Monday, August 29, 2011

Baby and Bath Water

Bathing your newborn

A common question that is asked by parents at their first visit to the pediatrician is, "when should I bathe my newborn?"

While there are numerous cultural beliefs, old-wives tales, and family traditions regarding how newborns and infants are washed, there are a few facts and tips that everyone should know about bathing babies.

About 100 children less than five years old drown in bath tubs each year.
·         Never leave a child alone in or around water for any amount of time.
o   Young children can drown in less than one inch of water.
o   Never allow a child to bathe a baby; this job should only be given to a responsible adult.
·         Bath toys and bath mats can harbor bacteria, make sure to disinfect all toys and mats after each bath and allow them to dry prior to using them again.
·         Always check the water temperature before placing a child into a bath or running the water over them.
o   It is generally recommended to have the water temperature be around the same as a normal body temperature (between 98-100 degrees).
§  What may be a good water temperature for you in the shower is typically too hot for a baby.
·         The depth of bath water for a newborn or infant should be about 2 inches.
o   Water depth should be no higher than their hips – when they are in a seated position.
·         Avoid using sponges to wash a baby – use a soft wash cloth instead.
o   Sponges are associated with an increased risk for contamination by bacteria and fungus.

The Bath
The American Academy of Pediatrics recommends that children are bathed with a wash cloth only on a padded, flat, surface until the umbilical cord stump falls off (usually around 1-2 weeks). 
·         Once the umbilical cord stump has fallen off, newborns can be bathed in a tub, sink, or “baby bath.”
·         Pediatric dermatologists recommend that a bath be no more than 5-10 minutes in length, with many pediatricians recommending less than 5 minutes for bath time.
o   Research in older children and adults has shown that a bath taking place just before bedtime is associated with a decreased amount of time it takes to fall asleep.  Consider making bath time occur just before putting your baby to bed.
·         Newborns and infants typically do not require more than 2-3 baths per week.
o   More frequent bathing can actually dry out a baby’s skin more than no bathing at all.
o   When do I start bathing my child everyday?
§  Once your baby begins to crawl and get dirty is the time that they will start requiring daily baths.
o   Always remember to wash in between all skin folds.
·         Avoid adding any cosmetic bath oils to the bath water as these can irritate an infant’s skin.

Water vs. Soap
Recommendations from pediatric dermatology societies state that using a mild non-scented liquid soap is ok, as long as it is mild in strength and non-irritating to the skin.
·         Water only baths are also ok for this age group.
o   Do you have “hard” water?
o   “Hard” water has been associated with increased risk for developing eczema, a type of dry skin rash.
§  You can purchase hard water testing kits at many hardware stores or online.
·         Mild liquid soaps are better at removing fecal material and urine residue from the diaper area than just water alone.
o   Adult soaps are typically too strong and harsh for a baby’s skin; look for washes indicated for babies.
·         Shampoo is not usually necessary at this age, but can be used if desired.
o   Look for baby shampoo that is non-irritating and mild in strength.

The After Bath
Babies should be dried immediately after bathing to prevent them from losing too much body heat.
·         Infants should be patted dry after the bath and placed immediately into clothing.
o   Never put damp clothes onto a baby.
o   Rubbing hard with a towel can actually damage an infant’s skin which is still maturing until 12 months old.
·         Use a moisture protectant (emollient) on their skin after the bath to protect the skin from becoming too dry and cracked.
o   Ask your pediatrician for recommendations on which moisture protectant to use.

Immediately discontinue the use of any bath product that irritates your baby’s skin or causes a rash.

For more information on newborn and infant bath recommendations and techniques, please consult with your pediatrician.

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