nursing policy on handling infant that is not bathed

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We have recently been having more and more parents who request their newborn NOT to receive an admission bath and shampoo. Sometimes these infants are not bathed for their entire stay. We do follow universal precautions, but I am wondering if any other hospital has developed a policy on how to handle these infants. We are considering a crib tag that states "contact precautions". I work at a hospital with over 4000/deliveries a year. I appreciate anyone's input on how this situation is handled at your hospital. Thanks!

Specializes in Postpartum, Antepartum, Psych., SDS, OR.

Gown, Gloves and clean any thing that comes in contact with un clean Mom and Infant prevents taking those little germs and who knows what else to your other patients. I love myself and will protect me, even when no one else cares.

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Specializes in ICU.

What will they think of next?

"Please do not diaper my child, as the confined environment of the diaper may inhibit their emotional growth."

:icon_roll

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I'm really surprised by the number of posters who think it's somehow 'out there' not to bath a baby shortly after birth. I think it must be one of those things that are different depending on what you're used to so you're surprised to hear others doing it a different way.

The hospital website I linked earlier says the first bath is usually given within 24 hours and that fits with my own experience of bathing mine the day after they were born. I think even this bath was more for appearance's sake and for making sure the new mother can manage a slippery newborn in the tub than anything else. These days when mothers are in hospital for such a short period of time anyway, it seems to be 'give the baby a bath if you want to, the things are there, otherwise it's fine to wait until you get home'. Even back when I had my kids, the nurses didn't bath the baby, the mother did it - with supervision and help from the nurse if needed.

I think babies are only bathed soon after birth here if there is a known risk of transmission of a blood-borne disease from the mother.

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Just another thought - in the hospital where I gave birth to my girls, the first bath was delayed until the baby had nursed several times. Baby hits the bath, swaddled up and SLEEPS. So no bath helped keep baby awake/alert just a touch longer. DD1 was bathed within the first hour after birth (while I was in recovery for my Csection). DD2's bath was delayed until she had nursed at least 2 or 3 times. I dont remember exactly how long as I was exhausted, but I could see a difference as she wasn't so sleepy.

I personally don't think this method is that "out there". A 2m google will find quite a few places doing this. UCSD, Boston Medical Center, etc.

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Specializes in Family Med, Adolescent Health, Lactation, Teaching.

i think some of the avidly pro-bath people posting are overestimating the risk of contamination by handling an unbathed newborn - more to the point, overestimating the "yuck" factor. my first son was born in a birth center, dried off with a towel and had a hat put on him, and had swaddle blankets on - we didn't give him his first bath for a WHILE after he was born, and all our family was handling him, my nurse didn't wear gloves to hold him, etc... it's not like he was caked w vernix or had my blood smeared all over him or anything. my second son was born in water but other than those first few seconds between birth and being in my arms, he didn't have a bath for a while either.

also - moms here are routinely screened for everything, so the nurses should know the status anyway as part of report. not to mention even handling a dry-towel-cleaned newborn infant of an HIV+ mom would be pretty low risk. (not to say don't wear gloves in that case, but still.)

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Not a nurse yet, but seriously that this is a discussion is humorous. I've had three kids. I have no idea what kind of bath they had in the hospital and I can tell you that it didn't matter either way to their well being, as all three have the same immune responses and health statuses. Their personalities are different, so maybe there was something there...

The first was C-section and the other two were VBAC. In some circles, the VBAC makes me evil. In others, I'm a hero. And believe me, I had these opinions stated directly to my face.

The first had a regular bath every single night once home and the cord fell off. The third got a bath at some point in her first year of living. What can I say? I had three in four years. What I can tell you is that none of them had any different cleanliness level due to a special bath. They were all clean. Perhaps the third was cleaned more from wiping off than some formal bath for quite a while, but whatever.

So it's not "out there", but really I think people worry too much about what's not important. Healthy baby, check. Healthy mom, check. Keeping everyone around you and caring for your baby and other babies healthy, check. There has to be a middle ground somewhere, right?

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I absolutely can not stand the level of medical involvement when it comes to the birth of children. When I did clinicals, each one of the pt's of the students had not even had their babies given back to them yet because they were still back in the nursery "under the hood" or waiting for who nows what. Out of three pts, two had episiotomies and one had a c-section.

The birth that I witnessed was so impersonal, the mother was not encouraged to take her baby, it went under the all important hood even though he was perfectly healthy, the father was pushed to the side and not encouraged to take part....ridiculous! The baby does not need to be bathed for more reasons than I care to take the time to list because they should be obvious, baby should be wiped off and be placed on mom's chest, lightly covered with a blanket, and allowed to bond, rest and soon nurse and the father should be enouraged to be right there with them. Any tests that need to be done should be done in the room, under a hood if needed, because the rooms can get chilly. No reason for the infant to be taken from the mom unless there is an absolute need.

My pt asked for her baby several times but had to wait for the nurse, who really seemed to care less whether mom got her baby now or in 3 hrs and oh, guess what, after having been away from mom for four hours, his blood sugar dropped...oh sorry mom, now you have to wait longer so WE, complete strangers, not you, can feed your baby, then wait and recheck the glucose...then a blood draw to make sure everything was ok then finally mom got to see her baby, about five hours after he was delivered. Oh, now WE will allow you to bond with your child.

I don't care if you have to wear gloves and a gown, yes the baby needs close personal contact, but not from YOU, from his/her FAMILY. I was sorely disappointed with the birth experiance of my two children, I would have choosen a midwife or a doula but there are not available in my area, and probably wouldn't have been covered by my insurance...sad

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Specializes in Obstetrics.

Oh brother. All I will say is after bathing MANY babies (thank goodness) and combing many clots of blood out of their hair, I think I'm on Team Bathe. And we don't just leave the babies hanging out to get cold. They're under a warmer the entire time. Giving birth may not always need a medical intervention but you're still in a hospital and there's certain precautions we need to follow.

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Specializes in Med Surg - Renal.
I appreciate anyone's input on how this situation is handled at your hospital. Thanks!

Bleach wipes?

(Kidding. Kinda)

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Baby Magic smell--Ahh!

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this is a great idea, but at our hospital the mom and baby are not separated. They come out to post partum as a couplet. Most of the time (unless parents refuse) the infant is bathed in the room it was born in and rewarmed under that Ohio table. If the bath is delayed, so is the recovery and transfer to postpartum. If we do the bath after they are admitted to the floor, we would need a warmer in every room or babies would leave their mom after admit and go to the nursery for a bath and rewarm. Thoughts?

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What will they think of next?

"Please do not diaper my child, as the confined environment of the diaper may inhibit their emotional growth."

:icon_roll

I'm in total of agreeance (sic)!

I believe everyone has examples where patients ideas and concerns override the best evidenced-base practices. Most recent and very common, a patient with a High K+ level. "I refuse to drink that nasty Kayexalate." So, the physician and medical staff have to find another way, and more invasive way I might add.

Mechanic: "You need a new starter, and we can get a new one on your vehicle in about 2 hours."

Customer: "Oh, I am against starters." Can we find another way to start the vehicle...please." LOL

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