5.08.2012

Baby's First Bath

There are so very many options after baby is born. One of the seemingly less considerable options is to bathe or not to bathe baby in the moments following birth.

Routinely, hospitals encourage families to have the hospital nursery staff bathe their baby within 2-4 hours after birth to 'decontaminate baby' from the messiness of birth.

So, with such a good argument in favor of bathing, why might you want to wait?

Body Fluids

Vernix
Once you bathe your baby, you strip baby of that lovely, antibacterial, antioxidizing, temperature regulating, moisturizing natural super-stuff called vernix. This white cheesy coating that many babies are born with is just amazing!
Vernix Caseosa is a marvelous mixture of skin oil and dead cells that baby shed while in the womb. Yes, even oil and dead cells are beautiful... when you consider that this helped to protect him from dehydration and now, while outside the womb, acts as an antioxidant, temperature-regulator, antibacterial (working against E. Coli, GBS, and other bacteria), wound super-healing, cleansing, and moisturizing cold cream.
"... the innate immune proteins found in vernix and amniotic fluid are similar to those found in breast milk. As the baby prepares for extrauterine life, pulmonary surfactant (a substance produced by the maturing fetal lungs) increases in the amniotic fluid, resulting in the detachment of vernix from the skin. The vernix mixes with the amniotic fluid and is swallowed by the growing fetus. Given the antimicrobial properties of this mixture, the authors conclude that there is “considerable functional and structural synergism between the prenatal biology of vernix caseosa and the postnatal biology of breast milk." - The American Journal of Obstetrics and Gynecology, 2004
Amazingly, we have been provided with our own personally, genetically, specifically formulated cold cream from the moment of birth that will prevent peeling of newborn skin as it acclimates to the extra-uterine environment, as well as protects against all the icky stuff it might encounter out here!-  read the rest here.
And, even if your baby is not coated in the stuff, know that baby always has a thin amount of it on their skin at birth (even if we can't see it)..

Amniotic Fluid

Once your baby is born, baby is also stripped from their lovely amniotic-like smell. This is important for mom and baby. That smell helps baby to latch on, not only for the first trip to the breast, but as long as we don't interrupt that olfactory cue.
This is the most studied input for the Breast Crawl and is believed to be the most important. Babies preferred their mother's unwashed breast to her washed breast, soon after birth. (Varendi et al, 1994). Besides secreting milk and colostrum, the nipple and areola are dense in glands that perhaps secrete attractive odours. Washing could have reduced or eliminated such odours. This is consistent with a previous study (Makin and Porter, 1989) where infants preferentially moved towards a gauze pad impregnated with the breast odour of a lactating woman.

Later Varendi et al (1996) showed that within the first hour after birth, significantly more babies spontaneously selected a breast treated with amniotic fluid than the alternative untreated breast. This attraction appears to be based on olfactory cues. Thus, amniotic fluid augments or overrides the attractiveness of the natural scent of the mother' breast. They postulated that observed attraction to amniotic fluid odour may reflect foetal exposure to that substance (i.e. prenatal olfactory learning). They also suggested that throughout the evolution of our species it was probably common for women to handle their babies themselves during and following delivery. Immediately after parturition, the mother's hands soiled with birth fluids would transfer the amniotic fluid to her breasts when she first attempted to nurse her neonate. This may be observed currently amongst non-human primates. The data presented illustrates the importance of maternal odours for newborn infants. Aside from guiding a neonate's overt behavioural responses, such olfactory stimuli also appear to have a calming effect on the infant and provide a basis for early individual recognition of the mother. - Read the rest here
So, it's a good thing to have that delightfully slippery, wet, wiggly baby placed right on your chest... and then the two of you to hold off on washing for a few feedings, if possible.

Temperature
Many, many babies that are regulating their temperatures just fine on their parent's chests, skin-to-skin, suddenly have a drop in body temperature when they are given a bath. This is simply common sense. Think of stepping out of a shower into a room and feeling chill afterward. It's the exact same concept.

