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Effects of bathing immediately after birth on early neonatal adaptation and morbidity: a prospective randomized
Y Nako1, A Harigaya, T Tomomasa
1Department of Pediatrics, Gunma University School of Medicine, Maebashi, Japan. yanako@showa.gunma-u.ac.jp
Insights
Bathing newborns immediately after birth did not negatively impact their vital signs or cause early health issues. This practice appears safe for healthy term and near-term infants.
Area of Science:
- Neonatal Care
- Pediatric Physiology
Background:
- The optimal timing for newborn bathing post-delivery remains unclear.
- Established guidelines for early newborn care lack definitive recommendations on immediate bathing.
Purpose of the Study:
- To investigate the effects of immediate postnatal bathing on newborn physiological parameters.
- To assess the impact of early bathing on early neonatal morbidity in healthy infants.
Main Methods:
- A randomized prospective comparative study involving 187 healthy term and near-term infants.
- Comparison between infants bathed 2-5 minutes after birth and a control group receiving dry care.
- Monitoring of rectal temperature, respiratory rate, heart rate, blood pressure, and SpO2, along with assessment of neonatal morbidity.
Main Results:
- Newborns bathed immediately after birth maintained significantly higher rectal temperatures compared to the dry care group.
- No significant differences were observed in respiratory rate, heart rate, blood pressure, or SpO2 between the groups.
- The incidence of early neonatal morbidity, including vomiting, feeding issues, and need for therapies, was comparable in both groups.
Conclusions:
- Immediate postnatal bathing is not associated with adverse effects on the physiological adaptation of healthy term and near-term newborns.
- Early bathing appears to be a safe practice for healthy newborns, with no increased risk of early neonatal morbidity.
Objective:
Because the risks and benefits of early bathing of newborn infants are not well established, we investigated the effects of bathing immediately after birth on rectal temperature, respiratory rate, heart rate, blood pressure, percutaneous arterial blood oxygen saturation (SpO2) and early neonatal morbidity.
Methods:
The study was designed as a randomized prospective comparative study in the neonatal care unit of a university hospital. A total of 187 healthy term and near-term newborn infants, who were delivered vaginally without asphyxia, between January and December 1997 were the study subjects. We compared findings in newborns who were bathed 2-5 min after birth (n = 95) with those of a control group (n = 92) who received dry care instead. Groups were comparable with respect to gestational age, birthweight, male: female ratio, Apgar score and umbilical blood pH. Rectal temperature was measured with an electronic thermometer immediately before the intervention bathing or dry care and at 30 min and 1, 2, 3, 8 and 12 h after birth. Heart rate, respiratory rate, systolic and diastolic blood pressure and SpO2 were measured at 1, 2, 8 and 12 h after birth. The incidence of early neonatal morbidity, including hyperbilirubinemia and gastrointestinal and respiratory problems, was also compared.
Results:
Rectal temperature changed over time postnatally in both groups (P < 0.0001, ANOVA) and there was a significant difference in rectal temperature between groups (P< 0.0001, ANOVA). Mean (+/- SEM) rectal temperature at 30 min after birth (i.e. approximately within 20 min after intervention) was significantly higher in the bathed group than in the control (dry care) group (37.30 +/- 0.06 is 37.00 +/- 0.05 degrees C, respectively; P = 0.000022). Respiratory rate, heart rate, blood pressure and the ratio of the number of infants with SpO2 90-94% and 95-100% did not differ significantly between the two groups. The incidence of early neonatal morbidity, including vomiting, acute gastric mucosal lesion, polycythemia, need for tube feeding, phototherapy and oxygen therapy, also did not differ between the two groups.
Conclusions:
Early bathing, minutes after birth, did not appear to adversely affect the adaptation of healthy full-term and near-term newborn infants.