One nurse’s research has created a waiting to bathe newborns policy for newborns in half of Advocate Health Systems hospitals.
This includes Advocate Sherman Hospital in Elgin, Ill., a Chicago Tribune news article reported on June 11.
Courtney Buss, RN, who works at Advocate Sherman, researched and recorded the benefits of vernix in newborns.
“Her research looked at Advocate Sherman Hospital births for one month during 2015, evaluating how many full-term, healthy babies had hypothermia and hypoglycemia as a baseline. Buss also looked at breastfeeding rates,” the article stated.
“Sherman’s Family Birthing Center rolled out a policy in February 2016 where nurses waited about 14 hours to give full-term, healthy newborns a bath,” Buss said in the article. “Any blood is wiped off but, a sponge bath is delayed.”
The article said rates for babies with hypothermia decreased from 29 to 14 percent in babies whose bathing was delayed, and breastfeeding rates increased from 51 to 71 percent.
Buss plans to publish her findings in a nursing journal in the fall, according to the article.
In February 2016, Kathleen Berchelmann, MD, published the article, “Delaying Baby’s First Bath: 8 Reasons why doctors recommend waiting up to 48 hours before bathing a newborn,” online at ChildrensMD.org. She pushes for delayed bathing based on World Health Organization recommendations.
The eight reasons Berchelmann listed in the article include:
1. Reduced risk of infection
2. Stabilized infant blood sugar
3. Improved temperature control
4. Improved breastfeeding
5. Improved maternal/infant bonding
6. No baby lotion required
7. Everyone wears gloves
8. Babies get to be bathed by their parents
Under improved temperature control, the article stated, “giving a baby a bath too soon can cause hypothermia. Inside mom it was about 98.6 degrees, but most babies are born in rooms that are about 70 degrees. In the first few hours after birth a baby has to use a lot of energy to keep warm. If a baby gets too cold, he or she can drop their blood sugar or have other complications.”
Under the category, “Keeping the Baby Warm,” WHO states in its 17-page Recommendations on Newborn Health document, “Bathing should be delayed until after 24 hours of birth. If this is not possible due to cultural reasons, bathing should be delayed for at least six hours.”
Some hospitals in the U.S. already have implemented the delayed bathing method for newborns based on WHO recommendations as well as evidence-based practice. Good Samaritan Hospital in Lafayette, Colo., changed its bathing policy two years ago, according to Health News Colorado article, ‘Wait for Eight’ bathing helps newborns thrive” published July 1, 2015.
“Diane Heronema, a registered nurse and lactation specialist at Good Samaritan, led efforts to establish new protocols for the first few hours after birth to improve outcomes,” the article stated.
In April, the Association of Women’s Health, Obstetric and Neonatal Nurses featured a podium presentation on delayed bathing at its Illinois Section Conference in East Peoria, Ill.
AWHONN has been recommending delayed bathing for at least five years, according to a poster presentation published on the Wiley Online Library from June 2012.
“The description of the process from admission to discharge identified the value in bath delay related to skin-to-skin research,” researchers wrote in the Journal of Obstetric, Gynecologic and Neonatal Nursing. “Our efforts were validated by the improved outcomes of practice change of newborn bath delay, which resulted in increased patient satisfaction.”
Courses Related to ‘Newborn’
CE246-60: Newborn Screening
(1 contact hr)
Screening newborns is critical because some babies are born with potentially life-threatening metabolic, endocrine, or hematological diseases that may not be obvious at birth. Nurses who care for newborns should know which conditions their state regularly screens for at birth and the specialists available for medical management. With an awareness of how these conditions present in the neonate and knowledge of how various circumstances may affect test results, nurses can ensure that infants are screened accurately and that affected families receive prompt referrals for the services they require. This educational activity will provide an overview of screening and processes needed to avoid false-positive or false-negative results.
CE394-60: Trends in Pediatric Genetics for Maternal-Child Nurses
(1 contact hr)
This module discusses the debate about newborn screening practices, carrier and prenatal screening for cystic fibrosis, and the latest information about enzyme replacement therapy for rare metabolic conditions. Genetic screening is a process for identifying certain diseases in a specific population. Screening can be prenatal, presymptomatic, heterozygote (carrier) and neonatal. Newborn screening is a type of presymptomatic blood testing done routinely on all neonates shortly after birth. Presymptomatic screening methods detect genetic changes that can cause disease before symptoms develop in certain populations, such as newborns. Newborn or neonatal genetic screening is an important public health program whose goal is to identify genetic diseases at birth. Each of the genetic conditions mentioned here illustrates how recent genetics research and technology has resulted in more precise screening (expanded newborn screening), testing (carrier testing for cystic fibrosis), and treatment options (enzyme replacement therapy) for patients and families. Nurses working with families in maternal-child settings need to understand trends in genetics to provide patients with the most comprehensive care available.
CE454: Late Preterm Infants Need Special Care
(1 contact hr)
The group of infants categorized as “late-preterm” are a growing public health concern. Although they may look like term newborns in appearance and weight, they have a greater risk for respiratory problems, temperature instability, hyperbilirubinemia, hypoglycemia, infection, apnea, feeding difficulties, breastfeeding failure, poor neurodevelopmental outcomes, and rehospitalization. In 2005, the National Institutes of Health recommended calling infants born between 34 0/7 weeks and 36 6/7 weeks “late-preterm” instead of near-term infants because their increased physiologic and metabolic immaturity reflected a higher morbidity and mortality rate, and their special needs are often closer to those of premature infants. This continuing education module provides nurses with information about the incidence, etiology, identification, and care of late-preterm infants.