My colleagues and I are beginning a 'delay the bath' initiative at our hospital.  Our current practice is to put baby skin-to-skin with mother until after the first breastfeed, then the infant is taken to the nursery and bathed and re-warmed under the warmer before returning to mom.  C-Section babies are bathed in their first hour, then taken to mom for breastfeeding.  We would like to delay the bath for 12 hours for all full-term breastfed babies, and keep mother and baby together instead.  

We have obtained mounds of evidence for this practice, and have presented it to nurses, pediatricians, and hospital administrators and everyone is in agreement to beginning this practice change.  But we have hit a road block with the issue of infection control.  Our infection control nurse wants nurses and all visitors to wear gloves and gowns when handling unbathed infants, and post signs in rooms that discourage visitors from kissing babies or otherwise putting their faces to the baby until after the first bath.  

I am concerned that if we treat the baby as a dirty, infectious object, this will be a significant barrier to nurse and patient buy-in.  But I can also understand the concern from the infection control nurse about visitors handling the baby against their clothes and then going to the rest of the hospital, for example the cafeteria, and touching objects there.  

I realize that, ideally, the mother and baby would be kept together and visitor interaction would be very limited.  But limiting visitors would be a huge patient dissatisfier, and would also negatively impact the delay the bath initiative.  

Does anyone have any evidence regarding infection control for this issue?  Approaching this in an evidence-based way is of utmost importance!  What is the policy of other hospitals who delay infant bathing?

Thanks for your input,

Julie Conaway, RN, BSN, IBCLC-RLC
Rolla, MO, USA

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