Booby Traps Series: Why the newborn bath should wait

This is the 32nd in a series on the Booby Traps, made possible by the generous support of Motherlove Herbal Company.

Continuing on with our series on Booby Traps in the hospital, today I’m writing about the newborn bath, and how its timing can pose a barrier to breastfeeding.

Remember the first video you ever saw of a birth?  For moms of my generation that was probably in a school health class.  For you younger moms it might have been online.  But either way, one of your first impressions might have been:  “Wow, that baby is kinda goopy.”

Yes, our little guys can make a pretty messy entrance into the world, but some gentle toweling off (ideally while on the mom’s chest) can go a long way to removing the goop.  What the evidence strongly suggests, however, is that dealing with it by whisking a baby away to its first bath is dangerous in several ways.  It’s clearly bad for maintaining the baby’s temperature, and – you guessed it – it’s harmful to breastfeeding, too.

Why?  Because a baby’s instincts to crawl to the breast – the whole sequence of newborn behaviors, in fact – is in part connected to the baby’s sense of smell.  In the Impact of Birthing Practices on Breastfeeding, Linda Smith explains:

The senses of smell and touch are especially powerful triggers of infant and maternal behavior, because the nerve fibers lead directly to the amygdala, the seat of emotional memory and fear conditioning.  The newborn’s sense of smell is especially acute in the first hours, triggering breast-seeking behaviors and movements.  Washing or bathing the mother or baby removes olfactory cues that support breastfeeding and attachment, and thus should be avoided.

Nowhere is this more evident that in the “breast crawl” (also referred to as “self attachment”): the instinctual movements of the newborn toward the breast in the first hour or so after birth.  The groundbreaking research by Righard in 1990, showed a marked difference in “breast crawl” behaviors between babies who were removed for bathing and measurements than babies who weren’t.

The sense of smell, and particularly the smell of amniotic fluid on the baby and a similar smell at the mother’s breast, appears to be one factor unlocking this sequence of instinctive behaviors.  This is also borne out by the fact that when a baby’s hands are washed, she is less likely to do the instinctual hand-to-mouth movements typically seen in the first hour after birth.

(And you probably won’t be surprised to hear that babies will turn toward pads which contain their mothers’ breast scent, but not toward an unscented pad.)

For these reasons, the first  California Department of Public Health (to name one of many health authorities) recommends in its Model Hospital Toolkit:

Babies are usually most ready to breastfeed during the first hour following birth. For the normal newborn this should occur prior to such interventions as: the newborn bath, glucose sticks, foot printing, and eye treatments.

During the first day of life, skin-to-skin time and breastfeeding should take priority over other routine events such as infant bathing, pictures, and visitors. [my emphasis]

It’s also for these reasons that the WHO recommends, in an international context:  “Ensure warmth by delaying the baby’s first bath to after the first 24 hours.”

My husband and I didn’t bathe either of our babies for a while, because – in spite of my 16 year old-self’s reaction in health class years ago – it was really the furthest thing from my mind.  My husband’s attitude was: “They have the rest of their lives to get clean.  They won’t have this time again.”

But not all moms feel as if they have this option.  Unfortunately, some moms are still pressured to have their babies bathed early on.  If you’re concerned that your baby might be bathed in the first hour, or that it might interrupt your skin-to-skin experience on your first day, you can specify your wishes in your birth plan, and discuss this with your providers.

As with many other potential Booby Traps in the hospital, if enough moms make noise about it, this policy may change.

Was your baby taken away for a bath in the first hour, or before you wanted it?  Did you want your baby bathed because of the ‘goop?’  How did these things relate to your breastfeeding experience?



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42 Comments | Last revised on 02/29/2012


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42 Responses to Booby Traps Series: Why the newborn bath should wait

  1. Anna says:

    my son did not have his first bath until he was over one week. we had learned about how good the vernix us for the baby’s skin and for bonding and breastfeeding, so we requested no bath in our birth plan. i was amazed that our hospital never once pressured us about that. he was not gross at all (well, maybe his hair was kind of icky) and he did the breast crawl and nursed like a champ about 20 minutes after delivery!

  2. Theresa says:

    I felt I needed a bath after delivery bc of how much blood was on my legs, so I took a bath with my baby 2 hrs after he was born. nursed him in the tub, lots of skin-to-skin; it was amazing :)

  3. Jen says:

    Both of mine were born at home and didn’t have baths until they were about a few weeks old. We did wipe them down, though, after they’d had plenty of mommy time.

