Delayed Bathing Newborn | Improves Breastfeeding Success

If you are a new or expectant parent, you might have heard that delaying your baby’s first bath can improve health outcomes.

You might be surprised to learn that many hospitals now have a delayed bathing policy to support the recommendation to avoid early bathing. Giving your baby time to absorb the vernix – that waxy, cheesy coating on a new baby’s skin – helps regulate body temperature and blood glucose levels. Delaying the first bath also allows the newborn to stay alert and interested in feeding, making those early moments and attempts at latching on more successful. The smell of the amniotic fluid on the skin is also familiar and comforting to your newborn, assisting the transition to the outside world.

There have even been studies to suggest that a delayed bath can improve breastfeeding initiation and outcomes. The first hours of your newborn’s life are so important; keeping your baby close, delaying visitors and avoiding any unnecessary interruptions can all contribute to breastfeeding success.

What is the benefit of delaying the newborn bath?

There are many benefits in a delayed bath for newborns and they have been backed up by scientific evidence.

Some of the benefits of delayed bathing are:

  1. Allows the newborn baby’s body temperature to stabilize, regulates the heart rate and breathing, reducing the risk of hypothermia
  2. Allows the vernix caseosa to stay intact; vernix cleanses, moisturizes and acts as a barrier from infection for a newborn baby
  3. Allows micro-organisms from the mother to colonize the baby’s skin
  4. Reduces stress hormones and vigorous crying in newborns, by releasing oxytocin in both the mother and infant, promoting feelings of calmness and connection.
  5. Allows time for adequate skin to skin contact between a mother and baby, improving early breastfeeding outcomes.
  6. Increases opportunities to observe the baby’s early feeding cues, such as rooting, mouthing, and hand-to-mouth movements.

For more information, you can read BellyBelly’s article Your Baby’s First Bath | 6 Serious Reasons To Delay.

How the vernix supports exclusive breastfeeding

Vernix is the naturally occurring thick, white film that covers a fetus in the last trimester of pregnancy and is present on a newborn baby at birth.

The amount of vernix present on your baby’s skin at birth relates to the gestation at they are born. Babies born closer to their due date or past their due date generally have less, while babies born earlier usually have a thicker coating. This makes sense as vernix creates a barrier that protects your baby from infection and helps regulate the body temperature, which is vital for babies born prematurely.

There is a decreased incidence of healthy newborns being separated from their mothers if thermoregulation is not required at birth. Keeping babies closer to their mother from birth improves the initiation and continuation of exclusive breastfeeding.

World Health Organization recommendation on delayed bathing of newborns

Within the World Health Organization recommendations for newborn health, for policy makers and health professionals, it is stated that delayed bathing of newborns should be avoided at least 24 hours after birth. If this is not possible, for cultural reasons, their first bath should be delayed for a minimum of 6 hours after birth.

Healthy full term newborns without complications should be placed in skin to skin contact with the mother immediately after birth, to prevent hypothermia and to promote breastfeeding initiation.

Low birth weight babies or those requiring medical attention after birth should be placed skin to skin with the mother as soon as they are clinically stable and the mother is ready.

Evidence that delayed bathing improves breastfeeding initiation

There is evidence to suggest that the practices that promote uninterrupted skin to skin contact between mother and baby (such as delayed bathing of newborns) improves breastfeeding rates.

For more information on this, you can read BellyBelly’s article 7 Huge Benefits of An Undisturbed First Hour After Birth.

More research is needed into the direct effects of delaying bathing of newborns and the associated outcomes on breastfeeding. In the few studies that have been conducted, however, there have been positive associations.

In a 2019 initiative to improve exclusive breastfeeding by delaying bathing of newborns, it was found that delayed bathing was associated with an increase in exclusive breastfeeding rates in hospital, and with the use of breast milk as part of the hospital discharge feeding plan.

In a 2020 study on the effects of delayed bathing of newborns on breastfeeding, hypothermia and hypoglycemia, results showed that the delayed bathing directly resulted in improving exclusive breastfeeding rates at the time of discharge from hospital.

Baby friendly practices within the hospital system

The Baby Friendly Hospital Initiative (BFHI) focuses on improving hospital stay and care and positive health outcomes for newborn babies. There are 10 steps in the BFHI; step 4 recommends delayed bathing of baby’s until after the initial period of skin to skin contact with mum and after completion of the baby’s first breastfeed.

The Royal Children’s Hospital clinical guidelines state that the newborn bath should take place no earlier than 6 hours, but ideally more than 24 hours after birth.

Further bathing principles in neonatal nursing state that sponge bathing is not recommended for a newborn bath, as it can result in stress and excessive heat loss.

What is a swaddled immersion bath?

In a swaddled immersion bath, your baby is placed into a tub of warm water while loosely swaddled in a light blanket. This helps your baby feel protected and secure.

The Royal Children’s Hospital recommends holding your baby in a swaddle, submerged in the water for a couple of minutes so the baby can adjust to the change of environment. After a couple of minutes have passed, limbs can be taken out of the swaddle, one at a time, to be cleaned before being re-wrapped.

Hospital studies have found that 38% of babies cried during a swaddled immersion bath, compared with 93% of babies who cried during a sponge bath. Studies found that sponge baths resulted in increased stress for both parents and babies.

When a mother feels stressed, it can affect her let-down reflex. It is also difficult to attach a crying baby to the breast for breastfeeding.

How often should I bath my newborn baby?

After your newborns initial bath, you do not need to bath the baby daily. Bathing too frequently can dry out your baby’s sensitive skin. For this reason, it is recommended to bath your baby 2-3 times per week.

You can keep babies clean between baths by cleaning their bottoms with each nappy change and using a soft wash cloth with warm water to gently wipe their faces.

Between baths, you should also check your baby’s skin folds to make sure they are clean. Areas such as the thighs, groin, armpits and chin can also be cleaned using warm water and a soft wash cloth.

Tips for bathing your newborn

When you are ready to give your newborn the first bath, here are some tips for making it as comfortable for your baby as possible:

  • Water temperature should be 37-37.5 degrees C and deep enough for baby to be fully immersed
  • Swaddled immersion is ideal
  • Vernix caseosa should stay intact, as far as possible
  • Bath time should be around 5 minutes
  • The outside environment should be controlled, to minimize heat loss when removing baby from the bath
  • Skin to skin contact can be used as a rewarming method after bathing.

Creating a postpartum plan for bathing

If you have a birth or breastfeeding plan prior to giving birth to your baby, you might like to include information about delaying your newborn’s first bath.

Including this as a part of your plan makes your wishes clear to your health care providers and serves as a reminder to you of important decisions, in the early hours and days after your baby’s birth.

For more information about writing a birth plan, you can read BellyBelly’s article Birth Plan – Why Write One? Free Birth Plan Template.

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