nursing policy on handling infant that is not bathed

Specialties Ob/Gyn

Published

We have recently been having more and more parents who request their newborn NOT to receive an admission bath and shampoo. Sometimes these infants are not bathed for their entire stay. We do follow universal precautions, but I am wondering if any other hospital has developed a policy on how to handle these infants. We are considering a crib tag that states "contact precautions". I work at a hospital with over 4000/deliveries a year. I appreciate anyone's input on how this situation is handled at your hospital. Thanks!

Specializes in Community, OB, Nursery.
this is a great idea, but at our hospital the mom and baby are not separated. They come out to post partum as a couplet. Most of the time (unless parents refuse) the infant is bathed in the room it was born in and rewarmed under that Ohio table. If the bath is delayed, so is the recovery and transfer to postpartum. If we do the bath after they are admitted to the floor, we would need a warmer in every room or babies would leave their mom after admit and go to the nursery for a bath and rewarm. Thoughts?

My place works more or less like this too, and most of our warming - both immediate post-delivery and post-bath is done skin to skin with mom. If Mom understands how to keep baby close to her and with a hat, it works way more often than not. Caveat always being that we're talking term healthy kids.

I'd be willing to bet a LOT of money that the average door handle in a hospital has WAY more germs on it than an unbathed newborn. Lol

Specializes in Postpartum, Antepartum, Psych., SDS, OR.

Foam/wash in and foam/wash out side the door.

Specializes in Trauma, ER, ICU, CCU, PACU, GI, Cardiology, OR.

i'm on board with the last two post... :yeah:

We just leave a sign on the crib that says please do not bathe me and the staff knows that they need gloves in this situation.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I absolutely can not stand the level of medical involvement when it comes to the birth of children. When I did clinicals, each one of the pt's of the students had not even had their babies given back to them yet because they were still back in the nursery "under the hood" or waiting for who knows what. Out of three point, two had episiotomies and one had a c-section.

The birth that I witnessed was so impersonal, the mother was not encouraged to take her baby, it went under the all important hood even though he was perfectly healthy, the father was pushed to the side and not encouraged to take part....ridiculous! The baby does not need to be bathed for more reasons than I care to take the time to list because they should be obvious, baby should be wiped off and be placed on mom's chest, lightly covered with a blanket, and allowed to bond, rest and soon nurse and the father should be encouraged to be right there with them. Any tests that need to be done should be done in the room, under a hood if needed, because the rooms can get chilly. No reason for the infant to be taken from the mom unless there is an absolute need.

My pt asked for her baby several times but had to wait for the nurse, who really seemed to care less whether mom got her baby now or in 3 hrs and oh, guess what, after having been away from mom for four hours, his blood sugar dropped...oh sorry mom, now you have to wait longer so WE, complete strangers, not you, can feed your baby, then wait and recheck the glucose...then a blood draw to make sure everything was ok then finally mom got to see her baby, about five hours after he was delivered. Oh, now WE will allow you to bond with your child.

I don't care if you have to wear gloves and a gown, yes the baby needs close personal contact, but not from YOU, from his/her FAMILY. I was sorely disappointed with the birth experience of my two children, I would have chosen a midwife or a doula but there are not available in my area, and probably wouldn't have been covered by my insurance...sad

I am sorry your experience in OB rotation was disappointing.....maybe th4ere were circumstances at foot that you were not aware of.......but we as nurses need to be very careful to not press our personal opinions and biases on patients. It sounds like this unit needs some guidance. It has been my experience that most OB units are very accommodating to the parents wishes and birth plan. There are always certain circumstances that raise ire amongst staff whether it is circumcision, immunization, and bathing a newborn.

I also feel bad that your were disappointed with your own birth experience most insurances do pay for midwives but probably not a doula. I know in my birth experience....I refused the epidural because I was terrified of a forcep being used. I was just glad they were born alive and unharmed. Peace:paw:

Specializes in Postpartum, Antepartum, Psych., SDS, OR.

Not knowing the big picture makes all the difference in the world. Maybe they were short in the nursery or the infant needed special care or another infant in the nursery did...unknown factors slow down the process of getting the babies out to parents.

Specializes in Family Med, Adolescent Health, Lactation, Teaching.

This is true but the fact remains, the standards for mother-baby friendly policy is that the default should be that the mother-infant dyad stays together. We're supposed to be moving away from having rows of healthy babies each isolated in their own little bassinet.

Specializes in Community, OB, Nursery.
This is true but the fact remains, the standards for mother-baby friendly policy is that the default should be that the mother-infant dyad stays together. We're supposed to be moving away from having rows of healthy babies each isolated in their own little bassinet.

Absolutely, you are right. Term healthy kids should stay with their moms, key there being term and healthy, and most fit that description. If there's an issue that needs closer monitoring, which is fortunately rare, then my job becomes making sure that baby is safely monitored. All the term healthy kids at my place come to the room with their moms, get bathed there, and most never leave. I like it better that way and don't believe in separating newborns from their mothers any more than absolutely necessary - but sometimes it is necessary. Separation should not be the norm, though.

Specializes in Postpartum, special care nursery.

Some moms choose to delay the first bath because of the protective properties of vernix, as mentioned before, and I've heard a couple other reasons.

- They want to experience the complex pheromonal cascade going on immediately post-birth.

- They don't want to interfere with or interrupt bonding, skin-to-skin, and breastfeeding.

- They are concerned about the harsh chemicals, dyes, perfumes, petroleums, and preservatives in the soaps that are typically used.

Oh yes...I remember one of our docs attempted a Leboyer..tried to plug up hole in bottom of bassinett,,,what a flood!

Well...can't really do this without the gross factor...there are some deliveries where mom passes her bowels, along with baby,,if baby has a fair amt of hair...really think this baby needs a good shampoo..

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