Today I was in the NBN from 7a - 3:30pm. Oh my goodness. I have never worked so hard in my life and have never been so frustrated with myself before! I am used to doing things right more often than not and I just can NOT get the hang of the newborn bath and general holding of the newborn. I got how to prop them up sitting, supporting under their chin and under the arm, but add in soap and water, not to mention wearing gloves, and I am a mess.
I tried bathing laying on a Chux in a bassinett, which was great til I got to the hair. THen I tried a football hold in one hand and using the other to pour warm water over head to rinse. Slippery and I was scared I would drop her into the sink.
I know, I know...practice.
I *was* the first one to notice jaundice in a little one today, and I did a TON of TPR's, so I did some stuff right. And I learned (mostly) how to generate charts etc. But I really really wish that I'd done better with the bathing. We are really supposed to do them in the room w/ the parents as a teaching/learning experience and I absolutely dread that.
Specializes in Obstetrics/Case Management/MIS/Quality.
how i love giving a newborn their first bath!! i lay 2-3 chux in the bassinet and the bassinet is under a standing radiant warmer to keep the little one warm. as the baby is cleaned, i remove a chux at a time to keep the baby always on a clean surface. at the end, i use a clean washcloth and squeeze warm water over the baby to rinse off the baby soap. then i thoroughly dry the baby and put on a diaper. then i wrap him/her in a dry towel and use the football hold to wash the hair, using a baby comb to comb out all the dried blood, etc. i usually then will do another shampoo for good measure and extra cleanliness and rinse that off well, dry thoroughly. the baby then stays under the radiant warmer for about 20 minutes or so to make sure the temp is back to normal. while under the warmer, i also put the baby blankets and undershirt in the crib to warm them as well for when the baby is ready to get dressed. nothing like the smell of a freshly laundered baby!!!
My grandbabies were both given tub baths after delivery. The nurse did the first one, but my son gave his second daughter her first bath, 15 months later. He was delighted, and the baby was very calm. I know the cord gets wet when we give baths, but it doesn't seem to be a problem.
BTW Their cords dried and fell of within ten days, without any cord care. It's not recommended at that hospital.
I agree that there is nothing wrong with a tub bath for a newborn, especially the first bath! The baby just spent 9 months floating in fluid, another few minutes with a wet cord is not going to cause problems, and the babies seem to be so much calmer in the tub! Unfortunately, not many units are set up with sufficient clean supplies and space to allow for tub bathing each newborn.
I agree that there is nothing wrong with a tub bath for a newborn, especially the first bath! The baby just spent 9 months floating in fluid, another few minutes with a wet cord is not going to cause problems, and the babies seem to be so much calmer in the tub! Unfortunately, not many units are set up with sufficient clean supplies and space to allow for tub bathing each newborn.
The reason our docs give for not giving tub baths early on isn't so much about the cord getting wet, since it's pretty darn boggy at that point. It's that it takes a day or two for the cord clamp to really compress that thing completely, and while the bleeding has stopped, that it's still a possibility for bacteria from the tub or water to get into the umbilical vessels.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
The latest research/evidence indicates that "cord care" need include nothing more than letting it dry and keep the area generally clean. There is no evidence that indicates deferring tub bathing OR using alcohol and/or methyline blue are helpful in preventing infection. Teaching parents to keep the area clean and the s/s of infection are effective and sufficient.
Glad you had an overall good experience in the Newborn Nursery!!
I worked in a newborn nursery for about 6 months before going to NICU. I never worked so hard in my life! Very busy, always lots to do and keep you busy. It was a great experience though, I really enjoyed it.
Just give yourself time to get into a routine with the baths and everything else .... it just takes time. Once our kiddos had 2 stable temps, then we could bathe them under the radiant warmer. When I first started doing it, I always did the body first. Got them all cleaned and dried. Then put a diaper on (learned to put the diaper on them before taking them to the sink after one pooped all the way from the bed to the sink!), took them to the sink and washed the hair. Then back to the bed to dry the hair and warm 'em up again.
But everyone had their own way of doing the baths. Another nurse always took the babies to the sink first and did their hair. So I started doing it that way after a while and found it worked out a lot better. That way I could take them to the sink, get their hair done ..... take them back to the warmer and dry their head off, then wash the rest of their body and not have to take them back out from under the warmer.
I'm just wondering why anyone is giving newborns tub baths at all. You're not supposed to do that until their umbilical cord falls off.
