Delaying Baby’s First Bath

My newborn daughter was screaming during her first bath as I watched helplessly from my bed. She was only about an hour old.  I was trying to breastfeed her when the nurse took her from my arms, telling me that the baby had to be bathed before I was transferred to a different room. We don’t do it this way anymore– it is now standard protocol at many hospitals to wait 8-24 hours to give a baby his or her first bath, and up to 48 hours if the baby was delivered by cesarian section. Delayed newborn bathing is consistent with World Health Organization recommendations and based on medical research. As a hospital-based pediatrician, I know that delayed bathing is the safest medical choice for babies. As a mom, it just seems right.

Here are 8 reasons why doctors recommend delaying a newborn’s first bath:

1. Reduced risk of infection: Babies are born covered in a white substance called vernix, which is composed of the skin cells your baby made early in development. Vernix contains proteins that prevent common bacterial infections. Think of vernix as a sort-of natural antibacterial ointment. Your baby is born covered in this anti-germ barrier. Bacteria such as Group B Strep and E. coli are often transmitted to newborns during delivery and can cause bloodstream infections, pneumonia and meningitis, and can be fatal. These are not rare infections– we test babies for them daily. Vernix is nature’s protection against these infections.
2. Stabilized infant blood sugar: Bathing a baby too soon after birth can cause low blood sugar. Here’s why: in the first few hours after birth a baby has to adjust to life outside the uterus, including losing the placenta as a source of blood sugar. Bathing causes crying, stress and the release of stress hormones. Stress hormones can cause a baby’s blood sugar to drop, which can make a baby too sleepy to wake up and breastfeed, causing the blood sugar to drop even more. Rarely, low blood sugar can cause neurological injury.
3. Improved temperature control: 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.
4. Improved maternal-infant bonding: New babies need to snuggle skin-to-skin with their mom be given a chance to try to breastfeed. I have been attending deliveries regularly for more than a decade, and I love it. But those first few minutes of life are not meant to be spent with me, a nurse or any healthcare professional. Those precious few minutes are meant for bonding between baby and parents. As long as the baby does not need help breathing or immediate resuscitation, babies need to be held by their mother. Infants who are held skin-to-skin on mom’s chest have better blood sugar and temperature control and have an easier time learning to breastfeed. We even do skin-to-skin at c-section deliveries. The bath can wait.
5. Improved breastfeeding: Studies show more breastfeeding success when moms are allowed to stay skin to skin with babies and this time is not interrupted by medical “procedures” or a bath. If you’ve ever struggled to breastfeed a newborn, you know how hard it can be to get them to latch onto your nipple. Breastfeeding can become a stressful burden on a very tired mother. But babies who breastfeed in the first hour of life—and preferably in the first 30 minutes—have a much easier time learning how to latch. Why? Because when the baby is inside mom’s uterus, she is constantly and rhythmically sucking in amniotic fluid and swallowing it. At birth, she cries, breaths air and starts to forget how to suck and swallow. If you wait more than an hour to breastfeed, babies can have a hard time latching, sucking and swallowing. If you breastfeed right away, the baby still remembers how to suck and swallow. If you put a baby skin-to-skin between mom’s bare breasts at delivery, she will be warm, soothed by mom’s voice, find the breast herself, latch right on and start nursing. The moms giggle and cry. They are so happy. This is how the first few minutes of life are meant to be. Forget the bath.
6. No baby lotion required: Vernix is a natural skin moisturizer and skin protectant. Babies need skin protection during the transition from the amniotic fluid into the air environment. If you delay the bath, there is no need for artificially scented baby lotion. Instead, you get to enjoy that new-baby smell.
7. Everyone will wear gloves: Hospital workers are always supposed to wear gloves when caring for an unbathed baby, to prevent exposure to body fluids such as amniotic fluid and blood. Some studies have shown that glove-wearing keeps babies safer too, by preventing transmission of common viruses and other infections from workers to babies.
8. Parents get to enjoy bathing their baby: After mom has had time to recover, parents can more easily participate in baby’s first bath and it becomes a teaching opportunity between nursing and parents. You can use whatever special baby bath products you choose and watch your baby coo and smile.

Delayed bathing is not yet protocol at some hospitals, but you can still request it. Be sure to include your desire for delayed bathing in your birth plan. Don’t have a birth plan? You need one. Here’s an example to get you started. Before writing your birth plan, be sure to think about these 11 medical decisions to make for your baby before delivery, or someone else will make them for you.