timing of newborn bath

Specialties Ob/Gyn

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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.
Originally posted by L&D_RN_OH

Because the Nsy nurses do the transition here. Not the L&D nurses.

The RT's do the intitial assessment and Apgars. The L&D nurses do a set of vitals at 30 min, allow parents and baby to bond for an hour or two, assist with breastfeeding, etc. But the full assessment, Ballard scale, Vit K, erythromycin ointment, and bath are done in the NSY, unless nursery staffing allows for a NSY nurse to transition at the bedside. Our policy states the newborn assessment must be done within 2 hours of birth. I keep them with Mom as long a I can, but if I wait much longer than 2 hours, the NSY will hunt me down. ;)

After Mom's recovery, she is turned over to the Mom/Baby nurse by L&D and report is given to her on the baby from the NSY nurse. Make sense?

NO none of this makes sense to me at all. It sounds inefficient and VERY un-patient-friendly (not to mention NOT baby-friendly). Sounds like a HUGE waste of resources to me on a well baby. We as LDRP nurses accomplish ALL the above, and RT never ever gets involved (nor does nursery) UNLESS a baby IS SICK. I am amazed any place works like this.

Just where do PATIENT's needs fit into this routine there? I can't see much opportunity for teaching and bonding, which are CRITICAL in that first hour or two. It sounds awful! It would not work where I am, at all. And as a birthing family I would have a HUGE problem with such a routine at your hospital. "Hospital routines" are a HUGE source/reason for dissatisfaction expressed by many patients....causing many to then elect to go to midwife-run birthing centers or simply birth at home in subsequent pregnancies. I can see why in some cases. Sorry.:kiss

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

dupe post sorry.

Specializes in cardiac, diabetes, OB/GYN.

I should have mentioned that I don't ususally do the bath before two hours, and in ldrps, to me the recovery phase is ongoing..I don't rush them into having baths. I take my cues from the parents AND if it is really busy, we delay, delay delay...some of our patients ask that no baths be given..Sorry, should have clarified myself..I do not rush into it...I would rather they savor the time with their baby...

Okay...I have a dumb question for you all...Are all babies given thier first bath that early. I don't remember my 2 kids getting their first bath until hrs later and I did it. Was I actually giving them their 2nd bath? They were both still cheesy and little bloody behind their ears..

This is such a great board that I've been checking every so often since preggo with #3..by the way I work in geriatrics so OB/GYN stuff is a whole different world for me:eek:

No Michelle, a lot of hospitals do the bath hours and hours later. I have worked in places where the routine was to wait until the next day. We did wipe them with towels, but baths were delayed because there has been some research showing it imporves breastfeeding and bonding. OB seems to be an area that is the least based on evidence, so you'll find that hospital policies vary widely.

SmilingBluEyes...can you be my nurse when I have my baby in February? :D

This is interesting. In comparison to the practices in United Kingdom, bathing in the first few hours is not common. They can have their bath whenever convenient or necessary (i.e. going home and it's the first born child,baby got dried lochia,parents wishes). Admission to the NICU because of cold stress is usually caused by forgetting to keep the baby warm all the time, and in our setting nothing to do with bathing.(NICU nurse):D

Babies here are bathed at least 2-3hrs after birth, if not more.

They stay in L&D until about 1.5hrs PP and then moved to the PP floor. There the nurse does a check over and then lets the PT know that the baby can be bathed whenever the PT wants.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Originally posted by littlemrs

SmilingBluEyes...can you be my nurse when I have my baby in February? :D

I would be honored!:kiss

I read a reply talking about all the things done pp in the NBN and not in the L&D room. The post read that vit K and erythromycin were given in the NBN. Where I work it is protocol that they are both given in no more than one hour from birth. I only takes a couple of minutes to do both, so I don't see why it would be delayed. In the L & D room we do both plus a physical by both the baby or labor nurse (if we have a free second L & D nurse to help do the baby stuff we do get one in to help) and a resident, the dubowitz to date the baby foot prints and bands, vitals at 1/2 hour, 1 hour and 1 & 1/2 hour marks. after this they can be transfered to post partum. The bath only gets done if we have the time. Sometimes it is too busy and we need the room for another laboring pt. The baby has to have a temp of at LEAST 36.4 C AND have eaten (which I haven't seen mentioned) before the bath. The babies that need to be in the special care nursery don't get most of that in the room only because they are usually rushed off to the SCN after resp distress, a mag baby, etc. and c/section babies. Other than that we do that all.

I have a question--do all of you L&D nurses have to have current NRP certification?

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Originally posted by susancox

I read a reply talking about all the things done pp in the NBN and not in the L&D room. The post read that vit K and erythromycin were given in the NBN. Where I work it is protocol that they are both given in no more than one hour from birth. I only takes a couple of minutes to do both, so I don't see why it would be delayed. In the L & D room we do both plus a physical by both the baby or labor nurse (if we have a free second L & D nurse to help do the baby stuff we do get one in to help) and a resident, the dubowitz to date the baby foot prints and bands, vitals at 1/2 hour, 1 hour and 1 & 1/2 hour marks. after this they can be transfered to post partum. The bath only gets done if we have the time. Sometimes it is too busy and we need the room for another laboring pt. The baby has to have a temp of at LEAST 36.4 C AND have eaten (which I haven't seen mentioned) before the bath. The babies that need to be in the special care nursery don't get most of that in the room only because they are usually rushed off to the SCN after resp distress, a mag baby, etc. and c/section babies. Other than that we do that all.

I have a question--do all of you L&D nurses have to have current NRP certification?

Yes, Susan, the need for TEMP, RESPs and SUGARS to be stable WAS indeed mentioned a couple of times above---this is a given for all newborns prior to bathing ...period.

And yes,where I work ALL RN's having anything to do with babies (that is labor/delivery, postpartum and newborn nursing) MUST have NRP certs current at all times. That is mandatory and if it lapses, we are taken off the schedule until we GET current. It's that important.

Want to add that we have a new policy, no Vit K until the first bath regardles of mom's PNC or labs.

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