Hi Lisa,

Yes, there is a lot of research about the benefits of delayed bathing. Our hospital just approved a policy recommending waiting a minimum of 24 hours to bathe the baby. For more reasons than just hypothermia. Here are some of the benefits noted in several studies:

Reduction in Hypothermia
Reduction in Hypoglycemia
Development of Healthy Skin Flora
Improved Skin Hydration
Improved Breastfeeding
Potential decrease in Infection due to Antimicrobial components in Vernix effective against Gram Negative and Gram Positive Bacteria, including GBBS

Years ago, hospitals just began bathing babies after they were born, assuming they were stable and no one bothered to research to see if this was beneficial or harmful. It looks as though there is mounting evidence to show that it certainly has no particular benefit, unless the mother was HIV or hepatitis positive. In those cases we bathe prior to administering injections or eye ointment.

The baby is born with a coating of vernix on it's skin. The is a barrier protection against heat loss. Just the same as when we put premies into a bag to keep them warm. When we wash off this barrier immediately after birth, it exposes the infant to heat loss. Then the baby burns blood sugar to try to stay warm, this is probably why we see it also impacting blood sugar levels.


Hypothermia and hypoglycemia:
 
A 12 hour delay at Cambridge Alliance Hospital, “The percentage of newborns experiencing hypoglycemia, which was 12.6 percent from December 2012 to March 2013, dropped to 6.5 percent from April to July 2013.”
 
http://www.challiance.org/Main/News/New_Initiative_at_CHA_Reduces_Hypoglycemia_in_Newb_731.aspx
 
Delayed bathing recommended at least 6 hours, but preferably 24 hours to prevent hypothermia by USAID, WHO and Save the Children:
 
http://www.savethechildren.org/atf/cf/%7B9def2ebe-10ae-432c-9bd0-df91d2eba74a%7D/EVERY-NEWBORNS-HEALTH.PDF
 
Delayed bathing recommended by Australian Government:
 
http://www.health.nsw.gov.au/sabs/Documents/2011-sn-015.pdf
 
Other studies that show decreased hypothermia and hypoglycemia when bath delayed 6 to 24 hours or more.
 
http://www.ncbi.nlm.nih.gov/pubmed/22861492
 
http://www.ncbi.nlm.nih.gov/pubmed/?term=immediate+newborn+care+practices+delay+thermoregulation
 
http://www.sciencedirect.com/science/article/pii/S0146000512001255
 
 
 
Bioactive components of vernix and skin hydration:
 
http://web.as.uky.edu/Biology/faculty/cooper/BCTC/Vernix%20Caseosa-1.pdf
 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763724/
 
http://web.as.uky.edu/Biology/faculty/cooper/BCTC/Vernix%20Caseosa-1.pdf
 
http://www.ncbi.nlm.nih.gov/pubmed/21967466
 
http://www.nature.com/pr/journal/v56/n3/full/pr2004261a.html
 
 
 
Breastfeeding - increased rates of exclusive breastfeeding
 
http://www.ncbi.nlm.nih.gov/pubmed/23635002
 
 
Tub bathing

http://www.ncbi.nlm.nih.gov/pubmed/?term=tub+bathing+versus+traditional+sponge
http://www.ncbi.nlm.nih.gov/pubmed/22375955
 
We recommend that RN’s and MD’s always wear gloves when handling infants regardless of whether or not they’ve been bathed. Visitors can be advised to wash hands before and after handling babies.
Delaying the bath for 8 to 12 hours showed a decrease in hypoglycemia and hypothermia and improvement in breastfeeding rates. However, for the development of the newborn’s skin and skin flora, a minimum of 24 hours is recommended. While the basal epidermal layer of the newborn’s skin is functional at birth, the stratum corneum is less hydrated during the first 2 weeks of life. Vernix has been demonstrated to one of the mechanisms that allows the newborn’s SC to become fully hydrated and form an acidic pH that inhibits the growth of bacteria. Bathing the infant in an alkaline soap interferes with the acidification of the skin. That is why we wait at least 24 hours before bathing the baby. 

I would tell you that I see far fewer babies having latch on difficulties. Honestly, I can't remember the last time that I had a baby that didn't latch on at 24 hours of age. And I haven't see a baby with dry, cracked skin for months now. 

It's all in how you explain it to the parents. They have been very positive about the change as long as the RN's are educating them on why we do it. If all the RN says is, "We aren't going to bathe the baby until tomorrow." Then the parents aren't on board with it. Also, they can always opt out. The nurses (usually) tell the parents that we want to wait until the baby is stable enough to handle being bathed without it dropping the baby's temperature. Usually they are so busy enjoying their baby, they couldn't really care and are completely fine with it. It was the RN's and MD's that had much harder time at first. Change is hard. I would recommend creating a little bedside display for your L&D rooms that explains why you wait to bathe the baby. And also a poster for the postpartum rooms that talks about hand hygiene and that you recommend washing hands before and after holding the baby.  

Good luck to you!

Tricia Shamblin, RN, IBCLC

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