December 28, 2018

The Link between Delaying Newborn Bath and Rates of Breastfeeding

The difference 12 hours can make

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Bathing a newborn just after birth has long been standard practice; however, a new Cleveland Clinic study found that waiting to bathe a healthy newborn 12 or more hours after birth increased the rate of breastfeeding exclusivity during the newborn hospital stay.

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Heather DiCioccio, DNP, RNC-MNN, Nursing Professional Development Specialist for the Mother/Baby Unit at Cleveland Clinic Hillcrest Hospital, led the study.

“We wanted to conduct research on this topic because more mothers were asking us not to bathe their baby right away,” Dr. DiCioccio says. They were reading on mom blogs that it was better to wait to bathe their baby the first time, since amniotic fluid has a similar smell to the breast — which may make it easier for the baby to latch.

“When we went to the literature to learn more about the link between delaying the first bath and breastfeeding exclusivity, we learned that data were scarce – we found only one study in the published literature,” she says. Dr. DiCioccio knew that for a new standard of care to take hold, she and her team would need rigorous data.

Study design and results

Beginning in April 2016, nurses at Hillcrest Hospital’s Mother/Baby unit began delaying the first bath for healthy newborns until at least 12 hours post-birth, with a goal of reaching 24 hours. After three months, they compared post-practice-change data with data from February 2016 (prior to practice change). The two data sets comprised about 1,000 mother/baby couplets.

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Breastfeeding exclusivity increased significantly when post-practice change was compared to pre-practice change. The effect was stronger in mothers who delivered vaginally, compared to those who delivered by C-section.

Staff and family reactions

“When the practice change began, some nurses resisted making the change,” Dr. DiCioccio says. Their resistance lessened once they saw how much parents liked it. “The staff really took ownership in the process and made it their standard.”

“It is now our policy to delay the bath at least 12 hours, unless the mom refuses to wait. In that case, we ask for two hours,” she says.

Dr. DiCioccio and her team are pursuing publication of the study and hope it spurs more research and ultimately changes the practice nationwide.

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Why Does Delaying the First Bath Increase Breastfeeding?

The answer is unclear, but research findings (Cleveland Clinic’s and that of others) point to a few factors:

  • Skin-to-skin time: “By not bathing babies, there is more skin-to-skin time with mom, so that can play a role,” Dr. DiCioccio says.
  • Smell: The similarity in smell between the amniotic fluid and the breast may encourage babies to latch.
  • Temperature: Babies in Dr. DiCioccio’s post-practice-change group were more likely to have stable/normalized temperatures post first bath. “They weren’t as cold as pre-practice change babies after their first bath, so they weren’t too tired out to nurse,” she says.

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