  4. Stacy says:

    I’m so glad you wrote this up because I have clients always asking what is bad about the bath. I explain how it effects them but never thought about how it effects the breastfeeding relationship. I now have another reason to give my clients.

  5. Erin Woytiuk says:

    This article brought me to tears. When my baby was born she was not breathing due to her cord being wrapped around her neck. The nurses took her from me and gave her oxygen. They wrapped her up and gave her to me after 5 minutes. I was groggy from the pain medication that I didn’t even think to nurse nor did the nurses encourage me to. She was taken from me again for her bath. I was left alone in the delivery room for over an hour. I did not see my daughter again until I was put into my room. She is now almost 11 months old and she shows no signs of weaning. We bed share and the breast is never refused. I will always mourn the time we were robbed of when she was first born.

    • Tanya Lieberman, IBCLC says:

      Erin,

      I understand how this made you feel, and you are certainly not alone. I have similar feelings about my first birth.

      One comfort might be remembering that, despite the early moments not going as you would have wanted, you’ve been able to establish a wonderful breastfeeding relationship. Not everyone who gets off to a start like yours does, so that’s something to be grateful for.

      Tanya

  6. Miriam says:

    Great article. You do have to be adamant in the hospital about no baths, as I found with my first birth. My second was born underwater, and then immediately did the chest crawl to nurse. She is also a thumb sucker from the womb. Since we were in the tub, we were both rinsed off, but for the first week, I wiped her down with olive oil on a soft cloth and then we bathed together after 7 or 8 days which she seemed to love. I’m 41 weeks now with my 3rd. =)

  7. Vicki says:

    I was wondering about an herbal bath an hour or two after baby is born to promote healing in both after breastfeeding has been initiated. Would this be detrimental as I would like to do this with my {possible} next baby. Thanks!

    • Tanya Lieberman, IBCLC says:

      Hi Vicki,

      I don’t know of any research on this, but I’d point to the recommendations I cited in the post about bathing taking a back seat to skin-to-skin in the first 24 hours. This is recommended because bathing can make babies’ temperatures unstable, because skin-to-skin time is just so important (and downright magical), and because olfactory cues that play a role in breastfeeding.

      So here’s my personal opinion (which might seem conservative to some): If it were me and I really wanted the baby to have an herbal bath, I’d plan it for the second day, or at least until the baby had had several good feedings and lots of skin to skin time.

      Tanya

    • Andrea W says:

      an herbal sitz bath is wonderful for healing your perineum after the birth. generally the herbal water in the tub only goes to about mid thigh. The baby has no need for the herbs. but you can still turn the heat on the bathroom and get skin to skin!

  8. Kiyomi D says:

    My daughter was taken and given her shots before being brought to me. I was still recovering from the blood loss and the nurses latched her on because “she is hungry and ready for mommy” they didn’t give her a bath until I had nursed over an hour and napped a bit, and had some visitors. Then she was taken to get cleaned up while I was moved to my postpartum room. She was there waiting for me when I got out of my shower. My son was taken for check up (in room) because he had meconium in the water and needed to make sure he didn’t aspirate any. He was then promptly returned to me to nurse and cuddle (I will admit to him being a bit more icky, but they toweled him off and while he was nursing they gently worked on getting some of the meconium out of his head full of hair) :) I am overall happy with both my hospital births.

  9. Jazmin says:

    My baby was born at a naval hospital where they push you to breast feed.
    She was taken from me right away because her rate was low but as soon as they made sure she was fine they have her back to me. It must have been maybe 5 min.
    As soon as they have her to me she started looking for my breast. She was on my breast for about 45 min and then they decided to do the glucose test and bath. I’m so glad we got that 45 minutes of bonding. :-)

  10. Leah says:

    Both of my boys had a bath between 12-24 hours old. Both times with my permission, and our hospital does not “take them away”, but rather the bath is done in the mothers room. My husband participated in both baths, and this practice is beneficial to new parents who have limited baby experience. The nurses were sensitive of our breastfeeding and we were able to decide a time that worked well for baby to be bathed.

  11. corissa says:

    I had dreams of reaching down, and bringing my baby directly to my boob :)… turns out I have a killer uterus!! I actually had two emergancy c-sections with general anesthesia. I did not get to hold my babies for about 3 hours. GOOD news is they both successfuly latched and exclusivly nursed. My first experiance did call for going to a lactation specialist. My point is that you can nurse even if you hit obsticles.

