nursing policy on handling infant that is not bathed

Specialties Ob/Gyn

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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!

The policy at our hospital is to not bath the babies (or separate them from mom) for at least six hours after birth. Then the bath is done in the room with the parents and the baby is rewarmed by placing babe skin to skin with mom. A little sign goes in the bassinet that says "I haven't had my bath yet!"

I'll echo what others have said about vernix being beneficial for babies' skin and add that the scent of amniotic fluid on the babies' hands also helps them initiate breastfeeding.

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Specializes in Ante-Intra-Postpartum, Post Gyne.

Studies show that delaying the bath for the first 24hrs is beneficial for temp regulations. Some hospitals even have a policy to delay the bath for 24hrs and just wiping the blood and secretions away with a warm wash cloth. I delay the bath for 24hrs unless the parents request or the mother has a communicable disease like Hep C

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Specializes in Obstetrics.
A tub bath submerging the baby to the shoulders? What about the umbilical cord? When I bathe the babies after they come from the delivery room, I teach the fathers while I'm bathing and reiterate no submerging the baby in an infant tub until the umbilical cord falls off. So I'm curious how your institution handles that. Were you seeing trends of infants not being able to maintain their body temp due to being bathed within an hour after birth?
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Specializes in Ante-Intra-Postpartum, Post Gyne.

If the parents insist on a bath right after birth I will often do a tub bath (not fully submerged...those pink basins), the cord hasn't started to dry yet; but explain how to do it with less water until the cord falls off for subsequent baths. If I wait 24hrs I use a peri bottle with warm water and warm washcloths, layers of towels and chux (towel, chux, towel, chux, ect) under the baby; peeling layers as I go. The policy I sited is just an example; not my hospital.

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Specializes in L&D/Maternity nursing.

If a parent/parents wish not to have their baby bathed, we absolutely accomodate that. We use universal precautions and a sign/repeat this in report. There are many reasons why a parent may choose not to have their infant bathed, most of which were previously covered by posters, so I will not become a broken record with regard to that.

And on 99% of our patients, we know their HIV, Hepatitis, Herpes, other communicable disease status, so the "unknown" really is a non issue for us the vast majority of the time.

If we do the bath, we just try and complete it within our 4 hour "recovery" period before we turn the couplet over to routine post-partum/newborn care. I absolutely wait at least 1-2 hours after delivery before I even suggest that we do the bath (closer to the two hour mark) so that mom and baby can get some good skin to skin in and attempt to breastfeed a time or two. IMO, that is way more important than the bath. The bath can always wait.

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Specializes in correctional, med/surg, postpartum, L&D,.

Immediately after delivery, babies go directly to mom's chest. They are wiped off, and stimulated. They aren't taken away to a warmer for evaluation or assessment unless there is a respiratory issue. They are left to bond on mom's chest unless the mother requests differently, and surprisingly, many do at our hospital. We don't bathe until the infant has nursed as a rule of thumb. We have no formal policy on bathing babies. Dads are involved fully. Med can be given while in mom's arms. We see no reason to move them. Later, they're weighed, measured and a full assessment is done.

In Summary: Babies are bathed about an hour and a half after delivery. I've only seen one mom who requested that the infant not be bathed and that was in the past month. Whatever. It was her choice. It was my choice to only handle that baby with gloves and a gown.

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If the parents insist on a bath right after birth I will often do a tub bath (not fully submerged...those pink basins), the cord hasn't started to dry yet; but explain how to do it with less water until the cord falls off for subsequent baths. If I wait 24hrs I use a peri bottle with warm water and warm washcloths, layers of towels and chux (towel, chux, towel, chux, ect) under the baby; peeling layers as I go. The policy I sited is just an example; not my hospital.

That's really interesting. Fully submerging in a tub is normal practice here. I have NEVER heard that it's inadvisable to submerge until the cord has fallen off.

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Specializes in Obstetrics.
That's really interesting. Fully submerging in a tub is normal practice here. I have NEVER heard that it's inadvisable to submerge until the cord has fallen off.
Really? That is interesting... It's part of our teaching to make sure mom and dad know not to submerge baby in an infant tub until the cord has fallen off. Crazy how different things are.
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Specializes in Family Med, Adolescent Health, Lactation, Teaching.

I haven't worked post-partum, only L&D, but I have 2 kids and we were definitely instructed to keep umbilicus dry until after cord falls off. I'm so glad to read that there are hospitals where the baby is kept on mom's chest for everything! I think it's fine for people to gown up, it certainly can't hurt. But I realized thinking about this thread, all the babies I've dealt with in the hospital were swaddled and wore hats, so the only exposed part of their bodies most of the time was their face.

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

Of course the babies are swaddled, with hats on...PP nurses do a head to toe each 8 hrs...in between this we take their vitals, monitor their I&O, feedings, weigh, change their bottoms, yes the blankes and nities come off..They are bathed under a radiant warmer when their temp is stable. It appears many of these comments are from nurses that haven't actually worked in Post Partum/Mother/Baby. Don't forget what may be in the human body secretions, blood, urine and feces, not to mention spit up. To thine own self be true, so you may be true to your patient, family and all you come in contact with. This is for a normal birthing even after stabilization has been acheived....

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

thank you zeke - as i said i haven't worked PP. my first baby was born in an inpatient birth center (i was discharged less than 24 hours after being admitted) and my second was born at home, so i haven't witnessed the head to toe assessments, though of course that makes sense - i assess my adult patients every shift! i guess i just have a hard time wrapping my mind around the whole healthy-newborn-as-inpatient. :)

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