Newborn Bath Research Articles

Delaying the Bath and In-Hospital Breastfeeding Rates

Until 2010, newborns at our institution were bathed in the nursery at approximately 2 hours of life. In May 2010, infant baths were delayed until at least 12 hours of life. Infants are now bathed in the hospital room with parents' participation and are placed skin-to-skin immediately after the bath. This study explored whether delaying the newborn's first bath correlates with increased in-hospital breastfeeding rates at our Baby-Friendly, urban safety-net hospital. We performed a retrospective chart review comparing in-hospital breastfeeding rates during the 6 months before and the 6 months after the bath was delayed. Of the infants, 702 met inclusion criteria. Before the bath was delayed, infants were bathed at an average of 2.4 hours of life. Afterward, infants were bathed at an average of 13.5 hours of life. In-hospital exclusive breastfeeding rates increased from 32.7% to 40.2% (p<0.05) after the bath was delayed. Multivariate logistic regression analysis showed that infants born after implementation of delayed bathing had odds of exclusive breastfeeding 39% greater than infants born prior to the intervention (adjusted odds ratio [AOR]=1.39; 95% confidence interval [CI] 1.02, 1.91) and 59% greater odds of near-exclusive breastfeeding (AOR=1.59; 95% CI 1.18, 2.15). The odds of breastfeeding initiation were 166% greater for infants born after the intervention than for infants born before the intervention (AOR=2.66; 95% CI 1.29, 5.46). In our cohort, a delayed newborn bath was associated with increased likelihood of breastfeeding initiation and with increased in-hospital breastfeeding rates.

Randomized, Controlled Trial Evaluating a Baby Wash Product on Skin Barrier Function in Healthy, Term Neonates

ObjectivesTo examine the hypothesis that the use of a wash product formulated for newborn (<1 month of age) bathing is not inferior (no worse) to bathing with water only.DesignAssessor-blinded, randomized, controlled, noninferiority trial.SettingA teaching hospital in the Northwest of England and in participants’ homes.ParticipantsThree-hundred-and-seven healthy, term infants recruited within 48 hours of birth.MethodWe compared bathing with a wash product (n = 159) to bathing with water alone (n = 148). The primary outcome was transepidermal water loss (TEWL) at 14 days postbirth; the predefined difference deemed to be unimportant was 1.2. Secondary outcomes comprised changes in stratum corneum hydration, skin surface pH, clinical observations of the skin, and maternal views.ResultsComplete TEWL data were obtained for 242 (78.8%) infants. Wash was noninferior to water alone in terms of TEWL (intention-to-treat analysis: 95% confidence interval [CI] for difference [wash–water, adjusted for family history of eczema, neonate state, and baseline] −1.24, 1.07; per protocol analysis: 95% CI −1.42, 1.09). No significant differences were found in secondary outcomes.ConclusionWe were unable to detect any differences between the newborn wash product and water. These findings provide reassurance to parents who choose to use the test newborn wash product or other technically equivalent cleansers and provide the evidence for health care professionals to support parental choice.

“Wait for Eight”: Improvement of Newborn Outcomes by the Implementation of Newborn Bath Delay

“Wait for Eight”: Improvement of Newborn Outcomes by the Implementation of Newborn Bath Delay

The impact of newborn bathing on the prevalence of neonatal hypothermia in Uganda: A randomized, controlled trial

To elucidate the impact of bathing on the prevalence of hypothermia among newborn babies exposed to the skin-to-skin (STS) care technique before and after bathing. Non-asphyxiated newborns after vaginal delivery (n = 249) in a Ugandan referral hospital were consecutively enrolled and randomized either to bathing at 60 min postpartum (n = 126) or no bathing (n = 123). All mothers practised skin-to-skin care of their newborns. Four rectal and tympanic registrations of newborn temperatures were carried out in both groups directly after drying at birth, and at 60, 70 and 90 min postpartum. Bathing of newborns in the first hour after delivery resulted in a significantly increased prevalence of hypothermia, defined as temperature <36.5 degrees C, at 70 and at 90 min postpartum despite the use of warmed water and the application of the STS method. There was no neonatal mortality. Aside from the bathing procedure, no background factor potentially predisposing the newborns to hypothermia was identified. Bathing newborn babies shortly after birth increased the risk of hypothermia despite the use of warm water and STS care for thermal protection of the newborn.