  12. Shelly says:

    I find this article irritating. Instead of making the hospital and healthcare providers that work in them the enemy just choose to deliver in a different setting. All settings have pros and cons. The hospital is not the enemy. If you feel that the hospital won’t allow you have the experience you want then home birthing or birthing centers are a better fit and choice for you. The people who work in mother/baby are not the enemy and in my experience go above and beyond to care for us (laboring moms). I delivered both of my children in a hospital. I had wonderful experiences, nursed right away and felt pampered. My babies were both cleaned/bathed at 3 hrs of life as is standard in that facility. Both of my babies received their eye ointment and first shot within 1 hr of life. Both of my children nursed within the first hour of life and then for 13+ months each. My children continue to be healthy thriving kiddos. I had a great experience because I chose the right facility for me.

    • I find your comment irritating. says:

      Unfortunately, lots of women are FORCED to give birth in a hospital setting, due to lack of midwifery care, or just being risked out for no damn good reason.

      (take me for example. I have 100% controlled insulin resistance, no medication taken for it. Yet I have been risked out of having a home birth, with no choice in the matter. The hospital IS the enemy to me in this case, and has been a fight tooth and nail my entire pregnancy, and I am terrified as to how the actual birth will go.)

      Just because something is “standard” doesn’t make it right. This article clearly explains why waiting to bathe is essential.

      • Wow says:

        Every woman should have the right to have the birth experience they want, regardless of whether they decide to give birth at home or in a hospital. Not everyone lives in an area that has a midwife practice, More often than not, the hospital is the only choice of birth place. This article isn’t stating that the nurses/doctors/hospital are the enemy. It is stating that sometimes the “cookie cutter” birth routine they implement at hospitals isn’t always the best choice for every family. if you’re fine with it – by all means, go for it. But do NOT tell women who want a different experience that they don’t deserve to have their wishes taken into account just because they give birth at a hospital.

      • megan says:

        I’m surprised you couldn’t do a home birth or birth center. Did yoy have other complications? I am also insulin resistant and after my glucose test came back, I was taken off of the “high risk” category. This pregnancy, i was never even considered high risk. Sounds like there’s more going on than you’re letting on.

  13. Deborah says:

    My baby was covered in meconium, so bathing her right away was imperative. I remember being irritated that she wasn’t handed to me right away (as I knew that would be ideal) – but I understand now why she was not. There’s ideal, and then there’s doing what’s best for the situation. They gave her to me to nurse as soon as she was bathed and the danger of inhaling meconium was gone.

    • Maria says:

      My son was taken away from me immediately after birth because of meconium, as well. We had a hard time nursing. Now two years later, I know that our bonding was affected by missing out of the immediate skin-to-skin.

    • Actually, a bath is not necessary even with meconium. If the meconium is light and the baby is vigorous at birth, the American Academy of Pediatrics (AAP) recommends that no interventions are needed. If the meconium is thick and/or the baby is not vigorous at birth, the AAP recommends recommends deeply suctioning the baby to get all meconium out of the larnyx. But no bathing is required.

  14. Melissa says:

    Hm…. I wonder what the implications are for waterbirth (of which I am a huge fan)? The temperature issue is probably taken into account, but surely amniotic fluid would get washed off baby’s hands, and moms breasts will have been submerged. Maybe it is OK because no soap is involved. Thoughts?

    • Tanya Lieberman, IBCLC says:

      I’m a big fan of water birth, too! I’m guessing that any decrease in olfactory cues is more than offset by having such a peaceful entry into the world. :)

      • Jen says:

        I would imagine the birth fluids in the water after the birth also offset whatever olfactory cues may have been rinsed away when the water was fresh and clean.

  15. Tara says:

    My daughter was born 4 months ago. I had dreams of how her birth would go. I wanted to go as natural as possible, I wanted to try to do the breast crawl so badly but at 36 weeks my little girl turned to footling breach so I had to have a c-section. There were a few complications but in the end all was well. Unfortunately I wasn’t able to see or touch my sweetheart until about 45 mins had past. It was horrible. My husband was the first one to hold her and cradle her. She wasn’t bathed but she was wiped down and swaddled in rough blankets then put on my shoulder so I could see her. After getting stitched up we were wheeled into a recovery room for about an hour where I held her but still no skin to skin contact. We were taken to our room but there were family and tons of people around and so there was still no skin to skin. Finally about 2 hours after she was born I had some alone time with her and my husband. I was able to take her wraps off and really bond with her. We struggled to breast feed and tried for 3 days to latch properly. She never did. By the time we went home she was so hungry I had to break out some formula. Granted I have inverted nipples and large breasts but she would just scream when I tried to feed her. The Dr. kept telling me that she wouldn’t eat much in the first week so not to worry about her not latching well.

