Hi Phyllis,

Thanks for the kind words and I apologize for the delayed response.  To
answer your questions:

1.  We've never worn gowns to bathe babies.  As for gloves, I've never had
anyone complain to me about wearing gloves.  I know that some nurses did
complain that water got into the gloves (thereby making them useless) but
one nurse suggested switching to the longer gloves they find in the O.R. to
prevent that from happening.  I know this is a terrible thing to admit, but
I actually don't wear gloves when I do my immersion baths.  I just don't
feel like I have a good enough grip on the babies when I'm gloved.  So I've
done baths without them for a long time.  I wash my hands very well before
and after.  If I have a known hepatitis positive mother or known/obvious
chorio, then I wear gloves as well.  I realize that isn't using universal
precautions but I just feel like I'm going to drop a baby if I don't.
 Perhaps it's time to start doing this.

2.  Yes, mothers and families DO have their own yuck factor and sometimes
ask me to please clean up their babies before they hold them.  I gently
explain why we don't do it and why it's best to leave baby alone to spend
time with mom and breastfeed.  RARELY have I had a mom, after a good and
gentle explanation, pursue bathing any further.  Most are happy to wait once
they understand the benefits.  If a baby smells really putrid (I've seen
this twice with awful cases of chorio) or if they baby has been swimming in
thick meconium for a long time, I'll make an exception.

3.  As we are a small, community hospital, our hearing tests are only done a
few hours a day, during the day.  So we just go ahead with the bath and the
hearing test is usually done much later, closer to discharge.

Hope this helps,

Christina Harris, RN
Federal Way, WA

On Sat, May 21, 2011 at 3:26 PM, Phyllis Adamson IBCLC <[log in to unmask]>wrote:

> Congratualtions Christina on such an effective change process.
> How did you handle the next two questions from staff:
> 1. they don't like having to glove and gown for so long a time
> 2. the mothers and their families have their own "yuck" factor
> Okay - there's a third: can you do the hearing test before the bath, or
> does it wait until after the bath for best results?
> Thanks for paving the way for many of us.
> Phyllis
>
> --
> Phyllis Adamson, BA, IBCLC
> Glendale, AZ.
> [log in to unmask]
>
>
> ---- Christina <[log in to unmask]> wrote:
>
> =============
> 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
>
>              ***********************************************
>
> Archives: http://community.lsoft.com/archives/LACTNET.html
> To reach list owners: [log in to unmask]
> Mail all list management commands to: [log in to unmask]
> COMMANDS:
> 1. To temporarily stop your subscription write in the body of an email: set
> lactnet nomail
> 2. To start it again: set lactnet mail
> 3. To unsubscribe: unsubscribe lactnet
> 4. To get a comprehensive list of rules and directions: get lactnet welcome
>

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome