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From:
Christina <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 21 May 2011 12:25:56 -0700
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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

On Sat, May 21, 2011 at 12:01 AM, Virginia Thorley <
[log in to unmask]> wrote:

> Mary, what I don't understand is why the babies are being bathed
> immediately, instead of having about an hour of skin-to-skin and then being
> bathed or washed? As well as delaying the skin-to-skin, bathing robs Mum
> and
> baby of the olfactory sensations that are part of early contact.
> What evidence does your hospital have for putting bathing ahead of
> skin-to-skin? The evidence I'm aware of supports immediate skin-to-skin.
>
> Virginia
>
> Dr Virginia Thorley, OAM, PhD, IBCLC, FILCA
> Brisbane, Qld, Australia
> E: [log in to unmask]
>
> On Fri, 20 May 2011 Mary Westra wrote:
> Subject:
>
> Hi all,
> I am trying to change our hospital practice for newborns from the stressful
> scrub a dub under the warmer where they howl,become exhausted and then
> don't
> feed well, to the gentler immersion bath.  The problem I am facing is
> trying
> to find a reusable tub that will be acceptable to our infection control
> team.  Can anyone give me suggestions or policy on this.  I find that the
> babies usually love the immersion bath and it is less time consuming for
> the
> staff.  Baby can go skin to skin after a brief drying.
> Thanks,
> Mary Westra RN, IBCLC
>
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