Bathing babies six hours after birth protects from infections – Paediatricians

P Paediatricians have said delaying bathing babies for at least six hours after birth protects them from infections and cold besides other proven health benefits.

The child health experts explained that during the first few hours after birth, the babies were still adjusting to the outside environment, and bathing them immediately disrupted their natural physiological processes, such as temperature regulation and hormonal balance.

The physicians clarified that the protective vernix caseosa, a creamy substance that covers a baby’s skin in the womb, helps to regulate the baby’s body temperature, provides moisture, and contains antimicrobial properties that shield the baby from infections.

The experts also stressed that delaying the bath allows for essential bonding time between the newborn and the parents, facilitating skin-to-skin contact that promotes attachment and breastfeeding.

A study by the International Childbirth Education Association shows that delaying the bath of a baby after birth could have a significant impact on the newborn’s survival.

The ICEA encouraged parents and care providers to embrace the practice, emphasising that it was endorsed by regulating bodies and, when done right, remains safe for families and care providers.

“Delaying bathing for at least eight hours after birth protects the newborn’s skin from bacterial invasion, keeps their skin conditioned, and keeps their blood sugar stable since bathing might lower their temperature and often cause the baby to cry, both of which can promote hypoglycemia,” it added.

According to the World Health Organisation, bathing should be delayed until 24 hours after birth or at least six hours if this is not possible due to cultural reasons.

The global health body re-emphasised the key elements of newborn care, including delayed bathing, skin-to-skin contact, breastfeeding, and immunisation.
They stated that given the vulnerability of preterm and low-birth-weight babies, interventions are needed to identify these newborns in care.

Speaking exclusively with PUNCH Healthwise in different interviews, the paediatricians said delaying the first bath protects the baby from infections and colds while encouraging the establishment of breastfeeding and bonding between mother and child.

The doctors pointed out that delaying babies’ baths after delivery helps healthcare providers monitor the baby’s health status during this critical period.

A Consultant Paediatrician at the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Dr Stanley Onah, said delaying the first bath of a newborn to at least six hours after birth protects the baby from infections and hypothermia.

He explained that during the initial hours of life, the babies are still adjusting and trying to acclimatise to the outside environment, emphasising that bathing them immediately could disrupt their natural physiological processes, such as temperature regulation and hormonal balance.

Highlighting other benefits associated with the delay, Onah said, “This practice protects the babies against cold and affords the babies the opportunity of acclimatisation with their new environment and gradually aligning with the new temperature.

“One of the benefits of this practice is that it prevents the baby from suffering hypothermia. Hypothermia is a low temperature. If the baby is coming from a womb environment, you don’t want the baby to come from a warm environment to a very cold environment. The baby could suffer some chemo-dynamic changes in that situation.

“So, you want to maintain as much as possible what the baby was encountering in the uterine environment so that the baby will acclimatise to the new environment.”

He noted that protective vernix caseosa also helps to regulate the baby’s body temperature, provides moisture, and contains antimicrobial properties that shield the baby from infections.

Onah, however, noted that in some special cases, a newborn is expected to be bathed immediately after birth to prevent potential infection from the mother.

He said, “There are no contrary indications to bathing a newborn immediately after birth. What we do by not washing them immediately is to mimic the womb environment where the baby is coming. Newborns can be bathed in some cases.

“There are no contrary indications to birthing. In fact, in some situations, you are encouraged to birth the baby with water and soap immediately after birth if the mother is suspected to be infected with the Human Immunodeficiency Virus or Hepatitis to reduce the risk of mother-to-child disease transmission.

“So, to prevent any possible infection of the baby through the mother’s contact, the baby will be washed off immediately to ensure that the infection or the virus does not have the chance of penetrating the baby’s body.

He further noted, “As I said earlier, there is no contrary indication to bathing immediately after birth. It is just that the baby has been in the womb environment and the womb is warm. We did not want to expose the baby to cold after birth, so we decided not to bathe the baby.

“The baby can suffer hypothermia. The baby can suffer a cold. So, we want an environment that will mimic what the baby has in the womb until the baby is able to acclimatise to the new environment. That is why we clean, dry, clothe, and sometimes, apply oil.”

He, however, noted that in some situations, if the mother has some infections like HIV and Hepatitis, the health professional is expected to bathe the baby almost immediately after birth to prevent unsuspected transmission of the diseases to the newborn.

“In this case, the baby has to be bathed with ordinary water and non-medicated baby’s soap,” he said.

Corroborating his statement, a Consultant Paediatrician at the Life International Hospital, Awka, Anambra State, Dr Sylvia Echendu said not bathing a baby immediately after birth had a number of benefits

On the importance of vernix on the skin of a baby, she explained that while the baby is still in the uterus, vernix forms a hydrophobic barrier, which protects against the loss of fluids and electrolytes.

Echendu said, “Vernix acts as an antimicrobial barrier to protect the baby as it passes through the birth canal. After the birth of the baby, the vernix still plays a role in protection.

“The newborn skin goes through some dramatic changes in the first few days. In particular, there is a decrease in PH and surface hydration. If vernix is left in place, the skin stays hydrated and has less cracking and peeling.”

She noted that there is evidence that Vernix acts as a thermoregulator, saying that this function drove the practice change to delay baths.

“Vernix has antioxidant properties and contains antibiotic properties that can protect against meconium, inter and extrauterine infections, and bacterial pathogens. Apart from the cold, delaying bathing a newborn, protects against several challenges,” she said.

She, however, added that there were times when the newborn bath was recommended immediately, saying, “If the mom is HIV positive or has a hepatitis virus then a bath is done to limit transmission to the baby and others who come in contact with the baby.”