Mary,
I am a nursery/Mother Baby nurse and IBCLC in a hospital.  We do about 200 deliveries per month.  We have done Mother/Baby Care
for about 10 years, but still have things to improve.  Most of our babies go to breast within the first 1 - 2 hours after birth, but then are 
taken away for the bath.  C/S babies are often bathed sooner because the mom is still in OR or PACU.  We are currently in the
process of changing the timing of the first bath.  We identified three reasons for the change.  1).  Earlier breastfeeding.  2).  Parents
report that they would have liked the bath done in their room.  3).  Thermoregulation.  We seem to have a high number of babies 
having temp instability and having a septic work up.  We also encourage skin to skin immediately after birth, and also post partum for 
mom's having breastfeeding difficulties.
The best resource we found for skin to skin and delaying the bath is from the WHO.  The title is "Thermal Protection of the Newborn:
a practical guide"  Written by
 "Maternal and Newborn Health/Safe Mothehood Unit
 Division of Reproductive Health (Technical Support)
World Health Organization
Geneva
This publication sites the concept of "the Warm Chain" which is 10 steps for thermoregulation.  #4 is Breastfeeding because it provides
the baby with calories to produce heat and with the warmth of skin to skin.  It also recommends delaying the bath for at least 6
hours after birth, and preferably waiting until the 2nd day of life.
If you want a copy of this, let me know.  We will begin implementing the 6 hour delayed bath this fall.  We need to get the kinks
ironed out on who will do the bath and how does the MB RN know it needs to be done.
Hope this helps
Beckie Trevino, RN, BSN, IBCLC
BryanLGH Medical Center
Lincoln Nebraska

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