Congratualtions Christina on such an effective change process.
How did you handle the next two questions from staff:  
1. they don't like having to glove and gown for so long a time
2. the mothers and their families have their own "yuck" factor
Okay - there's a third: can you do the hearing test before the bath, or does it wait until after the bath for best results?
Thanks for paving the way for many of us.
Phyllis

--
Phyllis Adamson, BA, IBCLC
Glendale, AZ.
[log in to unmask]


---- Christina <[log in to unmask]> wrote: 

=============
I used to post here a LONG time ago and now I just lurk and learn!  I'm a
neonatal nurse in my local community hospital and have had a long-time goal
to sit for the IBLCE exam.  I thought I'd pipe in here...

I was actually able to FINALLY effect some change in my local hospital with
regard to bathing.  I presented my neonatal educators information from the
WHO booklet entitled, "Thermal Protection of the Newborn" (because they use
these same guidelines to define the varying stages of hypothermia in their
own policies).  This booklet is available online for reading.  The WHO
recommends putting off bathing for a minimum of 6-24 hours post birth, in
favor of skin-to-skin care.  Our nurses had a long-standing tradition of
bathing almost right away.  When I took a hospital-sponsored S.T.A.B.L.E.
class, I questioned why we were bathing babies so soon if thermoregulation
was so important.  FINALLY the policy has been changed and I no longer even
entertain the idea of early bathing.  And of course I wait until
breastfeeding is well established before doing so.

The WHO booklet also recommends immersion bathing (which is something I've
always done anyway) in order to avoid excessive heat loss and to provide
infants with a more gentle, humane experience.  And no, unlike someone else
mentioned, no scrubbing of poor neonatal heads with toothbrushes!  I gently
use a comb with the hair submerged and it works beautifully.  In fact, most
of the babies I bathe actually sleep during their baths.  I keep them
covered the entire time.  The tub we use is one made by a company called
"Juvenile Solutions".  You can Google them and then type in "blue plastic
infant bath tub".  I'm not endorsing them at all, just sharing that that's
what we found to be in compliance with Infection Control.  It has a hole for
a plug.  We simply removed the plug and don't use one.  We place a Tegaderm
(clear occlusive opsite dressing) over the hole before bathing and it works
well.  Because there is no plug involved, it is very easy to disinfect after
use.

Hope this helps.

Christina Harris, RN
Federal Way, WA

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