Infant Bathing and Assessment

Infant Bathing

• Sponge baths are recommended for infants until the umbilical cord separates, usually within 10 to 14 days.
• Tub baths can be given after the umbilical cord site heals completely.
• Infants should be bathed once or twice a week and as needed when the skin is soiled with body secretions.
• The water temperature for a bath should be between 36.7° C to 37.8° C (98° F to 100° F).
• Parents should be taught how to safely bathe, handle, and dress the infant while maintaining body temperature.
• Parents should be aware of ways to provide sensory and social stimulation during bathing.

Assessing the Infant

• Inspect the infant's skin for signs of dryness, peeling, redness, drainage, or infection.
• Assess the umbilical cord site for redness, drainage, drying, and intactness.
• Assess the infant's temperature if they are at risk for hypothermia (below 36.7° C or 98° F).

Bathing Procedure

• Cleanse eyes with plain water from inner to outer canthus.
• Cleanse external ears with plain water and a twisted washcloth, avoid using cotton-tipped applicators.
• Cleanse face and neck with plain water, use a small amount of soap for soiled creases.
• Cleanse mouth with plain water, wash inside lips, cheeks, tongue, roof of mouth, and gum pads.
• Cleanse upper body with warm water and soap, rinse soap from hands.
• Cleanse abdomen around umbilicus with warm water, keeping the cord dry.
• Cleanse legs and outer buttocks with warm water and soap.
• Cleanse genitalia with plain water, wash from front to back for females, from urethra outward for males.
• Cleanse anal area with soap, rinse, and dry last.
• Shampoo hair with mild soap, rinse thoroughly.

Unexpected Outcomes and Nursing Interventions

• Diaper rash: cleanse and dry area after each bowel movement, expose to air and sunlight.
• Dry, cracked, peeling skin: limit bathing to two or three times a week, use plain water.
• Cradle cap: shampoo head daily, allowing shampoo or mineral oil to remain on scalp until crusts are softened, rinse thoroughly, use a comb to remove loosened crusts.
• Redness or drainage around the umbilical site: keep area clean and dry, keep diaper folded below umbilicus, report to healthcare provider.
• Infant's temperature falls below 36.7° C (98° F): wrap in extra blanket and place cap on head, reassess temperature in 30 minutes, warm infant according to protocol.
• Parents are unable to explain and demonstrate bath procedure: establish rapport, reassess teaching techniques, assess for unmet needs and cultural differences.

Documentation

• Record before and after bath temperatures.
• Document skin condition.
• Record parent teaching and response.