A parent of a preemie asks, “Once we get home, I’m a little nervous about bathing my baby. He is so small! It’s one thing to do it with you all here in the NICU, but I’m feeling a little nervous about bathing the baby at home. Any suggestions?”
Good question! Here is an article I crafted just for you (and a version of it is featured in the new consumer magazine, Healthy Mom and Babies, and the new AWHONN websites Health4women.org and Health4Mom.org ) on Bathing Your Preemie. Special thanks to the Farmer family and Annie Tao Photography for permission to use their photos.
Feel free to share this article with your friends, but please let people know you got it here! I welcome your questions and comments.
Congrats! You’re home!
You’ve done the bath in the hospital; but wait! What did they say again?? Here are 6 steps to help you complete the bath in a stress-free manner.
1. Be the Boy Scout
Just as you would gather supplies before making your favorite recipe, get those bath things assembled in a warm environment. Most bathrooms will serve for this activity. Avoid drafty kitchens, unless you mean to intentionally cool the baby. Silence the phone, or better yet, have an extra pair of hands to help in case…since parenting seems to invoke Murphy’s law.
Assuming your preemie’s umbilical cord has healed, you will dunk as opposed to swipe n’ wipe. Place the baby bathtub on a firm surface. Make sure articles remain away from baby’s reach. Prepare the after-bath area for drying by padding with extra clean towels. Better grab an extra diaper, since bathing often stimulates babies to relax and let it rip!
Before you begin, toss clean clothes and bath towels in the dryer on “delicate” to warm them for a special touch. (Never use the microwave or convection oven to warm clothes.) Remove and place towels on the prepared surface.
2. Test the Water
Baby’s bath should be warmer than lukewarm, so she doesn’t get chilled. Body temperature is 98.6 F, so figure about 99F-100F for bath water. A wise old maxim says to test by putting your elbow in the water, as our hands are used to warmer temperatures.
Use a non-glass container, and fill with rinse water before you begin.
Supporting head and shoulders
3. The Dunk
Spread your fingers and grasp the base of the skull and the shoulder girdle with one hand. Concentrate on supporting the upper body and allow the lower torso to float freely.
If your baby doesn’t relax into the bath, she may be telling you the water is too hot or cold, you are holding her at the wrong angle, or that she doesn’t feel well.
Wiping inner to outer corner
4. The Eyes Have It
Cleanse from top to bottom. Beginning with the eyes, use cotton balls or a corner of a clean washcloth in plain water. Squeeze out the excess water and with one swipe, move from the inner to the outer corner. Then change cotton balls, or rotate to another corner of the cloth. The principle here is to avoid cross-contamination; any bacteria housed in one eye is easily transfered to the other. With this in mind, also avoid back and forth swipes on the same eye.
Continue to wash the rest of the body with mild baby soap. (Note: For boys with fresh circumcisions, do a sponge bath until your baby’s doctor or healthcare provider confirms it is completely healed.)
Give extra attention to the neck folds and creases in the arms and legs.
Rinse, using the plastic pitcher. It will be helpful to have an extra pair of hands!
5. How Dry I Am!
Lift baby out of the tub, keeping the head and spine in alignment, and place on her back on those nice warm towels. Dry quickly, blotting, into the nooks and crannies of the neck, arms, and legs.
You may use a cotton swab to dry behind the ear or in the curlycues of the outer ear, but avoid entering the ear canal except to soak up what moisture is visible. (A cloth wrapped around a finger may do just as well.)
The skin, our largest organ, is a semi-permeable membrane, and clogs easily. Preemie skin is delicate, owing to the fact they have fewer layers beneath the surface, and it dries easily. Know that if you use lotions, creams, or powders, you will need to bathe more often. Lotion is not needed for most babies, but if you do so chose, use it sparingly, and avoid the face and genitalia.
6. When to Shampoo?
Applying water to the head causes an immediate cooling effect. If baby is feverish or the weather outside is hot, you may cool your baby with water to the head first. In most cases, plan to shampoo last.
The process of applying soap and doing an actual shampooing is not a daily need for baby (or most adults, for that matter). Once or twice a week should be sufficient.
Wrap baby in a warm, dry towel and place in the football hold, tucking her legs under your arm. Angle her head down slightly, to avoid getting water down her neck. Hold baby over the sink and use your hand or the plastic pitcher to wet the hair.
Next, add a small amount (about a dime-size) of baby shampoo to the back of the scalp. Proceed to stimulate the sebaceous glands beneath the scalp with your finger pads (or by using a soft baby brush), in a circular motion, until all the hair has been covered. This will help keep oil from accumulating in the pores. (Note: a condition known as sebaceous dermatitis or “cradle cap” may appear at first as scaly skin or dandruff. You may apply a small amount of natural oil and work into the scalp with a gentle massage, to loosen these flakes a few minutes prior bathing.) Be sure to rinse thoroughly.
Timing is everything
Remember, your preemie will likely be fatigued and sleep longer after the bath. Do make sure to begin about 30 minutes prior a feeding, to avoid stomach upset. Preemies, in particular, need to digest while unstressed.
If you feel overwhelmed at the prospect of bathing your preemie, you are not alone. Trust that you have grown to know your child and that you have the skills to parent her well. With practice, soon you’ll be recalling these 6 simple steps with ease, and baby bath time will be a fun and relaxing time for all!
Farmer triplets- all clean!
Candace Campbell, RN, MSN, has practiced as a NICU nurse, and educator for 20 years. Her documentary film, Micropremature Babies: How Low Can You Go? plus her delightful children’s books, My Mom Is A Nurse, and Good Things Come In Small Packages (I Was A Preemie), are available on Amazon.com or at: www.candycampbell.com or www.candythenurse.com. A percentage of the profits of each sale goes to our friends at the March of Dimes.