Where does your hospital complete the first bath

[mugwump]

I am doing a project and just want to get a concensus on how long after birth and where the first bath is done. for instance in labor and deliver, nursery or post partum?

[LDRNMOMMY, BSN, RN]

At the hospital I where I delivered my daughter she had her first bath right in the labor room. She had her bath within her first hour of life.

Where I used to work it was done in the well baby nursery. I am not really sure when the babies were given a bath in the nursery. I only worked L&D and we did not float at all. I do know the babies were not allowed to leave the nursery until the baby had a temp of >97.5 x3 after the bath.

[JenTheRN]

I work in a small OB unit with LDRP and NY. I try to do the first bath in the room with parents watching/participating if possible. Baths are done when infant vital signs, resps, and temp are stable, for most babies after one hour of age.

Sick babies will go to the NY after birth, and the bath is the last thing on our minds.

With c-sections, the bath is done in the NY when stable.

Some nurses take ALL the babies into the NY to do the bath, but I usually try to do it in the room. I think it makes it more special for mom and the family.

[JaneyW]

I have some strong opinions about this one. I have worked at a few places both as staff and registry and have seen it done many ways. Instead of getting a consensus, it might be more important to get some evidence-based input.

Research and AWHONN tell us that babies are warmed best by placing them skin to skin with their moms. Have a cold baby either before or after a bath? Get them to their mom and put them on the breast or at least skin to skin with a blanket over them--much better than a warmer in the nursery. It is also important to not rush into the bath before baby and mom get a chance to have some skin to skin time with mom and at least some nuzzling at the breast.

I am not a crazed breastfeeding nut, but feel that we often do what is most convenient for us or what we have always done instead of doing what is really best for our patients. Babies and moms need that time and touch. Units should design their care around it--including when they give baths and what rationale they use to separate moms and babies.

[Snugglibumkins]

I'm at a small hospital. Our babies are wiped on mom's belly, latched on to mom's breast immeadiately and then later (about 90 min or so later) the vit K, Hep B, and eye gtts are given and the vernix is rubbed into their skin (it's so good for them!!) Later that night, when things slow down after dinner time, Mom and Dad are shown how to give baby a bath and keep baby warm while doing it. Then the baby goes right back to mom's chest. We have a rate of 99% of our moms are breastfeeding at discharge. Last year (2007), we only had 2 moms decide to formula feed straight from birth, so our hospital policies reflect as much mom/baby time as possible, and as little nurse interference as possible.

[klone, MSN, RN]

Our first baths are done in the nursery. Once we have our new unit that will do strictly couplet care and LDRPs, the first bath (as well as all assessments) will be done in mom's room.

[Spidey's mom, ADN, BSN, RN]

Small rural hospital - small unstaffed nursery. We take the babies into the nursery - at least one hour, if not more, after delivery.

I like to wait - I've seen babies get too cold with a too soon first bath.

steph

[BirthCenterRN]

We do the bath in the room usually within 2 hours after delivery but it can be done after that. The only thing we are required to do within 2 hours is give the Vit K and Eye ointment. This can be done while the baby is with mom. We also do the immediate skin to skin and skin to skin for rewarming after the bath. I really try to encourage the first breastfeeding ASAP after delivery and before either mom or baby get a bath. I did have a baby 2 nights ago that despite all of my efforts he did not nurse and still hasn't. But myself as the nurse and the pt as the mom can both say that we did everything possible to make it happen. This is the first time that this has happened to me but I feel that my efforts still make the experience a good one.

[Northwind48]

I work in a busy urban tertiary care hospital. Approx 3000-3500 birth/year. We need to have 3 stable temps/ vital signs 1 hour apart before the bath is done in the patients room. I prefer to do the 1st bath myself then have the parents repeat before discharge.

[rnin02]

We can do the bath anytime after baby is 1 hour old and warm enough (98.0 for us). Usually for a vag. delivery baby stays with mom for till mom is ready to transfer to postpartum, and we take the baby to the nursery and do the bath when L&D is getting mom up to the bathroom, and moving her over to her new room. C-sections we usually do after the hour wait and then baby is usually nice and warm and ready by the time mom is out of recovery.

[CEG]

I'm at a small hospital. Our babies are wiped on mom's belly, latched on to mom's breast immeadiately and then later (about 90 min or so later) the vit K, Hep B, and eye gtts are given and the vernix is rubbed into their skin (it's so good for them!!) Later that night, when things slow down after dinner time, Mom and Dad are shown how to give baby a bath and keep baby warm while doing it. Then the baby goes right back to mom's chest. We have a rate of 99% of our moms are breastfeeding at discharge. Last year (2007), we only had 2 moms decide to formula feed straight from birth, so our hospital policies reflect as much mom/baby time as possible, and as little nurse interference as possible.

Wow, my husband is from Alaska and keeps trying to get me to go there. I may just have found my motivation:)

[crysobrn]

We are a smaller hospital. Generally for vag deliveries we have the mom hold/enjoy/breastfeed in the labor room. I like to give my moms at least an hour before I even bother them. When they are ready to move to the PP room (generally 2 hrs), the baby usually goes to the nursery, under heat while one of us moves mom. Then if baby's vs are stable (T 98.2 ish or higher) the bath is done. If mom is a c/s we generally try to get them bathed before mom is back to the floor but I can't say that always happens and most moms are happy to meet their baby "dirty."

I believe our protocol is that baby must have 3-4 sets of stable vitals... but I don't like to rush it.