Ped Skills - Infant Hygiene PPT Presentation

Maintaining Infant Hygiene and
Thermal Protection
NCM 107-PEDIA SKILLS LAB

LEARNING OBJECTIVES:
• Demonstrate safe and evidence-based techniques in providing routine
newborn care—including bathing, cord care, diapering, dressing, and
swaddling—while maintaining infant thermoregulation, hygiene, and
comfort.
• Identify and respond appropriately to signs of abnormal findings such
as hypothermia, skin irritation, or cord stump infection during and after
the procedure, in accordance with clinical guidelines and institutional
policies.
• Educate student nurses confidently on proper newborn hygiene and
thermoregulation practices, emphasizing infection prevention, safe
Maintaining Infant Hygiene and Thermal Protection

Why is it important?
• Proper infant hygiene and thermoregulation are essential
components of well baby care, minimizing infection risk,
maintaining skin integrity, and ensuring optimal
development.
• Routine care must follow an organized sequence: bathing,
cord stump care, diapering, dressing, and swaddling which
are all guided by physiologic and developmental principles.

Physiologic Principles
1. Thermal Stability
Before any care begins, the infant must be thermally
and cardiorespiratory stable to tolerate handling
(Silbert Flagg,2023).
Procedures like bathing must avoid heat loss;
recommended immersion or swaddle bathing at ~38 °C
is proven to better preserve core temperature and
reduce crying responses.

• Delay the first bath until the infant is
cardiorespiratory and thermally stable, generally
between 6–24 hours after birth to avoid
hypothermia and preserve the protective vernix
layer.
• Tub immersion or swaddled bathing improves
thermal stability versus sponge bathing (less
temperature variability, calmer behavior).

• Use warm water ( 38 °C), warm room (26–28 °C), and
≈
complete drying within 5 minutes post‐bath to prevent
heat loss.
• Dress infant in layers appropriate for room temperature;
avoid overdressing which risks overheating; avoid tight
swaddling that may restrict breathing or impair hip
development.

2. Stress Minimization
• Interventions should reduce physiological stress—
heart rate spikes, cortisol surges, disturbed breathing.
Swaddle bathing reduces these stress signals and
promotes organized behavior afterward .
• Swaddling supports the infant’s motor rest and
warmth while allowing hip flexion and movement;
avoid covering face or overheating.
• Swaddled immersion bathing is effective in
temperature maintenance and calming behavior.

3. Skin Integrity and Barrier
Protection
• Bathing should help preserve the vernix and
stratum corneum, avoiding harsh soaps and over-
cleansing.
• Cord stump should be kept dry and exposed;
overuse of antiseptics or moisture increases
infection risk
• Dry cord care is recommended: keep stump clean,
dry, and exposed to air; diaper should be folded

• Only cleanse if visibly soiled, using clean water;
avoid alcohol or unprescribed antiseptics unless
ordered (preserves skin barrier and reduces
irritation)
• Frequent diaper checks and changes prevent
diaper dermatitis. Use warm water or mild cloth
wipes; pat dry; apply barrier (zinc oxide/petrolatum)
if redness appears
3. Skin Integrity and Barrier
Protection

• Parental participation in routine care to enhance
bonding, confidence, and learning for home care
continuation.
Developmental Principles
1. Family Involvement
2. Support of Natural Behavior and
Comfort
• Swaddling after cleaning provides containment and promotes
rest—reducing startle reflexes and transitional stress.
• Maintaining the vernix supports innate antimicrobial
protection.

• Performing care in a progressive sequence
(bathe cord diaper dress swaddle)
→ → → →
allows stability checks between steps and keeps
the infant calm and physically supported.
Developmental Principles
3. Sequential Flow of Care

• Safety: Checking stability after each step ensures the
infant’s physiologic status remains optimal.
• Skin Protection: Avoid repeated wet-dry cycles that
compromise skin.
• Optimal Parent Learning Opportunity: Family
participation during bathing carries into other steps,
reinforcing technique.
Why Follow the Sequence?

