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Many babies are washed soon after they take their first breath, but new evidence shows it’s best to wait before that trip to a tiny tub.
Delaying a healthy newborn’s first bath for at least 12 hours after birth increases the odds of the mother exclusively breastfeeding her baby during her hospital stay, a study published Monday in the Journal of Obstetric, Gynecologic & Neonatal Nursing found.
“It makes us happy to see that happen,” lead author Heather Condo DiCioccio, DNP, RNC-MNN, told TODAY. “Any increase that we can get in breastfeeding rates is going to be significant.”
DiCioccio is a nursing professional development specialist for the Mother/Baby Unit at Cleveland Clinic Hillcrest Hospital in in Mayfield Heights, Ohio, which used to have a policy of bathing a baby within two hours of birth.
But when more and more patients began asking the nurses to hold off washing their newborns in recent years, she and her colleagues decided to look into reports that this practice could boost breastfeeding success. The World Health Organization already advises delaying a baby’s first bath until 24 hours after birth, though it doesn’t specify a rationale for the recommendation.
The study involved 996 pairs of women and their healthy newborns. About half — 448 — fell under the hospital’s previous policy of bathing babies when they were about two hours old. The other 548 mom-baby pairs followed the new protocol — with nurses delaying the first bath for at least 12 hours.
When researchers compared the two groups, they found exclusive breastfeeding rates — meaning no formula use during the family’s hospital stay — rose from 59.8 percent in the first group to 68.2 percent after the policy change.
Why is it happening?
One possible explanation is that delaying a bath translates into more uninterrupted skin-to-skin time between baby and mom, which means a calmer, less stressed-out baby who is ready to breastfeed.
“It’s important that you get to stay with your baby, have that bond with the baby without having the baby taken away from you right away,” said Debbie Onwuka, who recently gave birth at Cleveland Clinic Hillcrest Hospital. She was not part of the study, but followed the protocol of delaying her baby’s first bath for more than 12 hours.
“It also helps mom to calm down, too, just having their baby on their chest and knowing that they just created a human,” Onwuka added.
In the study, the effect was stronger on women who delivered vaginally — likely because their babies are placed on their chest immediately compared to C-section deliveries, when it may be up to 30 minutes before skin-to-skin contact begins, DiCioccio said.
Another possibility is that newborns are relying on a familiar scent that will guide them to the breast.
“They’ve been swimming in the amniotic fluid for 38, 39, 40 weeks of their life and the mother’s breast puts out a similar smell as that amniotic fluid,” DiCioccio said. “So the thought is maybe the two smells help that baby actually latch. It makes it easier for the baby to find something comfortable and normal and that they like.”
The study also found newborns who were bathed later were more likely to have a normal temperature after the bath, compared to the younger babies who were cold and perhaps too tired to breastfeed as a result. "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," notes Children's Mom Docs, a blog written by pediatricians.
Other benefits of delaying the first bath include not washing off the vernix, the white film newborns are covered with, which has antimicrobial properties and properties that help a baby’s lung development, DiCioccio said.
Some newborns may still need the first bath sooner
If the mother has been diagnosed with HIV, has active herpes lesions or hepatitis B or C, nurses will still bathe their newborns at around two hours of age because there’s too much risk of them being exposed to blood-borne pathogens, DiCioccio said.
Hospitals are following different policies
Every clinic has its "own thing” in place right now, she added, so it’s possible expectant mothers could encounter pushback. Some nurses may resist the changes, but DiCioccio urged them to reconsider.
“If the mother is willing to wait and wants to wait, let her,” she said.
As for new moms, DiCioccio had this advice: “Trust your gut. If your gut is saying, ‘I’m not quite ready to bathe my baby,’ go with it.”