timing of newborn bath

Specialties Ob/Gyn

Published

THE MBU I WORK ON IS HAVING A DILEMMA ABOUT THE IDEAL TIME THE NEWBORN BATH SHOULD BE GIVEN. WE HAVE BEEN GIVING THE BATH SOON AFTER THE DELIVERY DURING THE MOM'S RECOVERY PERIOD. OUR NICU SEEMS TO THINK WE ARE COLD STRESSING THE BABIES. MOST NURSES DO THE BATH UNDER THE WARMER. ALSO IF BABY'S TEMP IS LOW THE BATH IS POSTPONED TILL STABLE. WOULD LIKE TO HEAR OTHER HOSPITAL POLICIES OR ROUTINES ON THIS SUBJECT.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

omg Debbie that is awful....I feel for the moms and babies where you are too. and NO NOT ALL BABIES ARE TRULY COLD-STRESSED...maybe they need to realize what true cold stress is, versus what it is NOT.

And I heard about NOT bathing babies for first breastfeeding at a WHO conference and also from our LC specialist. I say why not?whats the harm in allowing skin-to-skin--- (just the way to avoid cold-stress)--- contact JUST as they are born to allow the BEST opportunity at bonding and breastfeeding? Better than an Ohio warmer, anytime, really! I think there IS something to it! I can't believe babies are whisked off to nurseries in this day and age. Glad I work where I do.....that would definately not sit well w/moms and other nurses here.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Perhaps practices after birth are regional? I am noticing some patterns here......here on the "left coast" (just a saying), we don't whisk healthy babies anyplace....no place I know does this....

But..... I remember in OK we DID take ALL Newborns into the nursery, no exceptions, for 2 hours' transition. I never questioned that practice cause I knew no better. Now I do. Glad I am out here now. It's just not sensible to put all babies in a warmer if they are stable....nothing better than Mom's arms and breast right after birth to ensure a nice transition for baby. Anyhow that is just my opinion........:rolleyes:

Specializes in NICU.

Do you do Ballard scoring on ALL your babies? It's not done here on normal term newborns, only on the pretermers, and then usually by the hospitalist.

We seem to have a problem with cold babies, especially small ones, being put skin to skin to warm them up. 20-30 mins of breastfeeding is good, but sometimes it burns up more calories than they are getting, to keep warm too. We don't have warmers on pp, so a baby has to go in an isolette which doesn't always work as well. On the other hand, they warm up much faster if they are covered up properly, on mom or in the isolette.

I wish I could get them to use warm bath blankets on the babies after delivery, but that's another project.

Originally posted by SmilingBluEyes

NOT A THING; ya missed my point, I guess. We should care somewhat about patient satisfaction. One way to help ensure it is to let MOM AND BABY bond first! Having 3 or 4 pairs of hands on the baby before Mom gets her chance IS NOT user-friendly.

I am sorry, I just think your system there sounds a bit wasteful and NON-baby friendly. Patients should be the FIRST Ones handling their babies, if they are healthy. NOT RT's and 2 or more nurses.

And RT has much better things to do than catch healthy babies where I work, I guess! (just ask them).:roll

I think you missed my point too. That was teasing, hence the big cheesy grin. I also think you aren't reading all of my posts. Most babies are put directly on Mom's belly. Moms and babes have the opportunity to bond, breastfeed, or whatever, for the first couple hours. THEN they go to the NSY for transition. I NEVER hold a baby before Mom and they are only taken out of Mom's arms for the few minutes it takes to weigh them. I don't why they do it in the room instead of the NSY. Probably because, as soon as baby hits room air, Mom is asking how much it weighs. :rolleyes:

And our RT's are assigned to OB. So I assume they consider it their job to attend births. :)

Ballard vs. Dubowitz???? Here in NY we use Dubowitz. Anyone out there know the defference? I hear a lot of people mention Ballard, does anyone else use Dubowitz?

Here we do the Dubowitz on every baby term or not because dating by LMP is so not an exact science.

As far as the warm blankets when baby goes to the mom's chest. Where I work most of the nurses ask the mom ahead of time if she wants to be skin to skin right after birth, as long as the baby is stable (crying, pink, etc.) and we put extra baby blankets or a large bath blanket/towel under the warmer. We turn it on at the same time we turn on oxygen, suction, and call for an extra L &D nurse, if one is available--at caput. That usually gives about 3-5 minutes for the blankets to get warm and then we put them over mom and baby. It works well. Cold blankets and the baby usually does get cold--the warm blankets and skin to skin help a lot.

I'm Curious....what's the rationale behind the "no Vit K before the bath"???? This is something new to me. What sort of time table then do you have to get the bath in and the Vit K in or do you have one????

Interesting how very different practice is everywhere. You'd think it would be more universal. ????????????????????????????

Originally posted by Mimi2RN

Do you do Ballard scoring on ALL your babies?

Yes, our NSY Ballards all newborns. That's how they determine SGA, LGA, AGA.

Originally posted by SmilingBluEyes

whats the harm in allowing skin-to-skin--- (just the way to avoid cold-stress)--- contact JUST as they are born to allow the BEST opportunity at bonding and breastfeeding?

I'm curious. Do you never have a Mom who wants baby cleaned up before she wants to touch it? We encounter that quite a bit unfortunately.

Specializes in Maternal - Child Health.

Delaying elective needlesticks until the bath is given reduces (in theory) the risk of transmitting hepatitis, HIV, and other blood-borne infections.

Originally posted by susancox

Ballard vs. Dubowitz???? Here in NY we use Dubowitz. Anyone out there know the defference?

We turn it on at the same time we turn on oxygen, suction, and call for an extra L &D nurse, if one is available--at caput. That usually gives about 3-5 minutes for the blankets to get warm and then we put them over mom and baby. It works well. Cold blankets and the baby usually does get cold--the warm blankets and skin to skin help a lot.

I'm not familiar with Dubowitz. I have only ever seen the Ballard scale used at the facilities I've been in.

We also stick the blankets under the warmer. But instead of calling for another nurse, our RT is there. I don't see what the difference is between 2 nurses or a nurse and an RT is. With only 2 or 3 other L&D nurses on the floor, there might not be an "extra" one available at delivery.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

NO we don't Ballard or Dubowitz babies unless known SGA/LGA (by dates or appearance---usually it's obvious) and blankets are kept warm in our warmers which are in each room...they are stocked with 3-4 baby blankets each that stay warm continuously. This with skin-to-skin contact keeps them warm enough 99.9% of the time, really.

At our hospital babies are put under the warmer until stable and assessments are completed.

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I would love to know the story behind this photo...

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