Historically it was common place for hospital staff to bathe the newborn within 2 hours of birth or even sooner years ago. Bathing the newborn separates the baby from the mother in this critical time. The baby also has more difficulty maintaining their temperature this soon after birth. This can lead to longer periods under the warmer. Even twenty-four hours later, babies can tolerate a quick bath with fewer temperature drops. But enough background. On to the evidence!
Multiple studies have been conducted on delayed bathing comparing multiple variables important in the newborn period. They studied temperature regulation, glucose levels, breastfeeding rates, skin-to-skin, bonding, and parent participation in newborn care. Here are just some of the amazing results:
One study compared babies that received a bath at two hours of age versus a bath at twenty-four hours old.
The study found that breastfeeding rates improved by 10 percent and formula supplementation decreased by 10 percent. There was a decrease in the incidence of low glucose (hypoglycemia) and lowered temperature (hypothermia). They found increased bonding and increased parent participation in infant care. (LiVolsi, 2018)
Another study found benefits of the vernix which provides nutrients and protection the baby's skin. Vernix is the coating on the baby's skin at birth. This study also found significant beneficial impacts on increased breastfeeding rates, and a lowered incidence of low glucose (hypoglycemia) and hypothermia. They also found increased skin-to-skin care and bonding! So many benefits from one action. (Liberth, Fontana, 2018)
The World Health Organization states:
"Bathing should be delayed until 24 hours after birth. If this is not possible due to cultural reasons, bathing should be delayed for at least six hours. Appropriate clothing of the baby for ambient temperature is recommended. This means one to two layers of clothes more than adults, and use of hats/caps. The mother and baby should not be separated and should stay in the same room 24 hours a day." (2012) Note: Clothing is needed if skin-to-skin is not being performed. A blanket draped over the back of the baby and a hat is required in the early hours with skin-to-skin. Hospital staff will instruct you on safe skin-to-skin positioning.
The baby has been bathed in the amniotic fluid for months. A woman's Montgomery glands, located on the areola, secrete a substance that is similar in taste and smell to the amniotic fluid. This assists the baby in finding the nipple to begin nursing. Delaying the bath preserves the familiar scents for the baby. This is one of the many reasons that delaying the bath can help with breastfeeding. Keeping the parents and the baby together for more hours, especially during the critical early hours is very important. By minimizing incidences of hypothermia and lowering hypoglycemia, this powerful time is protected more successfully.
Simple but powerful practices have immense positive effects on outcomes for babies and parents. Ask for a delayed newborn bath!Â
~Cathy Walker, MA, RN, IBCLC
Registered Nurse and Lactation Consultant
References
LIBERTH, M.; FONTANA, J. Benefits of Delayed Bathing. JOGNN: Journal of Obstetric, Gynecologic & Neonatal Nursing, [s. l.], v. 47, p. S30–S31, 2018. DisponÃvel em:<https://search-ebscohost-com.libdb.fairfield.edu:8443/login.aspx?direct=true&db=rzh&AN=130486177&site=ehost-live&scope=site>. Acesso em: 6 maio. 2019.
​LiVolsi, K. (2018). Improving Neonatal Outcomes through the Implementation of a Delayed Bathing Program. Improving Neonatal Outcomes Through The Implementation Of A Delayed Bathing Program, 1. Retrieved from https://search-ebscohost-com.libdb.fairfield.edu:8443/login.aspx?direct=true&db=rzh&AN=131799073&site=ehost-live&scope=site
WHO (2012), WHO recommendation on bathing and other immediate postnatal care of the newborn. retrieved on 5/6/2019 https://extranet.who.int/rhl/topics/newborn-health/care-newborn-infant/who-recommendation-bathing-and-other-immediate-postnatal-care-newborn
Cathy Walker, MA, RN, IBCLC
5/6/2019
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