Delaying Baby’s First Bath

While you might imagine your newborn looking perfectly cherubic from the moment she’s handed to you, in reality her skin likely won’t appear quite like you might expect. Newborn skin is often bluish-red and covered in residual vernix caseosa, the cheesy coating that keeps a baby’s skin protected in the amniotic bath of your uterus. Premature babies have quite a lot of vernix at birth, on-time babies have little and overdue babies may have a bit in their skin folds and under their nails.

For much of the past century, practitioners in hospitals scrubbed that vernix right off immediately after birth. “With the transition to hospital-based care and concerns about germs in the early- to mid-1900s, babies were sent to nurseries, and there was a tendency to clean them off right away,” says Ben Hoffman, M.D., a pediatrician at Doernbecher Children’s Hospital.

“The common practice has been to bathe baby immediately, and that’s related to superstitions that baby was ‘contaminated’ or ‘filthy’ at birth,” agrees William Keenan, M.D., a professor of pediatrics and obstetrics, gynecology and women’s health at the Saint Louis University School of Medicine. “The thought was there would be benefit in immediate bathing. But in fact, it’s just the opposite.”

Over the past few years, experts have been leaning toward a new approach: the “wait to bathe” movement. Keenan says he’s been advocating for the concept for all 45 years he’s been a pediatrician, in addition to a number of other labor and delivery practices that support mothers and families in the birth process — what he characterizes “as a kinder, more aware approach to needs at time of delivery.”

Babies, Keenan explains, are not contaminated at birth. “Their skin has natural protection from infection from the contents from womb. You get better protection from infection if you don’t bathe right away,” he says.

Newborns are also vulnerable to the cold due to thin skin and less ability to generate heat; delaying bathing helps babies to better adjust to the new climate in the outside world. That’s why the World Health Organization (WHO) has for years recommended that practitioners wait at least six hours and ideally at least 24 hours post-birth to give babies their first bath.

Hoffman says WHO’s wait to bathe recommendations actually fall in line with its baby-friendly hospital initiative, launched in the early 1990s, which calls for more maternal-infant bonding, including skin-to-skin contact and breastfeeding immediately after birth. “It’s the idea that you don’t want to separate baby from mom, because those first minutes to hours are really important to developing that bonding relationship. Taking baby away in the first hour for a bath inhibits that,” he says.

A growing number of hospitals and practitioners are catching on. In the last couple of years, Keenan says he’s seen more progress on the wait to bathe movement than the prior 35. “There’s been a gentler view towards birth and the care of the baby, and that’s made a difference. There’s been really a revolution in skill level at bedside, which includes a more hands-off approach,” he says.

At the hospital where Hoffman works, babies often don’t get a bath at all before leaving the hospital — and he thinks waiting for a few hours is beneficial for both moms and their babies. “Anything that can improve bonding and breastfeeding is a good thing,” he says.

What this means for you

In all likelihood, your hospital will delay bathing your baby — especially if you’re at a “baby-friendly” establishment. But not all hospitals are in line with this practice. So if your birth team rushes to wash your baby after birth, speak up.

And if you’re at all nervous about baby’s first scrub-down, ask if you can give a bath together with your nursing team before you head home. Doing so can ease your worries by offering an opportunity to observe and practice with a pro who’s done it thousands of times before.


Protecting Your Newborn’s Skin

Gentle Care for Newborn Skin

Newborn Care 101

Baby Month 1: Your Newborn Guide

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