Why you should delay baby's first bath

Newborns are usually washed in hospital soon after birth, but here’s why you may want to wait.

TP06-steps-baby-first-bath-june-2015-article

Before she latched—before she even opened her eyes—my eldest daughter had her first bath in the hospital. She was just a few hours old when our skin-to-skin snuggle was interrupted by an efficient nurse who insisted it was time for the tub. I assumed the bath was next on the checklist (after the routine Apgar test and being weighed) and didn’t question the timing. But when my second baby was born at home, my midwife suggested we wait on the bath. She said vernix caseosa, the waxy coating on newborns’ skin, is a natural moisturizer and cleanser, and protects against infection. Plus, babies are not good at regulating their temperature, and being bathed doesn’t help. After a full 10 days of enjoying that fresh baby smell—and after the first diaper explosion—we bathed her.

“Babies are not born dirty,” says Michael Farmer, head of the Department of Family Practice and postpartum medical director at BC Women’s Hospital & Health Centre. “At BC Women’s, there is no urgent need to get the newborn baby bathed, and this can be delayed at the parents’ request. Mother-baby bonding time is very important, and the caregivers would not want to interfere with skin-to-skin time and establishing breastfeeding. Bathing a newborn can certainly wait.” A good towel rub is all that’s needed to remove any amniotic fluid, blood and meconium, he adds.

It’s standard practice for nurses to bathe babies in hospital, and parents are usually encouraged to participate. How long after birth the first bath takes place varies among Canadian hospitals, and studies suggest some may be rushing it. In 2010, researchers at the Boston Medical Center increased the wait time for newborn baths to at least 12 hours after birth from its standard two to four. They found that delaying bathing a newborn was associated with a significant increase in exclusive breastfeeding rates, which may be due to limiting stress following delivery, when infants are working to stabilize their temperatures.

My midwife’s advice on the benefits of vernix was on point. According to research published in the American Journal of Obstetrics & Gynecology, the vernix, removed during early bathing, contains antimicrobial proteins that are active against group B strep, E. coli and other common perinatal pathogens. 

So how long should you wait? The World Health Organization advises delaying the bath for 24 hours, though a survey of Canadian hospitals found that kind of wait is not the norm. At BC Women’s, the initial bath doesn’t happen until at least four hours and often up to 24 hours postpartum. At Toronto East General Hospital, a healthy full-term baby who has maintained a stable temperature is bathed after eight hours at the earliest. Every hospital contacted said parents’ requests to delay the bath are always honoured. 

“The first bath in hospital is now much more of a teaching and learning experience for the new parents,” says Farmer. “It is not done for hygiene, but it is certainly helpful for parents to learn how to bathe their newborns.”

Chantal Joy watched attentively as a nursing student at The Ottawa Hospital bathed her eldest daughter for the first time, explaining everything step by step. The new mom was grateful for the lesson. “Beyond the nervousness, I found it very awkward to bathe such a tiny person. I was worried that she would somehow slip out of my hands and under the water,” says Joy, adding that she felt much more confident after the demonstration. Joy later researched the health benefits of delayed bathing and decided to wait when her second child was born. “There was no real reason to have my daughter bathed right away. I bathed her about a week after she was born.”

Expert tip: Instead of giving her a bath, help your baby maintain her body temperature by washing her face, head and hair (if she has any!) while she’s wrapped up. Wipe each eye from inside corner to outside using a different bit of your damp cloth and then wash her face.

A version of this article originally appeared in our June 2015 issue, with the headline “Delaying the bath,” p. 46.

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