PREPARATION
ASSESSMENT AND
IMPLEMENTATION
EVALUATION AND
DOCUMENTATION
AFTERCARE

1. Verify physician’s order and infant stability (vital signs
and stress level)
Preparation
Rationale:Ensures infant is thermally stable and
suitable for bathing or handling.
2. Wash hands thoroughly and don clean gloves (if
needed).
Rationale:
Prevents infection and maintains asepsis

3. Gather and prepare all required materials:
PREPARATION
●warm water
○basin
○towels
●mild soap (baby bath soap/baby wash)
○diaper
○cotton balls
○baby clothes (layette/tie-side)
○swaddling blanket
○mittens,booties, and cap/bonnet
(optional)
Rationale:
Promotes
efficiency and
avoids leaving
infant
unattended

4. Adjust room temperature to ~26–28 °C and water
temperature to 37.5–38 °C
PREPARATION
Rationale:
Prevents hypothermia and promotes infant
comfort
5. Explain procedure to caregiver and encourage participation
Rationale:
Promotes learning and parental bonding with
infant

6. Remove clothing except diaper; wrap infant in towel or
blanket if swaddle bathing
7. Gently clean the infant’s face with cotton balls
soaked in water; no soap
Rationale:
Minimizes heat loss and maintains
containment
Rationale:
Avoids eye or skin irritation; face is most
exposed
ASSESSMENT AND
IMPLEMENTATION

8. Immerse infant slowly in tub or basin, supporting head
and neck
9. Wash body using gentle strokes; avoid scrubbing;
rinse thoroughly
Rationale:
Provides warmth and reduces stress
reactions
Rationale:
Protects skin integrity and avoids trauma
ASSESSMENT AND
IMPLEMENTATION

10. Remove from bath, dry completely using patting
motions especially in folds
11. Inspect cord stump for redness, discharge, or foul
odor
Rationale:
Prevents moisture retention and heat loss
Rationale:
Identifies early signs of infection
ASSESSMENT AND
IMPLEMENTATION

12. Clean stump only if visibly soiled using clean water and
dry gauze; fold diaper below stump
13. Clean genital area with warm water or soft wipes; pat
dry
Rationale:
Promotes natural drying and prevents
contamination
Rationale:
Prevents diaper rash and maintains hygiene
ASSESSMENT AND
IMPLEMENTATION

14. Apply barrier cream if skin is red or irritated.
15. Choose cotton clothing appropriate to room
temperature
Rationale:
Protects against moisture and friction-
related injury
Rationale:
Prevents overheating or chilling
ASSESSMENT AND
IMPLEMENTATION

16. Dress infant in layers; ensure clothes are comfortable
and non-restrictive
17. Place infant on flat surface and swaddle snugly, hips
loose, face uncovered. Do not wrap tightly around chest.
Rationale:
Supports free movement and comfort
Rationale:
Promotes warmth, security, and reduces
startle reflex
ASSESSMENT AND
IMPLEMENTATION

18. Check temperature post-procedure (axillary)
19. Reassess cord area after drying for signs of bleeding or
discharge
Rationale:
Ensures normothermia and effective thermal
protection
Rationale:
Identifies complications needing referral
EVALUATION AND
DOCUMENTATION

20. Check skin for residual moisture or new irritation
21. Observe infant’s comfort level and breathing pattern
Rationale:
Detects early onset of dermatitis
Rationale:
Ensures airway is clear and infant is settled
EVALUATION AND
DOCUMENTATION

22. Document time, methods used, and any abnormalities
observed
Rationale:
Ensures accurate records and continuity of
care
EVALUATION AND
DOCUMENTATION

23. Return infant to bassinet or to the mother for skin-to-
skin holding or feeding
24. Discard used supplies properly; sanitize reusable items
Rationale:
Supports bonding, thermoregulation, and
glucose stability
Rationale:
Maintains a clean and safe environment
AFTERCARE

25. Wash hands after procedure
26. Provide health teaching to mother an/or guarduan
on cord care, diapering, and signs of concern (e.g., fever,
cord infection)
Rationale:Prevents cross-contamination
Rationale:
Empowers parents and promotes safe care
at home
AFTERCARE

Short Quiz
Physical Assessment and Anthropometric Measurements of a Newborn

Checking with
rationalizatio
n

Guided
Practice
Assessment

Return
Demonstration Next
Week
SIMULATION

Ped Skills - Infant Hygiene PPT Presentation

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