Bathing and Beyond: Current Bathing Controversies for Newborn Infants

Area of Science:

• Neonatal care
• Dermatology
• Public health

Background:

• Newborn bathing practices are debated, including timing, necessity, and methods for hospitalized premature and full-term infants in the Neonatal Intensive Care Unit (NICU).
• Current practices range from immediate bathing to delaying the first bath, with varied approaches for infants requiring intensive care.

Purpose of the Study:

• To review existing literature on newborn infant bathing.
• To examine controversies surrounding bathing practices for Neonatal Intensive Care Unit (NICU) patients.
• To specifically investigate the use and implications of daily chlorhexidine gluconate (CHG) baths for neonates.

Main Methods:

• Literature review of studies on newborn bathing.
• Analysis of research on temperature regulation, skin parameters, and breastfeeding outcomes related to bathing timing and methods.
• Evaluation of safety data and concerns regarding chlorhexidine gluconate (CHG) use in Neonatal Intensive Care Units (NICUs).

Main Results:

• Delaying the first newborn bath to 1 hour after delivery can maintain temperature and offers benefits like improved breastfeeding.
• Immersion bathing is associated with better temperature regulation and reduced infant stress.
• Daily bathing is not essential; premature infants can be bathed every 4 days without increased skin colonization. No significant differences in skin parameters were observed with water alone versus water and mild cleanser.
• Concerns exist regarding systemic absorption of chlorhexidine gluconate (CHG), particularly its potential to cross the blood-brain barrier in premature infants, warranting caution with daily NICU bathing.

Conclusions:

• Evidence-based practices, such as the benefits of immersion bathing, should guide Neonatal Intensive Care Unit (NICU) patient care.
• Further research is necessary to establish the risks and benefits of daily chlorhexidine gluconate (CHG) bathing before widespread adoption in the NICU.