1. Baby’s First Bath: A Family-
Centered Approach
By: Alecia Rickenbach, 1LT AN
2. Benefits of Bathing Infants at the
Bedside
• Educational opportunity for New Parents
• Bonding experience
• A great way to involve the father or other family
members in infant care
• Skin to skin contact following the bath improves infant
stabilization
• Faster and easier than bathing infants in the treatment
room
• Builds rapport with the family and your patient
• Supports the Patient Caring Touch System
• Supports the Texas Ten Step Star Achiever Initiative
3. How Do Bedside Infant Baths Support PCTs?
• Patient Centered Practice:
Allowing parents to
experience their baby’s
first bath provides a
learning and bonding
experience.
• Evidence-Based Practice:
Skin to skin contact
provides better
physiological stabilization
benefits than a radiant
warmer.
4. How do Bedside
Infant Baths Support
Texas Ten Step Star
Achiever Initiative?
• Step 7 of the initiative is to
allow mothers and their
babies to remain together
as much as possible during
their hospital stay.
• In the event babies
demonstrate hunger cues
after or during the bath
they have the opportunity
to breastfeed while in skin
to skin contact.
5. Comparing the Infant Warming
Options
Skin to Skin Contact
• When performed with
mother—adjusts per infant’s
specific need (Dabrowski,
2007)
• Stabilizes infant heart rate and
respiratory rate (Moore, 2007)
• Increases infant blood glucose
compared to infants in an
open crib (Moore, 2007)
• Decreases infant crying and
grimacing (Elliott, 2000)
– Can be used to console infant
during or after hep B vaccine
Radiant Warmer
• Infant temperature
continues to increase
(unless attached to servo)
• Continued warmth can be
delivered during actual
bathing of infant
6. Setting Your Bath up for Success
• Turn up the temperature in
the room to 80°F about thirty
minutes prior to the bath
• Educate parents on the
importance (and safety) of
skin-to-skin after the bath
– Emphasize keeping infant skin-
to-skin for at least ten minutes
or until infant’s temperature is
within parameters
• Educate parents on the
importance of bathing the
infant thoroughly and quickly
– Infant should be fully exposed
for no longer than five minutes
7. Encouraging Parental Participation
• Parents can be a great help
during the infant’s bath!
• Often times new parents are a
little scared of the first bath. They
don’t want to do it “wrong”. To
allow them to feel involved
without overwhelming them, you
might try offering them a specific
task:
– “Would you like to hold the baby or
wash his/her hair?”
– “Would you like to soap the baby or
rinse him/her?”
8. Suggested Supplies
• Two towels
• One blue chux pad
• Sponge
• Baby Soap
• Rinse Bottle
• Emesis Basin
• New Diaper
• Family Member to perform
skin-to-skin contact
– Doesn’t have to be Mom, a
lot of fathers enjoy this
experience as well!
9. Step 1: Set up your supplies
• Double layer the towels
and place next to the sink
with the blue chux pad on
top
• Fill rinse bottle with warm
water
• Prepare emesis basin with
warm soapy water
• Ensure baby’s initial
temperature is within
parameters
10. Step 2: Wash Baby’s Hair
• Leave the newborn
swaddled and hold the
baby while a family
member washes the
baby’s hair.
11. Step 3: Wash Baby’s Body
• Place baby on the blue
chux and remove
blanket
• Soap and rinse baby
with parent(s)
assistance
• Dry thoroughly
12. Step 4: Place Skin to Skin
• Place infant in direct
contact with the family
member’s skin.
– Mothers need to unbutton
their hospital gown
– Fathers will need to
remove their shirts to
provide sufficient skin to
skin contact
– Cover baby with a blanket
to prevent body heat from
escaping
13. What Skin to Skin Should Look Like
YES! Infant is in direct contact
with the skin!
NO! Infant is not in direct contact
with the skin.
14. Step 5: Check Temperature
• Check an initial post-bath
temp when baby is initially
placed skin to skin. If this
temperature is within
parameters no additional
checks are needed as long as
baby remains skin to skin for
ten minutes.
• If the initial temperature is
below parameters, recheck
after ten minutes of skin to
skin contact.
• If the baby’s temperature is
still lower than 97.7, keep
baby skin to skin and recheck
in another twenty minutes.
15. What if my baby is cold?
• If baby’s temperature
has not recovered thirty
minutes after the bath,
notify the pediatrician
as the newborn may
need to be warmed
under the radiant
warmer and/or may
need a spot glucose
check.
16. 97
97.5
98
98.5
99
99.5
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32
InfantTemperature
Number of Infants
MBU 21JUN-04AUG 2014
PRE and POST Infant Bath Temperatures
Pre
Post
18. Interpreting Our Results
• Time period data collected: 21JUN2014-04AUG2014
• 32 baths were performed at the bedside during this
time period.
– 29 infants were within parameters immediately following
the bath
– 3 infants were below parameters immediately following
the bath, all three of these infants were within parameters
after ten minutes of skin to skin contact
19. Continuing Our Research for Process
Improvement
• A newborn temperature
tracker will be left with the
charge nurse
• After you perform an infant
bath please, please record
your results!
• Thank you for support in
this transition!
• Please refer questions to
CPT Alsup-Morton or the
Ten Steps Committee
Representatives:
– 1LT Rickenbach
– Mrs. Sheedy
20. References
• Dabrowski, G. (2007). Skin to skin contact: Giving birth back to
mother and babies. AWHONN, 11(1), 66-71.
• Elliott, B., Larry, G., & Lisa, W. (2000). Skin-to-skin contact is
anaglesic in healthy newborns. Pediatrics: Official Journal of the
American Academy of Pediatrics, 105(1), 1-6.
• Medves, J., & O'Brien, B. (2004). The effect of bather and location
of first bath on maintaining thermal stability in newborns. JOGNN,
33(2), 175-182.
• Moore, E., Anderson, G., & Bergman, N. (2007). Early skin-to-skin
contact for mothers and their healthy newborn infants. The
Cochrane Library, (3), 1-40.
• Texas Ten Step Star Achiever Training Toolkit. (2014, January 1).
Retrieved September 29, 2014, from http://texastenstep.org/
• MBU Pictures: Thomas Murgel and Morgan Harper
