered in a much larger proportional dose than it would in an older child or adult.
Immature Lungs and a Faster Respiratory Rate
Preemies breathe faster than full-term infants, who themselves breathe significantly faster than adults. That higher respiratory rate means they inhale more air, and more of whatever is in that air, per unit of body weight per hour. Volatile organic compounds (VOCs), synthetic fragrances, and airborne particles from cleaning products all arrive in greater relative doses.
Their immature detoxification and excretion systems then retain what enters the body for longer. A full-term newborn metabolizes and clears substances slowly compared to adults; a preemie clears them more slowly still. Chemicals accumulate in biological fluids rather than being efficiently processed out.
The NICU's Chemical Problem: DEHP in Medical Equipment
A significant and underappreciated source of chemical exposure for premature infants is the medical equipment surrounding them. Most NICU devices, feeding tubes, IV fluid bags, respiratory tubing, are manufactured from polyvinyl chloride (PVC), a plastic that requires softening agents to be flexible enough for medical use. The most common softener is di(2-ethylhexyl) phthalate, or DEHP.
DEHP is not chemically bound to the plastic. It leaches continuously into whatever fluid or air it contacts. For a preemie receiving nutrition through a feeding tube or fluids through an IV line, DEHP exposure is constant and unavoidable unless the equipment itself is DEHP-free.
What the research links DEHP exposure to: Damage to the developing brain, liver, heart, lungs, and male reproductive tract during critical developmental windows. The concern is specifically about exposure during the early periods when organ systems are still forming, exactly the period when most preemies are in intensive care.
Some hospitals have begun transitioning to DEHP-free alternatives, such as the CARESAFE line by B. Braun. Many have not. This is something parents can ask about and advocate for. See our NICU checklist for the specific conversation to have with your care team.
BPA and Its "Safer" Substitutes
Bisphenol A (BPA) is another compound that shows up in NICU environments. Urinary BPA concentrations measured in premature infants undergoing intensive therapy have been found at approximately ten times higher than in the general population, a direct reflection of the intensity of plastic device exposure during their care.
The widespread move to "BPA-free" products is less reassuring than it sounds. Many BPA substitutes, Bisphenol F (BPF) and Bisphenol A Diglycidyl Ether (BADGE) among them, appear to have estrogenic and antiandrogenic effects comparable to, and in some cases stronger than, BPA itself. Swapping BPA for its structural relatives doesn't necessarily reduce biological activity; it may simply redirect it.
The practical implication: "BPA-free" on a product label is not the same as "bisphenol-free." When choosing any hard plastic items that will have repeated or extended contact with your preemie, look for brands that explicitly test for the full family of bisphenol compounds, not just BPA.
What This Means for Products You Choose
The physiology above isn't a reason for panic, and it's a framework for prioritizing. You can't eliminate every chemical exposure, and trying to do so would be exhausting and ultimately counterproductive. But you can make high-impact substitutions in the areas where contact time and absorption risk are highest:
- Clothing and textiles: Anything touching preemie skin directly, and touching it for hours at a time, is worth scrutinizing. Conventional fabric dyes, finishing treatments, and flame retardants can all be absorbed through compromised skin barriers. GOTS-certified organic cotton is the cleanest option.
- Skincare and topical products: Fragrances, parabens, and preservatives applied to skin that lacks a full barrier go straight through. Fragrance-free, minimal-ingredient products are the only appropriate choice.
- Medical equipment: This is the hardest category to control, but parents can advocate for DEHP-free IV lines and feeding tubes at NICU facilities that have them available.
The research points consistently toward the same direction: reducing the cumulative chemical load during the NICU stay is a meaningful clinical goal, not an aesthetic preference. Every substitution in the high-contact categories matters more for a preemie than for a full-term infant, precisely because their bodies are doing less to filter what comes in.
For the practical side, what to actually pack, what to request, and what organic products meet the clinical requirements. See our follow-up: The Organic NICU Checklist: What to Pack for Your Preemie.
This post contains affiliate links. See our affiliate disclosure. We are not medical professionals. For personalized medical guidance, consult your pediatrician or neonatologist.