Delaying the newborn bath

cayenne06, MSN, CNM · Apr 19, 2016

Can I get some information on what you do at your facility regarding bathing the newborn? How did staff react? I know majority of the research states to delay the newborn bath 12-24 hours. We are looking into delaying the bath as well (currently we bathe approximately 2 hours after delivery, unless parents request to wait). I'm already seeing (and hearing) pushback and it hasn't even been instituted or really talked about much yet. The culture on this unit is very "this is what we've always done". Thanks! I appreciate any info!!

You hit the nail on the head with the comment "this is what we've always done." The only way to implement a change like this is to get staff buy-in, and make it EASY. So, education sessions regarding the benefits of delayed bathing with plenty of time for concerns to be addressed. Input from the staff about the barriers they might face to implementing this, and ideas about how to fix them. Take a look at your postpartum flow in general- is admitting breathing down your neck for weights and measures asap? Are nurses worried about handling "contaminated" babies?

Usually most of it comes down to the huge amount of tasks we have to complete after birth, and a desire to get it all done asap, so as not to burden the oncoming shift and to have everything ready in case you have to switch gears to a new admit. I think it is important to make it a unit-wide protocol, so that there are no ifs ands or buts about it, and the nurses don't have to worry about the oncoming shift being upset about it not being done.

Once you are ready to implement the changes needed to support the protocol, you have to then assess how it is affecting the work flow and other aspects of patient care, and make adjustments if needed. I started working (as a student CNM) in a big tertiary unit just a month or two after they implemented the change to delayed bathing. I didn't meet a single nurse who wasn't happy with the change- it really made the initial PP period much less rushed, and when it is finally bath time, mom is usually recovered enough that she can fully participate if she desires, which really facilitates education for new moms.

If you are making a big culture change like this, you might as well throw in 1 hour of uninterrupted skin to skin for stable (and willing) couplets, while you are at it :)

BSNbeauty, BSN, RN · Apr 20, 2016

I am interested in any articles you find that supports delayed bathing. I think it's a fantastic idea and will promote bonding and breastreading.

PinkNBlue, BSN, RN · Apr 20, 2016

Cayenne, thank you SO much for that information. I think that will be extremely beneficial in the roll out of this new initiative. I greatly appreciate your input. The culture of the unit is very negative, which is so upsetting to me. It's all about what's best for the nurses when really, this needs to be about the patient and their experience. It's not about us.

prnqday, sure! I'll attach some articles here. UNRAVELING THE MYSTERY OF VERNIX CASEOSA

http://www.who.int/maternal_child_adolescent/documents/guidelines-recommendations-newborn-health.pdf (page 4)

“Wait for Eight”: Improvement of Newborn Outcomes by the Implementation of Newborn Bath Delay - Lipka - 2

BSNbeauty, BSN, RN · Apr 22, 2016

Thanks so much !!!!

lavenderskies, BSN · May 5, 2016

We put all babies that are not needing resus right skin to skin for min of an hour. Babies needing resus come skin to skin asap.

Even in the OR.

Baths may not be given until 6 hr out.

Calinurse4 · May 5, 2016

We just began delaying the bath at our facility this month. Under normal circumstances, we wait at least 8 hours but prefer longer. Since we have implemented it, half my patients have discharged without a bath. Most parents are really on board with waiting as long as possible. If and when the baby gets a bath, they get a yellow ducky hat and sticker on their crib card.

PinkNBlue, BSN, RN · May 12, 2016

Thank you guys! It's going to be a big challenge I can already tell. We get such grief from some of the nurses who've been there for ages already, if a parent requests to delay the bath currently. Frustrating. I appreciate everyone's input!

quazar · May 12, 2016

We put all babies that are not needing resus right skin to skin for min of an hour. Babies needing resus come skin to skin asap.
Even in the OR.
Baths may not be given until 6 hr out.

Same at my facility.

southernbelle08 · May 15, 2016

We have started delaying the bath if the parents request it. We also do not separate baby & Mom at all unless parents request it - and the majority still do. Otherwise, we give them a bath at a few hours old. At our facility we are trying to become more "baby friendly" but it has been slow going. People are used to the old ways.

kdot2003 · May 22, 2016

Still doing the 2 hour bath thing. Some patients want it sooner...

Strawberrygirl2 · Aug 6, 2016

I think our protocol says to wait at least 6 hours. We always wait longer, especially if there is breastfeeding difficulties or we are checking sugars or something, then we wait at least 12 hours. Some other hospitals in the area aren't even doing baths in the hospital anymore. I think that is fine as long as bathing technique and proper skin care in the diaper and cord area are discussed with patients. But I don't mind bathing them if the parents want it. Or if the hair is nasty and chunky, because... come on....