The impact of newborn bathing on the prevalence of neonatal hypothermia in Uganda: A randomized, controlled trial

The impact of newborn bathing on the prevalence of neonatal hypothermia in Uganda: A randomized, controlled trial

Changes in Newborn Bathing Practices May Increase the Risk for Omphalitis

Aseptic cord care, in conjunction with antibacterial skin care, has reduced the incidence of omphalitis specifically caused by Staphylococcus aureus. However, this practice has resulted in the emergence of resistant organisms that may pose a greater risk for newborn infections. Subsequently, many institutions have changed to dry cord care and nonantiseptic whole-body baths, a practice that has not been adequately studied to determine potential infectious risks. Three cases of omphalitis occurring after an institutional change to nonantiseptic whole-body baths are presented. Clinical diagnosis and treatment of omphalitis are reviewed. Recommendations for surveillance of omphalitis are offered.

Adaptation of kangaroo mother care for community-based application.

Working with a multidisciplinary team of Ecuadorians, Bangladeshis and Americans, we developed a simple protocol for community-based implementation of kangaroo mother care (CKMC) that does not require birth weight or clinical judgment to identify which newborns should receive CKMC. CKMC could stabilize newborns and possibly reduce neonatal mortality where there is little medical care for newborns and low birth weight (LBW) is common. During their CKMC training, community-based workers identified 35 expectant or recently delivered women in the pilot study area and taught them about CKMC. Women were interviewed at 1 month postpartum to evaluate their experience with CKMC. In all, 77% of mothers initiated skin-to-skin care and 85% with LBW babies did so (37% were LBW). CKMC mothers delayed newborn bathing. Few slept upright with their newborns. CKMC was quickly and popularly adopted. A randomized controlled cluster trial is planned to determine whether CKMC reduces neonatal mortality.

Reflections on the interactive newborn bath demonstration.

This article describes how a staff nurse changed the routine nature of her work on a mother/baby unit. Using patient education techniques and a newly acquired knowledge about newborn behavior enhanced how she completed the newborn bath demonstration for new parents. She applied her understanding of newborn reflexes, newborn states and state management, and consoling interventions to alter her practice and help parents explore the newborn together. This nurse's goal was to educate and simultaneously empower the parents to better read their baby's cues and respond to their baby. She recounts how this new interactive approach has benefitted the newborns and parents, and has enhanced her satisfaction with her everyday work.

The interactive newborn bath.

The interactive newborn bath is an innovative approach to the traditional baby bath. This article uses a Brazelton infant behavior perspective to describe a rationale and methodology for this family-centered nursing intervention. It offers the nurse detailed suggestions for observing and identifying infant states, interpreting infant behavior, calming and orienting newborns, and eliciting selected reflexes. In this approach, the nurse assumes an expanded role as a facilitator of infant-parent interaction. The baby's behavior and the bath experience are used to engage parents with their newborns. The nurse encourages parents to observe, touch, and respond to their infants in order to develop more responsive parenting skills and better enjoy their babies. The interactive approach can enrich nursing practice by transforming the standard newborn bath into an exploratory adventure in which the nurse joins with parents to better understand and respond to the newest member of their family.

Newborn Chemical Exposure from Over-the-Counter Skin Care Products

Human exposure to potentially toxic environmental chemicals is a major concern to our society. Over-the-counter (OTC) skin care products are a potential source of environmental chemical exposure to newborns. A prospective study was undertaken to define existing newborn bathing practices and quantitate environmental chemical exposure from OTC skin care products. One hundred-ninety six mothers of infants discharged from our newborn nursery were asked to respond to a questionnaire concerning newborn bathing practices and OTC skin care product usage. Complete questionnaires were returned by 23% of the mothers. The average newborn had 8 +/- 3 (+/- SEM) skin care products applied with the resultant exposure to 48 +/- 18 different environmental chemicals. Forty-seven percent of our respondents used a baby powder. The average one month old was bathed 4 times a week and was shampooed 3 times weekly. Seventy-eight percent of the respondents reported that their newborn had a rash but only 45% of those reporting a rash sought professional medical advice. Thirty-seven percent of the mothers reporting a rash made a change in bathing practice or product selection. In view of our findings, the human newborn is exposed to a large number of environmental chemicals thorough topical OTC preparations. The efficacy, transcutaneous absorption and potential toxicity of these products should be investigated.

Bathing of the New Born

Bathing of the New Born