Wanted- tips on bathing stillborns, etc....

[LDRN697]

Hi everyone. I was wondering if anyone has any tips on how to bathe stillborns. Many of the nurses I work with say there is really no way to bathe them espcially if the skin is already peeling. I just want to make them look the best that I can for the families and pictures. Also if you can share any information about your bereavement program and resources that would be great. I am currently coordinating our bereavement program and I need all the suggestions I can get.

Thanks

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[HazeK]

I don't meant to gross you out, but if the baby is very, very peeling when you go to wash it, just scrub a bit with a wet wash cloth & most of the peeling sking will come off into the bath water, leaving behind soft skin that may be a bit "weepy", but much easier to handle, dress & touch. Just document how "peel-y" the skin was, in case Pathologist needs the info.

I tell families that the outer layer of skin has died & started to peel, just like the skin on your back dies & peels with a bad sunburn. Tell them the baby's skin may feel slightly moist or damp, just like where a sunburn has blistered, popped & peeled. Be sure to tell them there is one difference though, that their baby doesn't feel any pain when the parents touch them. (YOU & I know this, but sometimes a parent's grief blocks common sense.)

hope this will help

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[floridaRN13]

Bereavement info-our hospital has a "shattered dreams" packet we give our patients. This includes a memory packet (length of baby marked, clay impressions of footprints and a lock of hair if parents desire), an information booklet and their baby's photo(s). There is also the option to have professional photos taken by a special photographer that offers this service, and does a beautiful, tasteful job. There is also a support group that is offered to parents that meets for I believe 12 weeks, and the facilitator is a mental health counselor who experienced a stillbirth. This counselor brings in various speakers over the course of the group's meeting, including an OB physician who will answer medical questions. On a separate note, nurses at our hospital who work in the women's area take a one day bereavement course, which is very helpful. We review the medical, documentation, spiritual and emotional aspects, as well as cultural differences. Hope this helps.

[bagladyrn, RN]

What I usually do if a stillborn baby is "peeling" is to lay the baby on a towel and just use a washcloth or 4x4 to squeeze warm water over the baby, dabbing gently at the worst spots. If the baby has hair I will squirt a little shampoo on it, rub very gentlly with my fingertips and again rinse by squeezing or pouring warm water over it. If the baby is very "fragile" I will just kind of smooth the hair into place with my fingertips rather than use a comb. I dry the baby with a dabbing or patting motion rather than rubbing.

[NurseNora, BSN, RN]

nowilaymedowntosleep.org is a site that is about an organization of professional photographers who take beautiful pictures of stillborn babies and their parents. Have a tissue handy if you visit the site.

Resolve Through Sharing has a program for breaved parents. They have printed material for parents, family and friends and guidelines for hospital staff.

I've tried peeling a badly mascerated infant and did not like the outcome. Now I just explain why it's happening and perhaps remove the biggest pieces of peeled skin. The best suggestion for photographing tiny, midtrimester stillborns I think I got here in another thread:The really little ones look much more natural if you put them in a container of water. Instead of lying flat like a puddle, the arms and legs assume a much more natural position with elbows and knees bent.

floridaRN13, where do you get the kits for the clay impressions of the hands and feet? One of my coworks has mentioned this and it sounds like a really good idea, but she can't remember the name of the company.

[LittleLisaLawrence]

my hospital uses rts bereavement services (found here: http://www.bereavementprograms.com/). *they also have memory boxes available.*

tips on bathing stillborns…

have a warm basin of water to receive the baby. prearrange for the doctor to hand the baby to you and gently place the baby in water.

- this bathes the baby, and bodily fluids will rinse away.

- this also preserves integrity of skin and minimizes slippage.

- do not rub to wash or dry the baby.

- do not use soaps-this will hasten a skin breakdown.

we offer baby unclothed, wrapped in a blanket to parents for bonding. if lotion or powder is desired, we place it on the blanket, not the baby. we encourage parents to dress their baby, even tiny ones.

[Elvish, BSN, DNP, RN, NP]

These are all great suggestions.

[babyktchr, BSN, RN]

I use a gel compound for a cast for the babies foot, and then use a standard quick drying plaster after. You get a great 3D effect if you use some sort of mold. I use a heart shaped mold and when the plaster is dry, you peel the 3D gel mold from the plaster. The molds can be used over and over for different things. I find the gel mold at AC Moore. I get great results and have gotten very positive feedback.

As far as bathing, using a lot of water and just squeezing it over the baby usually does the trick. I never try to get off all of the vernix (if more term baby). If already peeling, I use different techniques in photography to hide those, and then just good communication with your parents, letting them know what to expect.

The RTS website has great information and links to different websites for help.

[OzMW]

Wow, I would never try to peel/scrub the skin of a macerated baby. Just wouldn't feel right. I certainly explain to the parents before the birth that that is what they'll see. Just a gentle dip for photos and a quick clean, but no scrubbing of skin. I would be mortified if someone did that to my stillborn baby.

When delivering these babys I make a nest of blankets at the end of the bed, tell the parents what its for and place the baby there. When the parents are ready they can then pick baby up etc.

[txspadequeenRN, BSN, RN]

anyone that can do this task is a very special person...i would fall apart.:bowingpur

[Elvish, BSN, DNP, RN, NP]

i would fall apart.

sometimes we do too.....

[floridaRN13]

To the person who asked me (several weeks ago) about where we get our footprint/handprint clay impressions for the stillborns...

After weeks of forgetting to ask the person who is in charge of this, I finally caught her in the hall a few days ago. She says they just buy the impression kits at a craft store (Joann's or Michael's in our area of Florida) and use those. They generally come in a little tin and you can imprint the baby's hands or feet, so they have a lasting memento of their precious little one.

Also, and I think this is so thoughtful and sweet. There is a church in our area that makes and provides tiny garments for the babies that need something to be buried in. They look like a small shirt/gown, the size of doll clothes, and come in a small box with a sweet card with a special verse expressing sympathy to the recipient. It started with a lady who lost a baby and had nothing small enough to bury it in. There is another group of special people who make and donate specially weighted teddy bears, so the families have something to hold, that sort of feels like a baby. (I know this may sound weird to some, but some people find comfort in this, and if it helps, great!)