Effect of newborn bathing training with the swaddled and tub bathing methods given to primiparous pregnant women on the mother's experience, satisfaction and newborn's stress during the first bathing of the newborn at home: A mixed method study

A global survey on national standard care for newborn bathing

AIM

To describe national standard care for newborn bathing and its influential factors.

METHODS

A global survey was conducted using a web-based questionnaire. The targeted countries were 166 member countries of either the International Confederation of Midwives (ICM) or the International Council of Nurses (ICN). An eligible person included someone well informed of midwifery education/training or neonatal care, including newborn bathing, in their country. To examine the factors associated with the standard care for newborn bathing, information on mean annual temperature, precipitation, gross domestic product per capita, and basic water coverage was collected as external factors. Student's t tests and Chi-square tests were used for analysis.

RESULTS

Care standards were identified in 46 countries: seven from Africa, eight from the Americas, 15 from Asia, 14 from Europe, and two from Oceania. In most countries, newborns were bathed with warm water in a tub within 10 min. Bathing frequency, moisturization, and use of soap or cleanser varied by country. There were significant associations between bathing frequency and temperature and between moisturization and precipitation.

CONCLUSION

The national standard care for newborn bathing in each country was unique. Standard bathing care was associated with the climate. More consideration should be given to the differences in standard care for newborn bathing between countries when interpreting existing studies and conducting future studies on neonatal skin care.

Evidence-Based Consensus Recommendations for Skin Care in Healthy, Full-Term Neonates in India

Purpose

Neonatal skin care practices guided by personal experience and preferences might be substantially different across different hospital settings. The aim of this consensus recommendation is to provide clinical practice guidance to healthcare practitioners on evidence-based neonatal skin care practices from delivery-to-discharge, in hospital settings.

Patients and Methods

A Scientific Advisory Board meeting on "Evidence-based Neonatal Skin Care Practices and Protocols" was held in December 2020 with an expert panel comprising neonatologists, pediatricians, obstetricians and gynecologists and pediatric dermatologist. Comprehensive literature search was performed up to 23 March 2021 using PubMed and Google Scholar to retrieve relevant evidence.

Results

Recommendations were developed on critical aspects of skin care in healthy full-term neonates including cleansing at birth, skin-to-skin care, cord care, diaper area care, initial and routine bathing, cleansers and emollients use, and criteria to choose appropriate skin care products. Recommendations include inclusion of skin assessment in routine neonatal care, first bath timing after cardio-respiratory and thermal stabilization, 6-24 hours after birth; bathing with water alone or adding a mild liquid cleanser could be considered appropriate as it does not impact the developing skin barrier; use of emollients is recommended for neonates with higher risk of development of eczema to maintain and enhance skin barrier function and integrity; and inclusion of skin care advice in neonatal discharge checklist. Importance of rigorous quality control, high-quality clinical trials for assessment of baby products, usage of products that are formulated appropriately for newborns, and full label transparency for baby products were highlighted. The panel identified gaps in literature and discussed the scope for future research.

Conclusion

These recommendations may help to standardize evidence-based skin care for healthy full-term neonates in Indian hospital settings to improve the quality of care that neonates receive in hospital and facilitate improvement in overall neonatal health outcomes.

Hot fomentation of newborn fontanelles as an indigenous practice in Ghana: implications for policy and integrated community-based health care in Covid-19 pandemic and beyond

OBJECTIVE

African newborns undergo numerous traditional and religious practices ranging from fontanelle fomentation to total head shaving, scalp molding, skin scarification and ano-genital irrigation which can negatively impact the health of neonates. Hot fomentation of fontanelles has been a predominant indigenous home-based postnatal practice in Ghana and among Africans in the diaspora. Mobility restrictions during the Covid-19 pandemic has impacted direct access to facility-based care as well as home care. The flourishing of newborn traditional practices among African populations during this Covid-19 pandemic offers opportunities to rethink the provision of family healthcare support for newborns during the ongoing pandemic and beyond. Hence, the aim of this critical review was to examine and describe a common indigenous practice-hot fontanelle fomentation to inform home birth support, discharge planning, and the delivery of optimal home-based care support.

STUDY DESIGN

This study is a review of literature on hot fomentation of newborn fontanelles.

METHODS

Literature search in CINAHL, PubMed, African Index Medicus and Scopus, was conducted and evidence synthesised from articles ranging from 1983-2022. Sixty articles were reviewed; however, 10 manuscripts were excluded prior to screening. The other 19 were exempted because they were either below 1983 or were not the best fit for the study purpose. In all, 31 studies were included in the study. The study was guided by Madeleine Leininger's Culture Care Diversity and Universality care theory.

