Thanks for everyone's help with this:

Heather wrote:

I have had a reply off list from someone who says 

I can post it to Lactnet - she says

"the nurses in our hospitals don't like to wear 
gloves and have to put them on anew every time 
they touch a baby who still has mother's body 
fluids on herso they bathe 'em all in the first 
hour if possible, unless mothers know it causes 
lots of temp destabilization and refuses to have 
her babe bathed.
Good babies can go south after that bath since babe is far from mother's skin."

This seems to me that bathing is a convenience 
for the institution, and not a clinical need. 
Obviously, if there are risks to staff or baby of 
an ungloved hand, then wear gloves - but don't 
bath the baby for that reason.

Heather Welford Neil
NCT bfc, tutor, UK
--


I couldn't agree more. It's definitely about convenience for the nurse and about having difficulty with change. We're trying to work towards Baby Friendly and are changing many things at our hospital. Of all the things that they've had to change, I was shocked this was the thing that I've had the most vocal opposition against by the nurses. 

Mostly the L&D nurses were upset that they may have to go out to PP on a slow day and bathe a baby. They view that as a PP nurse job and they don't want anything to do with the babies. 

The nurses feel they don't want to take the chance of touching a "dirty" baby by accident. Good grief. I told them, first of all, you do realize they were are only giving these babies a sponge bath right? We aren't putting them in an autoclave. You aren't sterilizing these babies. Even when you give them a sponge bath, they still have remnants of amniotic fluid and vernix on them. They always have had vernix on them and you've been touching them for years. How many times do you still see vernix on their skin after their bath? I also firmly disagree that this is more work, it's easier and less work. Right now we "have" to give the baby a bath at 2-3 hours after delivery. So for staffing, we need to find someone at that time no matter how busy we are to bathe the baby. If we just said some time after 24 hours, that gives us a lot more leeway as to finding time when it's slower to bathe the baby. Some of our parents lately have been wanting to give the
 first bath themselves, or even give it at home after they are discharged. That's even easier for the nurses. But they are really opposed to the idea. I'm being told it's "unsafe" for the nurses. 

I think it's a good idea to bathe the babies whose moms are HIV or Hepatitis positive, just to minimize risk. But really I disagree that necessarily handling them without gloves, increases the nurses risk. The amniotic fluid and vernix is still on the baby even after a sponge bath, there's just less of it. 

Tricia Shamblin, RN, IBCLC

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