I have worked on an ob unit for almost 7 years and had never experienced the whole "bathing the baby in a sink full of water" until we had a nurse get hired on from a bigger hospital. I asked her the same question and she promptly told me that the baby has been immersed in water for the last 9 months and it is very soothing to them. She told me it doesnt hurt for them to have their first bath like that. It is quite amazing how calm they are when she does that. I know when I am bathing a baby...they scream. Except when I wash the hair. They seem to enjoy that.
I also worked in a low risk facility where it was very normal for all newborns to get a tub bath...pretty interesting
I have worked on an ob unit for almost 7 years and had never experienced the whole "bathing the baby in a sink full of water" until we had a nurse get hired on from a bigger hospital. I asked her the same question and she promptly told me that the baby has been immersed in water for the last 9 months and it is very soothing to them. She told me it doesnt hurt for them to have their first bath like that. It is quite amazing how calm they are when she does that. I know when I am bathing a baby...they scream. Except when I wash the hair. They seem to enjoy that.
I also worked in a low risk facility where it was very normal for all newborns to get a tub bath...pretty interesting
I understand the part about the cord already being wet. What I'm worried about is bacteria being transmitted through the cord since it's still so thick (not totally compressed flat in the clamp) and the vessels are still present.
how i love giving a newborn their first bath!! i lay 2-3 chux in the bassinet and the bassinet is under a standing radiant warmer to keep the little one warm. as the baby is cleaned, i remove a chux at a time to keep the baby always on a clean surface. at the end, i use a clean washcloth and squeeze warm water over the baby to rinse off the baby soap. then i thoroughly dry the baby and put on a diaper. then i wrap him/her in a dry towel and use the football hold to wash the hair, using a baby comb to comb out all the dried blood, etc. i usually then will do another shampoo for good measure and extra cleanliness and rinse that off well, dry thoroughly. the baby then stays under the radiant warmer for about 20 minutes or so to make sure the temp is back to normal. while under the warmer, i also put the baby blankets and undershirt in the crib to warm them as well for when the baby is ready to get dressed. nothing like the smell of a freshly laundered baby!!!
ummm i can just smell their pretty little heads and want to wrap them up in my arms and admire them. who wouldn't want to be a newborn in your care! you have a sweet way of taking good care of them little ones!
I agree with Gompers. I wouldn't be comfortable giving a tub bath to a newborn, particularly in a hospital sink. I do hope they're disinfected between babies. There may not be "evidence" of umbilical infection, but all it takes is one. One word- Vapotherm Enough hopitals do tub baths and it wouldn't surprise me if that practice eventually get's stopped, too.
I agree with Gompers. I wouldn't be comfortable giving a tub bath to a newborn, particularly in a hospital sink. I do hope they're disinfected between babies. There may not be "evidence" of umbilical infection, but all it takes is one. One word- Vapotherm Enough hopitals do tub baths and it wouldn't surprise me if that practice eventually get's stopped, too.
Gompers raises an interesting point that I hadn't heard before, and would love to read some research on.
I've given newborns tub baths in the hospital setting, but only in their own basin, never a sink. That does sound gross! Just like the Jacuzzi tubs used in labor-unless it is my own, there is no way I would get into one! I've worked in hospitals that had them in L&D, and they offer a great comfort to moms, but I can't imagine how they can be sufficiently disinfected between patients.
Enough hopitals do tub baths and it wouldn't surprise me if that practice eventually get's stopped, too.
QTBabyNurse, BSN, RN
136 Posts
how i love giving a newborn their first bath!! i lay 2-3 chux in the bassinet and the bassinet is under a standing radiant warmer to keep the little one warm. as the baby is cleaned, i remove a chux at a time to keep the baby always on a clean surface. at the end, i use a clean washcloth and squeeze warm water over the baby to rinse off the baby soap. then i thoroughly dry the baby and put on a diaper. then i wrap him/her in a dry towel and use the football hold to wash the hair, using a baby comb to comb out all the dried blood, etc. i usually then will do another shampoo for good measure and extra cleanliness and rinse that off well, dry thoroughly. the baby then stays under the radiant warmer for about 20 minutes or so to make sure the temp is back to normal. while under the warmer, i also put the baby blankets and undershirt in the crib to warm them as well for when the baby is ready to get dressed. nothing like the smell of a freshly laundered baby!!!