Delayed Bathing in Newborns

Erin Bodine, Juliana Rotz, Mary Duda, Chelsea McNeal, & Madison Stryffeler
Introduction
● Healthcare workers are constantly reevaluating what can be done to better newborns overall health.
● By not bathing newborns after birth and allowing the vernix to stay on the baby’s skin for hours after
delivery helps with moisture retention and thermoregulation.
● When thermoregulation is maintained, glycemic control of the newborn is more stable.
● There is a correlation between delaying a bath and prolonging the amniotic fluid exposure with
increased breastfeeding rates.
● In order to address the issue regarding delayed newborn baths, information was acquired via
OhioLINK databases. Specifically CINAHL Plus with Full Text, MEDLINE, and Electronic Journal
Center.
● Eight sources were reviewed for comprehensive data collection regarding delayed newborn baths.
Research Question:
“In newborns, how does waiting 24 hours to bathe compared to
bathing within 24 hours influence newborn’s adaptation to
extrauterine life during the first 72 hours of life?”
Skin and Vernix
● Vernix caseosa is a natural protective barrier that protects the skin from the womb
environment
● First noticed at week 17 gestation and continues to cover the body
● Vernix covers 72% of the infant’s body if their gestational age is in between 33-37
weeks
● Why preserve vernix on the skin by delaying a bath?
○ Increases skin hydration
○ Decreases skin pH values
○ Decreases skin erythema
Skin Moisture
● Research has shown benefits to delaying newborn baths
● Using a “DMM Skin Moisture Meter” researchers were able to determine skin
moisture levels ranging from 0-99%
● Measurements were and before the bath, after the bath, and 10 minutes after the bath

10th minute after bathing

moisture level: 10th minute measurements in this
Bath after 24 hours = 24.31% study suggest postponing the first
Bath after 48 hours = 25.50% bath is effective in preserving
skin moisture.
The moisture level is statistically
significantly higher bathing after
48 hours.
Thermoregulation Background
● Important to monitor newborn temperatures
● Newborns adapting to extrauterine life
● Multiple modes of heat loss occur
● Goal of newborn temperatures:
○ Refrain from going into hypothermic range, 97.7 degrees Fahrenheit
Thermoregulation
● Studies found benefits from delaying bath 24
hours
○ Decrease incidence hypothermia
● When bath delayed 1-12 hours: no significant
decrease in hypothermia rates
● Vernix and biofluids assist in
thermoregulation of newborn
○ Bath / removal too early may increase rates of
hypothermia
Thermoregulation
● When bath delayed 24 hours:
○ Most hypothermic events
occur pre-bath
○ Hypothermia rates 2.5 times
greater
● Pre-bath temperature had higher
incidence of hypothermia the longer
the bath was delayed
● When bath delayed 24 hours:
○ Post-bath temperature
significantly decreased rates of
hypothermia
○ Postbath temperatures more
often in normothermic range
than if the bath was not
delayed
Thermoregulation Conclusion
● There are benefits from delaying newborn bath

● If delayed too long may have hypothermic event prebath

● If bathed too early higher incidence hypothermic event (postbath)

● More research needs to be done to find optimal time for the newborn
bath
○ To avoid hypothermia both prebath and postbath
BATHING TECHNIQUES: Conventional
vs. WHO Recommendations
● Conventional bathing is traditionally done
within 6 hours after birth.

● The World Health Organization (WHO)

recommends delaying baths for 24 hours
after birth.
Glucose Stability Does delaying newborn baths for 24 hours contribute to

glucose stability?

● To understand glucose stability the criteria for

hypoglycemia in newborns has to be recognized.

● In newborns, hypoglycemia is usually recognized

as a blood glucose level that ranges from 45-47

mg/dL according to our research.

● Most research validates delayed bathing as a

proactive measure to prevent hypoglycemia and

maintain thermoregulation in a newborn.

Glucose Stability
● There is a correlation between thermoregulation and glycemic control when delaying newborn baths for 24 hours.

● Delayed bathing decreases cold stressor episodes.

● Cold Stressors = Increased metabolic rate which is needed to keep them warm.

● Increased metabolic rate = Decreased glucose stores, which in turn leads to hypoglycemia.

● Research found that both high risk and healthy newborns benefited in both thermoregulation and glucose stability

when bathing was delayed 24 hours.

● The majority of newborns studied were births with no complications.

Breastfeeding
● Researchers have found an increase in
hospital exclusive breastfeeding when
delaying the newborn bath by at least
12 hours
○ Increased from 59.8% to 68.2%
○ Total of a 14.5%growth
● Exclusive breastfeeding = no formula
nutrition from birth until discharge
● Suckling reflex lasted longer when
exposed to amniotic fluid longer
Breastfeeding
● Baby-Friendly designated hospitals already have above average rate of hospital
exclusive breastfeeding with delayed baths
○ Will not see as much of an increase when delaying newborn bath for at least 12-24 hours compared to
non-baby-friendly hospitals
Conclusion
● The paper concluded that there was sufficient amount of evidence that proved that
allowing vernix and other substances to remain on the infant’s skin improved the
moisture of their skin, thermoregulation, glycemic control and breastfeeding rates.
● Not enough studies have been conducted to determine the newborns’ adaptation to
extrauterine light during the specific time frame of their first 72 hours of life.
● However, research concluded that delaying a newborn bath can benefit the newborn
beyond 72 hours by establishing healthy bodily functions from the start.