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!

Not in the US but I'm pretty sure a bath soon after delivery is not common where I am. When I had my kids, any visible blood was given a bit of a wipe with a towel. I gave them a bath in the tub the following day.

When my grandkids were born, they weren't bathed at all until they were home. I don't think it was anything to do with temperature regulation or the umbilical cord, it was just considered unnecessary. Their parents were advised not to wash the vernix off when they did bath them, just let it come off in its own time. They all had a bit of vernix in their skin folds for a week or more after they were born despite a couple of baths.

I don't work in OB so would like to learn more about the reason for bathing a baby shortly after birth. If it's to do with blood or body fluids on the baby's skin, wouldn't staff be wearing gloves anyway?

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Vernix has good antibacterial properties?...so what! Washing with soap and water is also antibacterial... Oh Lordy.. Oh Lordy when will the insanity stop, and medicine become more of a profession again. PROFESSIONAL vs. Google search MedicineMD. Duh........:bugeyes:

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Vernix has good antibacterial properties?...so what! Washing with soap and water is also antibacterial... Oh Lordy.. Oh Lordy when will the insanity stop, and medicine become more of a profession again. PROFESSIONAL vs. Google search MedicineMD. Duh........:bugeyes:

Why do you think it's insane and/or unprofessional to leave vernix on a newborn's skin?

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Well, enlighten me with why it isn't? Vernix shields the infant from bacteria growth for what period of time? :barf01:

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:eek::eek: I'm not OB/GYN was just surfing. Why in heaven's name would anyone refuse their baby a bath???? What's the rationale? The bigger question is why would the hospital comply?

Strike the last question. Customer service.

A friend of a friend of a friend said it was a good idea and that they should include it in their birth plan.

I posted prior to reading the full thread and seeing that several people have specific reasons for for not doing so and I can respect that ---- but , I still say for the average person requesting it, they don't really know why.

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A friend of a friend of a friend said it was a good idea and that they should include it in their birth plan.

Well, it is official... if it comes from a friend-of-a-friend, and of another friend...then, it is true. My friend's friend had a friend..and he was a great friend of a friend's friend.

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Well, enlighten me with why it isn't? Vernix shields the infant from bacteria growth for what period of time? :barf01:

There are other benefits besides some protection from bacterial growth. I don't know how long the protective benefits last but does it matter? If it isn't harmful, if it's actually beneficial, why the need to wash it off?

I haven't done any research because it's not something I've ever had to worry about before, I was taught years ago there are benefits to leaving it and in my personal experience I've never been told it should be washed off. Just had a quick look now and found these - I acknowledge it wasn't a 'thorough review of the literature'.

Medscape: Medscape Access

National Guideline Clearinghouse | Neonatal skin care, second edition. Evidence-based clinical practice guideline.

http://www.rch.org.au/rchcpg/index.cfm?doc_id=12620

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
There are other benefits besides some protection from bacterial growth. I don't know how long the protective benefits last but does it matter? If it isn't harmful, if it's actually beneficial, why the need to wash it off?

I haven't done any research because it's not something I've ever had to worry about before, I was taught years ago there are benefits to leaving it and in my personal experience I've never been told it should be washed off. Just had a quick look now and found these - I acknowledge it wasn't a 'thorough review of the literature'.

Medscape: Medscape Access

Very educational.....I have specialized critical care and emergency medicine. I like learning something every day. I like Medscape.....you have to register but it is free. I ahve belonged a long time.

OK next question.....What could be spread by not bathing them.

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Stick around long enough, it'll go full circle again. Anyone remember Leboyer?

Years ago when that was all the rage, some parents were absolutely convinced that their child would not be well adjusted unless they had the warm bath immediately in the delivery room.

Thankfully, most do just fine, in spite of us. :specs:

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Specializes in LTC/Rehab.
sommeil, I'm curious, did you allow your baby to be wiped with warm cloths? Hair washed? Or was it straight from the womb, towel-dried and that was it? In the hospital where I did clinicals, the baby was placed under a radiant warmer and skin temp was monitored while the extremities and core was washed and dried. Then the baby was dressed, swaddled, and the hair was washed, immediately dried and a hat put on.

With my 2 born in the hosptial we allowed them to wipe them off with warm cloths. With my two born at home (waterbirth) I just put them up against my skin and then put a towel over us.

The place where i'm doing clinicals has techs that wash the babies. Some of them are really good about keeping baby warm and some of them are not.

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Specializes in LTC/Rehab.

diligent-trooper:

isn't it great that we have a choice to wash or not! does it bother you if mom doesn't want to wash her baby? we have a large native american population here and some of the moms believe that if they put the meconium on their face it can take away their melasma.

i don't believe it does but if that's what they want to do and they aren't hurting anyone, then who cares?

most of our moms here keep their placentas too. some plant trees and some eat it. again, totally their choice.

i'm glad i'm living in a state that has very open-minded, non-judgemental people. our hospitals do water births here too. it's great.

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Specializes in Maternal - Child Health.

Any bacteria/virus that is present blood or body fluids (cervical or lady partsl secretions, amniotic fluid, possibly urine) such as HIV, hepatitis B & C.

Herpes is transmitted from mother to infant during delivery by contact with infected cervical secretions and/or undetected lesions, so I believe that herpes virus may be present on the surface of the unbathed newborn's skin.

Also, while CMV is usually transmitted via the placenta during pregnancy, it is also a bloodborne pathogen. I believe it may also be present on the skin surface of an unbathed infant.

http://www.humanillnesses.com/Infectious-Diseases-Co-Ha/Congenital-Infections.html

Vernix provides antibacterial protection to a newborn's skin and is also an excellent skin protectant. (That's its job in utero, after all.) I have never advocated scrubbing an infant to remove vernix. It wears off rapidly from exposed skin, and poses no risk if it remains only in the baby's creases.

There is no need to wear gloves simply to handle a baby once it has been bathed, and I believe that it is beneficial for a newborn to experience skin contact with caregivers, whether parents or nurses. But if mom and dad don't want junior to be bathed, gloves are a must, and I agree with previous posters that a gown should be worn also. Why risk transferring dried blood onto your scrubs and then onto another baby?

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