RESULTS

The current study identifies hot fomentation of newborn fontanelles practices in Ghana, the description of hot fomentation practices and the dangers associated with it. The findings and suggested ways to help overcome this challenge.

CONCLUSION

There are several neonatal indigenous practices including fontanelle fomentation which pose threat to the health of the neonate as discussed in this study. Future research needs to investigate innovative ways of fontanelle fomentation where necessary instead of the use of hot water by mothers, especially in this Covid-19 pandemic where health and mobility restrictions impact physical access to timely health care. This research will help educate mothers about the dangers of fontanel fomentation and reduce the practice, especially in rural areas of developing countries. This could help reduce neonatal mortality and unnecessary healthcare costs.

Effects of swaddled and traditional tub bathing on stress and physiological parameters of preterm infants: A randomized clinical trial in China

PURPOSE

The present research aims to study the effects of swaddled and traditional tub bathing on premature infants to identify better ways to bathe.

DESIGN AND METHODS

Eligible premature infants (n = 60) were randomly assigned to either swaddled bathing or traditional tub bathing group. Stress scores and physiological indicators were measured 10 min before, immediately after, and 10 min after bathing. Crying times were also recorded for both groups. Data were reported as mean and standard deviation (SD) or frequency (percentage). For analyzing the data, the Student t-test and Chi-square test were employed.

RESULTS

Swaddled bathing has less effect on the respiratory rate, heart rate, and oxygen saturation (p < 0.05). Both bathing methods led to a decrease in the temperature of infants. Still, the temperature of infants 10 min after bathing, in the swaddled bathing group was rose higher than the traditional tub bathing (t = 2.813, p < 0.05). The stress score of the swaddled bathing group, immediately after and ten minutes after bathing was lower than the traditional tub bathing group. The crying time of the swaddled bathing group was 32 ± 24.740(s) lower than the traditional tub bathing group 94.43 ± 41.625(s).

CONCLUSIONS

The advantages of swaddled bathing over traditional tub bathing were validated for feasibility in China's preterm infants. Swaddled bathing is recommended method for bathing technique in the neonatal intensive care unit.

PRACTICE IMPLICATIONS

Swaddled bathing is beneficial for the development of premature infants, as it results in less noxious stimuli and stress on the developing premature neonates.

Construção e validação de um vídeo educativo sobre o banho de imersão do recém-nascido

RESUMO Objetivo Construir e validar um vídeo educativo sobre o banho de imersão do recém-nascido. Método Pesquisa metodológica, de produção tecnológica, desenvolvida nas fases: pré-produção, produção e pós-produção no período de dezembro de 2020 a fevereiro de 2022, validado por enfermeiros doutores,profissionais da área da comunicação social, equipe de enfermagem, puérperas e familiares. Utilizou-se o Índice de Validade de Conteúdo para avaliar concordância entre juízes e público-alvo e Alfa de Cronbrach a confiabilidade dos itens. Resultados O vídeo tem oito minutos e 34 segundos e foi organizado emantes, durante e após o banho. Roteiro/script e storyboard avaliados quanto ao objetivo, conteúdo, relevância, ambiente, linguagem verbal e inclusão de tópicos e vídeo quanto a funcionalidade, usabilidade, eficiência, técnica audiovisual, ambiente e procedimento, todos alcançaram índices iguais ou maiores a 0,80. Conclusão O vídeo apresenta potencial tecnológico para ser utilizado durante ações de educação emsaúde e práticas de educação permanente.

Construction and validation of an educational video on the newborn immersion bath

ABSTRACT Objective To build and validate an educational video about the immersion bath of the newborn. Method Methodological research, of technological production, developed in the phases: pre-production, production and post-production in the period from December 2020 to February 2022, validated by nurse practitioners, professionals in the area of social communication, nursing team, puerperal women and family members. The Content Validity Index was used to assess consistency and Cronbrach's Alpha reliability. Results The video is eight minutes and 34 seconds long and was organized into before, during and after the shower. The script/script and storyboard were evaluated regarding the objective, content, relevance, environment, verbal language and inclusion of topics and the video regarding functionality, usability, efficiency, audiovisual technique, environment and procedure, all of which achieved indices equal to or greater than 0,80. Conclusion The video has technological potential to be used during health education actions and in continuing education practices.