The Health Reporter Is In: Aug. 10, 2017

The Health Reporter Is In: Aug. 10, 2017

Questions for our Health Reporter? Click here and veteran reporter Deb Pressey will chase down your answer.

Q: Some hospitals are following the World Health Organization's recommendation to delay a newborn baby's first bath by 24 hours after birth. What's the policy on that at local hospitals?

A: Carle Foundation Hospital and Presence Covenant Medical Center both promote a bathing delay and honor the wishes of the parents.

Provided mom and dad are on board, they both delay baby's first bath, but generally not for as long as 24 hours.

Carle changed its policy on newborn bathing last October, encouraging parents to delay that first bath for 12 hours after birth. Covenant delays new baby bathing for at least four hours, or longer when parents request that, nurses at those hospitals said.

"A lot of it is based on parent preference, and what's going on with mom and baby," said Robyn Wienke, patient care manager at Covenant's birthing center. "We always try to get babies skin-to-skin as soon as possible."

Getting a newborn into skin-to-skin contact with mom — or if mom's not able, with dad — right after birth already delays that first bath by four hours, "and it can be longer. If parents ask we will delay more," Wienke said.

Both Covenant and Carle promote skin-to-skin bonding time with baby and parent(s) right after birth, and the bathing delay also helps stabilize the baby's blood sugar, helps regulate baby's body temperature and eases and promotes breast feeding, according to both hospitals.

Specifically, the WHO recommendation states the following:

"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. Appropriate clothing of the baby for ambient temperature is recommended. This means one to two layers of clothes more than adults, and use of hats/caps. The mother and baby should not be separated, and should stay in the same room 24 hours a day."

Some parents are put off by holding a baby who is still "gunky" and hasn't been cleansed of amniotic fluid and the vernix covering the skin, though the longer the mom goes into the pregnancy, the more of that vernix that will have been absorbed, Wienke said.

Vernix is the white, waxy substance covering a baby's skin that forms during the third trimester and helps protect against pathogens. Left on after birth for a time, it also helps to stabilize body temperature, she said.

A new-born baby doesn't have the same kind of body temperature regulation adults have, Wienke said.

"When they're born, their bodies are trying to adapt to being on the outside," she said.

With a 24-hour delay, the baby reaps the full benefit of the vernix, Wienke said, but even with an earlier bath, the vernix isn't completely removed because it's so thick.

Melissa Reigart, a nurse in Carle's OB services and an educator for its mother-baby unit, recalled attending an in-state conference more than a year ago in which delayed bathing was a topic and about a quarter of those attending raised their hands when the speaker asked how many hospitals were delaying first baths. She brought the idea back to Carle, and Carle spent last summer coming up with new materials for expectant parents so they wouldn't be surprised by a new policy, she said.

As of last October, Carle now delays baby's first bath by 12 hours with the parents' permission, she said.

Carle set out with a goal of 85 percent participation in the 12-hour delay, but the participation has been 96 percent, Reigart said.

"It was met with less resistance than we expected," she said.

Wienke said a bathing delay also cuts down on disruptions right after birth for the baby, and allows time for a new mom to participate if she can't get out of bed right away. It can even allow time for siblings to arrive and participate, and "it's kind of a family event this way," she said.

All this applies to normal term births, according to the hospitals. At Covenant, a pre-term and/or sick baby in the special care nursery might not be bathed for 24 hours or longer to avoid the additional stress, Wienke said. Carle will delay the bath for an hour for term babies and two hours for pre-term babies if parents object to the 12-hour delay, Reigart said.

Of course, there are also times that first bath can't be delayed due to safety reasons for the baby. If the moms are positive for HIV or hepatitis B or come in with active herpes, the baby gets that bath right after birth, then is placed skin-to-skin with mom, Reigart said.

Carle has a lot of families that come in with birthing plans for the hospital to follow, Reigart said.

"What's really cool is we are seeing a lot of delayed bathing on the birth plans," she said.

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