Baths on your unit

[debstmomy]

Looking for some input!!! We are devoleping new bathing protocols for our unit come early next spring. While I do need evidence based information, I thought I would start with some general information gathered from other units. If you could help me out, that would be great! If you have links for evidence based studies, even better!

How often do you bath your babies??

Do you use bath tubs on your unit?

What soap/lotions does your unit use??

I'll just start with those basic questions for now!

[NicuGal, MSN, RN]

It depends on the baby as to how often they are bathed. We weigh most of our kids over a kilo every 3 days, under a kilo and stable twice a week or as ordered. We give them a wash down then and we change linens with weights or as needed. Under a kilo we use sterile water only, over a kilo we can use soap.

We still have Johnson's on the floor but many parents bring in Aveeno baby.

We don't use tubs unless the parents bring their baby one...we can't share tubs per ID. We will use the foot basins for the smaller kids if the need a tub bath or have a sore butt that need soaked.

[newnicurn]

We bathe infants 3 times a week. We weigh all patients everyday unless they are not medically stable ie HFJV or HFOV, nitric oxide, 5 channel pnemogram. We use Johnson and Johnson baby soap, and water from the sink. I use my own discretion to use sterile water from time to time. We use basins for "sponge baths" but do not submerge babies in water before 2 weeks of age.

[milkglass]

We don't have an official protocol for our unit but here's how it goes. Most of our babies are weighed on bath nights, which is Tues, Thurs, Saturday. We use to weigh every night, but was determined unnecessary. It's soap + tap water. Sterile water is used for those under 32wks or 1000grams. Of course if they are unstable at any size, we may not bath/weigh that night.

We have two "speciality" areas in our unit with their own protocols.

-One is the "small baby" area (born

- The second is the "chronic baby" (usually diagnosed with BPD or has a prolonged hospital stay) which are bathed three times a week (Tues, Thurs, Sats) and weighed one (Thursdays)

We use Johnson and Johnson soap. We use small sterile bowls (which are probably bowls used in the OR) that we keep in their bedside drawer til they're D/C'd. We basically give sponge baths in the bed. Only the older chronic kids get actual tub baths, and they are the type of tubs you would buy for your own home.

No policy on lotion currently. Some of the older nurses tell parents not to (I don't know the reasoning), but most people say yes to baby lotion if they're bigger (in step-down, getting ready to go home, or in the chronic area).

Hope this helps! What is your unit currently doing?

[champagnesupeRNova]

Wow our unit is so different. We weigh all babies every day regardless of their status. We have no set in stone policy on baths. It's really up to the nurse's discretion. For feeder/growers, they might get a bath once a week. For the babies in isolettes and oxygen, baths are really low on the priority and they sometimes only get wipe downs once every 2 weeks. I would really argue that NICU babies don't need baths 3 times a week - that seems unnecessary.

[katierobin23]

We do weighs every night unless the baby is really sick and unstable. Baths are every other night once stable. We always use sterile water. Johnson's and Johnson's is the soap we have, but it's at the nurses discretion when to use it or not...most do, depends on the baby.

I might be off on the exact time frames, but our policy looks something like this: The first bath is delayed if the baby is on any sort of o2 support. After 48 hours, we can bathe if Fio2 requirement is 30% or less on NC or HFNC. Same for CPAP/stable conventional vent after 72 hours. HFJV kids don't get bathed unless absolutely necessary.

At any point, if the nurse feels the baby won't tolerate a bath, we do not have to give it. Every other night is more of a recommendation than a requirement. On the flip side, if a baby seems to need a bath (smells bad, greasy hair) even though he/she got one the night before, we can do another one. That usually only happens on our older kids or the big sweaty ones.

We change linens with baths or as needed :)

Funny how different units can vary so much on things like this.

[NICURN29]

We bathe every 3-4 days, and we schedule according to when the families can some in and take part in it (unless the baby is too unstable, in which case the night nurses do it). It can be anything from a quick wipe down to a complete sponge bath to a swaddle bath in a pink basin to a bath in a baby tub. We weigh every night, unless a baby is very unstable, and that is on night shift. We do head circumference and length weekly, on Sunday nights.

ETA - We also use J&J soap, although we usually just use water on the littler babies. And we don't routinely put lotion on our babies. Some parents bring it in, but the nurses don't use it on the babies.

[HighCensus]

I just got done developing guidelines for the use of bathtubs in our NICU in conjunction with infection control. Most evidence based information is going to be against the use of bath tubs. Because of our unique population in my unit we worked on guidelines that would balance infection control prevention and developmental care. With that being said not each of our patients qualifies for a bathtub.

We bathe patients every Tuesday/Saturday and prn. For our smaller babies or unstable patients we use bath wipes. Patients progress to sponge baths, swaddle bathing, or tub bathing depending on their developmental needs.

We use J&J for bathing although some patients have Aveeno baths scheduled. J&J lotion depending on the patient.

Here are two resources for bathing:

Am J Crit Care. 2009 Jan;18(1):31-8,41; discussion 39-40. doi: 10.4037/ajcc2009968

Am J Infect Control. 2012 Aug;40(6):562-4. doi: 10.1016/j.ajic.2011.07.014. Epub 2011 Dec 16