Best Practive for bathing neonates?

[BABY--RN]

I have ben asked to look into the best practice for bathing our infants in the nicu.. Right now we are using tap water and a name brand baby soap and lotion. Our yougest babes get a sponge bath, but some of our older ones do get to take a tub bath. What do you do in your units? The suggestion has been made by our ID department for us to use the adult comfort baths (wet wipes that do not require rinsing). ID doesn't like the idea of using tap water. I have not gotten hold of these kits yet and was just checking to see what everyone else was using.

Thanks for all your input,

Kim

level III NICU

North Carolina

[SteveNNP, MSN, NP]

I usually sponge bathe the ones with IV's, etc using warm water and J&J soap. The bigger ones get tub baths. I hose out the tub with Cavicide and rinse it well. I'm leery about wiping chemicals all over a baby and not rinsing it off..... (comfortbaths)

[BABY--RN]

Thanks Steve-

Cant say that I am fond of the comfort bath idea either.

[Jolie, BSN]

Why is ID concerned about tap water? Has it been shown to be contaminated? If so, what does the staff do about handwashing?

[prmenrs, RN]

I'm with Steve. Baby skin is very different than adult skin; the babies could actually absorb the ingredients of the body wash. It's one thing to use baby wipes on their bottoms, another to basically immerse them and not rinse it off.

By the time a baby is ready for a tub bath, they should be able to tolerate tap water. One tip: Use a clean plastic bag, place the tub into the bag, then bathe. That way the bathtub gets less germs. You still need to clean it, of course, but if any thing is left from the previous bathee, it's not a problem.

ELBW babies, esp relatively new ones, should have sterile water used for clean-ups; they shouldn't need all that much bathing, anyway.

[BABY--RN]

Our tap water was just tested...it had a very "earthy smell", but was "ok". Our babies each have their own personal bathtubs--so that is not an issue. Once again I agree that adult bath wipes are not a good idea, however our infection control nurse has given me this lovely project, and I was just curious as to what other NICU's were doing. Had not heard of using the sterile water for ELBW infants..Thanks for the ideas:Snowman1:

[prmenrs, RN]

Challenges in Neonatal Nursing: Providing Evidence-Based Skin Care

http://www.medscape.com/viewarticle/465017

Carolyn Lund has lectured extensively on this subject. She is @ Children's in Oakland.

You can also read the chapter in Merenstein and Gardner, or other reference nursing texts, about skin care and bathing. Search "neonatal nursing" on Amazon.

[cocco]

According to our policy ELBW infants are bathed with sterile water and older ones are bathed with tap water and J&J soap.

[SteveNNP, MSN, NP]

I have bathed several infants with sterile H2o who had some sort of open lesions, such as Langerhans Histiocytosis, CMV, HSV...... my VLBW's get "spot-cleaned" with a few sterile h20 bullets and a clean, soft wipe.

[Imafloat, BSN, RN]

Our babies get a swaddle bath with heated sterile water and J&J babywash as needed. Each baby has their own tub and "ramp." The tiny ones or fragile ones are spot washed with sterile water and 2x2s.

[t2000JC]

So where I used to work some people used the scrub brushes for the full-term babies first bath, especially if they were very "gunky". What do you think? t.

[prmenrs, RN]

So where I used to work some people used the scrub brushes for the full-term babies first bath, especially if they were very "gunky". What do you think? t.

MY opinion is that is a very bad thing to do. Not sure what you mean by gunky, but vernix is not all bad. I don't think it's important to get it out of every crevice. Using a brush can cause microabrasions, and a way for nasty hospital oraganisms to gain a way in. You can get most stuff off w/soft cloths/4x4's whatever you have. Might take more than one try on the hair.

Also, probably feels like sandpaper to the babies. No, no scrub brushes. No.