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The Effect of Delaying the First Newborn

Bath on Breastfeeding Exclusivity

Joni H. Lisenbee, MSN, RN, IBCLC • Mary Ellen Wright, PhD, APRN, CPNP
Jennifer Holloway, BSN, RN • Sheri Denslow PhD, MPH
Mission Health • Asheville, NC

Background Collection Methods Interpretation

The World Health Organization (2013) recommends that bathing be delayed until • Data was extracted from the retrospective chart review and the data warehouse In this study there were no significant differences in the pre and post
after 24 hours of age in a newborn. Thermoregulation is a primary consideration in software qlikview intervention groups related to feeding frequency or exclusive breastfeeding
the timing of the first bath and often cultural reasons make the bath a priority • The Statistical Package for Social Sciences (SPSS) was be used to analyze the data. associated with delayed bathing.
over breastfeeding initiation, skin to skin and bonding time with the mother. The Using logistic regression analysis there was significant difference found in the
events of the immediate postpartum period are highly associated with the • Frequency statistics were used to describe the demographic characteristics of the factor of phototherapy in the pre and post intervention groups (p = < 0.01).
initiation and duration of breastfeeding and exclusive breastfeeding. Bartick and participant population.
Reinhold (2010) study found that “if 90% of US families could comply with medical • Bivariate tests of association between the predictor variable (intervention vs. control
• Because the exclusivity rate at the tertiary care center in this study was already
recommendations to breastfeed exclusively for 6 months, the United States would group status) and the outcome (exclusive breastfeeding) were performed using X² tests.
near 70% it may have caused less of an impact than on a tertiary care center
save $13 billion per year and prevent an excess 911 deaths, nearly all of which • Multivariate logistical regression analysis to tests for the differences in odds of exclusive that has not already instituted those evidenced based breastfeeding practices.
would be in infants” (Bartick & Reinhold, 2010, p. e1048). breastfeeding before and after the intervention in relation to the confounding personal
factors and the multiple variable being compared: infant birthdate, birth time, location of • Feeding frequency was taken from electronic documentation and quality of
birth, whether Baby Friendly Hospital designation, feeding type, length of hospital stay, length feeds was not taken into consideration.
of neonatal intensive care unit stay if applicable, gestational age, and exclusive breastfeeding
upon discharge to home. Significance was set at p < 0.05 (significance level 95%).
Results • Research has already shown several benefits to delaying the first bath of the
Purpose newborn. Among those benefits are a reduction in hypothermia, hypoglycemia
• The aim of this research study was to find out if delaying the stressor of the (McInerney, C. M., & Gupta, A., 2015) and one study delay of bathing for 12
first newborn bath would cause an increase in feeding frequency while hours showed an increase in breastfeeding exclusivity (Preer, et al, 2013).
hospitalized post birth. • Even though this study did not show any statistical significance related to
• Also if the factors of Baby Friendly Hospitalization, gestational age, serum exclusive breastfeeding, it did show significance in the factor of phototherapy.
bilirubin, or phototherapy significant influence the correlation of delayed infant Future studies should be performed to further evaluate the variables such as
bathing and exclusive breastfeeding rates on hospital discharge to home. frequency of feedings, serum bilirubin, and a more in depth look at the effect
delayed bathing has on hyperbilirubinemia.
Design • The impact of improved feeding in infants could have significant impact on
• This study is a comparative, correlational, cohort study involving two groups improving health outcomes in this population.
of infants:
1.) Infants receiving the intervention of delayed bathing in the postpartum period,
2.) Comparison group of infants who did not have delayed bathing, correlated
with exclusive breastfeeding during postpartum hospitalization.
• Exclusive breast milk feeding is defined as giving no other food or drink – not
even water – except breast milk. References
Agency for Healthcare Quality and Research (2007). Breastfeeding and Maternal and Infant Health Outcomes
Setting in Developed Countries. Retrieved from
• A medium sized health system using three of the hospital sites to obtain patient Bartick M Reinhold A 2010 burden of suboptimal breastfeeding in the United States: A pediatric cost analysis.
data. Bartick, M., & Reinhold, A. (2010). The burden of suboptimal breastfeeding in the United States: A pediatric
cost analysis. Pediatrics, 125(5), e1048-56. 20121021100456236107230
• 1st hospital: 394 deliveries per year. Centers for Disease Control and Prevention. (2016). Breastfeeding among U.S. Children Born 2002–2012,
CDC National Immunization Surveys. Retrieved from
• 2nd hospital: 200 deliveries per year.
McInerney, C. M., & Gupta, A. (2015). Delaying the First Bath Decreases the Incidence of Neonatal
• 3rd hospital: 4000 births per year. Hypoglycemia...Proceedings of the 2015 AWHONN Convention. JOGNN: Journal of Obstetric, Gynecologic
& Neonatal Nursing, 44S73-4. doi:10.1111/1552-6909.12650.
Time frame
Preer, G., Pisegna, J. M., Cook, J. T., Henri, A., & Philipp, B. L. (2013). Delaying the Bath and In-Hospital
• Four months before and four months after implementation of delayed bathing Breastfeeding Rates. Breastfeeding Medicine, 8(6), 485.
on July 1st, 2016. World Health Organization. (2013). WHO recommendations on postnatal care of the mother and newborn.
Geneva: World Health Organization, 2013.