I have heard, over and over, nurses use this as an excuse to bathe the newborn: "we need to bathe the baby to see if they can regulate/maintain their own body temperature.". The downside is that they are creating the very circumstances where a baby might have a hard time regulating their own body temperature.

Study after study has found that skin-to-skin care helps regulate babies body temperature, respiration, and heart rate better than any radiant warmer (heated baby bed) can. This is because mom's body is the ideal temperature for baby and mom will attend to babies needs immediately and decrease the probability that baby is stressed/crying/gasping to be nursed. (see IBC for more information).
So what is it about a mother’s body that makes skin-to-skin care so important? Because of the unique symbiosis between a mother and her baby, a mother’s body is designed to provide the perfect environment for her newborn baby. When a baby is placed on her mother’s chest, the temperature of mom’s body not only keeps baby warm, but helps regulate a baby’s temperature to what he/she needs at that very moment. Some babies are born with the inability to regulate their own temperature. Studies have shown that skin-to-skin care is best for keeping a baby’s ideal temperature. It is often reported that artificial heat from an incubator cannot replicate the effects of mom’s touch. It also has been shown that the temperature for twins who are each placed on one of mom’s breasts are regulated independently, adjusting according to their individual needs! - Read the rest here.
Even with all of this information, though, once babies temperature drops from a bath in a nursery, the nurses will not bring a baby back to mom to be held skin to skin. Instead, they will place them in a radiant warmer and wait for baby to warm up, regardless of babies feeding cues.. this, on average, takes an hour of observation.


Stress
I know most of you have seen this: baby in another bed, in another room, far from the warm bodies of his parents, crying.his.heart.out. After awhile, he simple stops. He gives up. He is tired and distressed, so he goes into preservation mode and simply sleeps.
Babies cry. They cry to let us know that they need something. And when we don't respond to those cries, it causes them undue amounts of stress. Science has shown that stress in infancy can result in enduring negative impacts on the brain. Prolonged cries in infants causes increased blood pressure in the brain, elevates stress hormones, obstructs blood from draining out of the brain, and decreases oxygenation to the brain. Excessive crying results in an oversensitive stress system (likened to a faulty burglar alarm in one book) that can lead to a fear of being alone, separation anxiety, panic attacks and addictions. Harvard researchers found that it makes them more susceptible to stress as adults and changes the nervous system so that they are overly sensitive to future trauma. Chronic stress in infancy can also lead to an over-active adrenaline system, which results in the child using increased aggression, impulsivity, and violence. Another study showed that persistent crying episodes in infancy is linked with a 10 times greater chance of the child having ADHD, resulting in poor school performance and antisocial behaviour. However, if you consistently soothe your child's distress and take any anguished crying seriously, highly effective stress response systems are established in the brain that allow your child to cope with stress later in life.... 
Researchers have shown that although leaving a baby to cry it out does often lead to the cries eventually stopping, the cries do not stop because the child is content or the problem has been alleviated. Rather, they stop because the baby has given up hope that a caregiver will respond and provide comfort. This results in a detached baby. Detached children are less responsive, appear to be depressed or "not there" and often lack empathy. - Read the rest here.
What does this have to do with a newborn bath? Well, if you let the nursery nurses take your child to another room to bath your baby.. or even if baby gets bathed in your room with someone who does this same thing day in and day out, it normally looks like the videos below. And then, after baby has cried and cried through a temperature lowering procedure, then they are left to cry some more (or simply 'go away' by falling asleep) in a radiant warmer to begin that pesky temperature regulating.

This is what a typical hospital bath looks like:

As does this variation, although she has some great things to say in this particular video:



But THIS is what a first bath should be like... 


So with that, I will leave you with this: just sayin',  with all the harm that can come from washing your baby in the hospital, what harm can come from not washing your baby in the hospital? Consider these points when making a decision on how to care for your baby after birth.

2 comments:

Summer said...

Oh my goodness! That first video was excruciating to watch!! I didn't finish it. Poor little baby.

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