I expect that there are some references out there about not bathing baby in the first hour as it would probalby remove some of that natural protective flora on the baby's skin.

I would be concerned about doing a sponge bath so soon as it will lower a baby's temperature though evaporative heat loss.  In our hospital it is policy not to do any bathing until 6 hours and temperture is stable as the baby need this time to continue "adapting to extrauterine life."  Any baby who is "just hanging on,"  will crash after the stress of a bath. I'd look at it this way.  Why do more work than you have to?  That baby is going to need a bath at some point.  It should be delayed until the parents can take part.  This prevents needing to do a second bath to demonstrate to the parents how to bathe a baby.  Yes, I know it isn't rocket science but so many parents are very anxoius about baby baths.

Cordelia RN BSN IBCLC

> From:    "Westra, Mary" <[log in to unmask]>
> Subject: initial newborn bath/culture change
> 
> I am an IBCLC at a tertiary level county hospital in the US with over
> 4,000 births per year.  Basically, the births are a 
> conveyer belt system
> which is designed to keep mother and baby safe and alive until
> discharge.   Breastfeeding is a very low priority in 
> the eyes of many.
> However, I am very confident that this can be changed.  I 
> am addressing
> the wise ones on the list for a problem for which I need 
> research backed
> evidence.
> 
> =20
> 
> When a baby is born vaginally in the birthing room, a nurse is 
> assignedspecifically to that baby. She is responsible for a 
> large amount of
> tasks to be preformed within the first hour of life or 
> less.  There is
> always a rush to get the mother baby couplet moved to the postpartum
> floor as quickly as possible because we have patients backed up in
> triage waiting for a labor bed.  The nurse taking care of 
> the baby has
> been taught the importance of skin to skin and no separation. Many
> babies do latch at this time.  However, there are sacred 
> routines which
> some nurses are unable to part with which disturb this.  
> The main
> obstacle I am running into is that the nurses want to bathe the 
> baby as
> soon as the temperature of the baby is 36.6.  The nurses 
> believe that
> giving the baby a bath (not immersion) helps them oxygenate and helps
> lung expansion.  Another argument that they give me is that 
> the mothers
> don't like a "goopy" baby on them. I point out that usually a good
> drying off of the baby is adequate.=20
> 
> =20
> 
> Most of the nurses are open to change of practice if there is good
> evidence supporting the change (scientific name journals).  
> Please, do
> we have evidence that shows that a bath during the first hour of life
> does more harm than good? One of the nurses bathes baby all but his
> hands because she says that the smell of the amniotic fluid on 
> the hands
> is enough to not disturb the breastfeeding.
> 
> Please help! Any ideas to assist with this culture change?=20
> 
> =20
> 
> Signed,
> 
> "Desperate"
> 
> =20
> 
> (Mary Westra RN, IBCLC)=20
> 
> 
> 

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