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Discussion

Newborn Baths

Hello all. I would like to know at what hour of life you perform the initial newborn bath? Also, if there is evidenced based practice on delaying a newborn bath past 6 hours of life. Any info would be greatly appreciated. Thanks.

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We usually give baths around 2 hours of life and if their temp is atleast 98 F

This study finds that delaying bathing from 2.4 hours after birth to 13.5 hours after birth increases in-hospital exclusive breastfeeding rates from 32.7% to 40.2%. The odds of initiation of breastfeeding were increased by 166% when bathing was delayed.

Preer, G., Pisegna, J. M., Cook, J. T., Henri, A., & Philipp, B. L. (2013). Delaying the bath and in-hospital breastfeeding rates. Breastfeeding Medicine: The Official Journal Of The Academy Of Breastfeeding Medicine, 8(6), 485-490. doi:10.1089/bfm.2012.0158

This study discusses the risks of early bathing, including infant colonization of unfavorable hospital flora (as opposed to maternal flora), increased risk of hypothermia, and removal of the vernix, which is protective against E. Coli bacteria.

Sobel, H. L., Silvestre, M. A., Mantaring, J. 3., Oliveros, Y. E., & Nyunt-U, S. (2011). Immediate newborn care practices delay thermoregulation and breastfeeding initiation. Acta Paediatrica (Oslo, Norway: 1992), 100(8), 1127-1133. doi:10.1111/j.1651-2227.2011.02215.x

There are also the benefits of vernix:

"A multiple-site national study was conducted by the National Association of Neonatal Nursing (NANN) and the Association of Women's Health Obstetrical and Neonatal Nursing (AWHONN) in 1998.69 A consensus statement based on the results of the study directed “removal of all vernix is not necessary for hygienic reasons” and “vernix may provide antibacterial promotion and wound healing”. Interestingly, the World Health Organization (WHO) also recommends leaving vernix intact on the skin surface after birth.70"

UNRAVELING THE MYSTERY OF VERNIX CASEOSA

Although I don't love the cheese, I probably won't have my kids bathed right away either, especially with rampant noscomial infections

We currently bathe newborns between the 1st and second hour. We are in the process of going baby friendly, so this will change soon.

The other hidden benefit is that we nurses tend to keep our hands off noobs (or at least wear gloves) when they are still "contaminated" from birth.

well...respectfully, I don't think the fact that you don't have to wear gloves with a newborn that has been bathed is a sufficient justification to give them a bath.

  • Experts

We wait for the bath until at least 6 hours, sometimes more if kiddo hasn't breastfed well yet or if parents don't want it.

Some of our kids go home with no bath at all.

Only exceptions are if mom is positive for a bloodborne pathogen such as HBV, HCV, or HIV.

We bathe between two and twelve hours, depending on temp stability, breastfeeding, and parental choice.

well...respectfully, I don't think the fact that you don't have to wear gloves with a newborn that has been bathed is a sufficient justification to give them a bath.

I think you misunderstood. She said that was a benefit of NOT bathing - then nurses wear gloves to touch them (i.e. less of risk of nosocomial infection in the infant).

well...respectfully, I don't think the fact that you don't have to wear gloves with a newborn that has been bathed is a sufficient justification to give them a bath.

We don't wear gloves with our babies, and the closest thing they get to a bath is if they happened to be born during a water birth! Of course, that doesn't remove vernix. Our moms go home 4-12 hours post-birth (this is a freestanding birth center). We'll wipe them down some, but Mom and family get to give the first bath unless it's specifically requested.

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