    I hate that i never had that time with her. I mourn the fact that she couldn’t latch and is now on formula. She’s a healthy 4month old but I wish things could have been different. I wish I had been more vocal about my wants and wishes! Next time I will speak up and get my way.

    In the last 4 months we have bonded really well and she is an amazing baby. She’s happy and very well adjusted and quite chubby! :)

  16. Ilse says:

    In Holland everyone promotes the first skin to skin contact and there are hardly any conditions under which the skin to skin is not possible. The bath won’t be done until earliest the next day.
    My little girl and I cuddled for over an hour before we were even thinking about wiping her down.

  17. Lyz says:

    Requests not to bathe aren’t always followed.

    The Labor support staff were very helpful in meeting our needs and special requests, but as soon as we were moved to post-partum the nurses ganged up on me (3 in the tiny room, and the largest one started bathing my baby with her back to me so I couldn’t see what was going on.) I was so angry. Then they tried to take him without a parent, to the nursery. I wish I hadn’t been so exhausted (28+ hours of labor on 2 hours sleep) I’d have been able to be more assertive.

    Nursing was very difficult for the first 2 weeks. We’re at 13 months now, established but the beginning would have drove others to quitting.

    • I’ve heard of post-partum nurses ganging up on women so many times…it just baffles me. Why don’t they “get” the concept of customer service?

    • Rachel L says:

      This is a situation that should be reported to the hospital. It’s not okay. The hospital needs to receive complaints so that they can correct the nursing culture.

  18. MSmith says:

    In my personal experiences in two different hospitals with my three(8,5 and 11months), none of them whisked away, all of them were wiped down hours after they were born and they do not put them in a bath like the picture shows, they cleaned them with a warm wet cloth, I had to actually remind the nurse about 9 hours that my now 5 year old still had goo on her. It didn’t affect breastfeeding at all, my son(8yearold) ate enough for five babies (25lbs at 6 months) and the girls did fine. I guess I had great experiences at these hospitals in my town. I will say, they do treat the younger mothers like they are stupid and will you if you let them.
    My son didn’t get his first “bath” until he was around 4 weeks old because his belly button didn’t fall off till then and my daughters were around 2-3 weeks.

  19. new mom says:

    I agree with an earlier comment – that hospitals are not the enemy – if you’re concerned with what is “standard” or will be allowed/encouraged then check before hand to find out. I gave birth to a healthy baby girl 6 weeks ago and she was promptly placed on my chest skin to skin and she tried to breastfeed (took a little bit of practice, but eventually we figured it out :) ). They did everything that had to be done immediately both for her and for me (had to be stitched up) while she was on me, and wiped her down a bit with towels. Then we hung out skin to skin for most of her first 2 days while we were there in the hospital and she didn’t have her first bath until just before we left (about 56 hours after birth), when the nurses came in and showed us how to do the bath.
    I understand that this isn’t how it is in every hospital, but don’t assume that just because you choose to or have to for other reasons have a hospital birth that you will not be able to take advantage of all of these great things like skin to skin and early breastfeeding).

  20. Michelle says:

    I was a hospital transfer from a birth center 24 hours after my water broke. I was very scared but have to admit that the hospital birth was pleasant where I was (St. Petersburg General) my daughter was born and they went to place her on my chest but her cord was too short to reach so they let me cut it and I immediately put her on my breast. I nursed her and relaxed for a good hour. They then asked to wrap her up cause her temp was low. While they brought me to the recovery room she was bathed with my mom present and really it was a wipedown with a cloth and a combing of the hair. I was terrified of breast feeding interference from hospital staff due to horror stories I had heard but my nurses were so helpful and I couldn’t have been happier. I said no pacifier and they listened. They let me rest while my daughter was in the nursery which I was ok with after 36 hours of labor and they would wheel her in any time they said she was “sucking” or fussy so I could nurse. It was a beautiful experience. Just be vocal about your wishes and *most* hospitals will be understanding. Mine was and by the time the lactation consultant came in I had violet in the football hold and she was eating away. The LC said “how many is this for you?” And I said “my first!” She was very pleased. Hospitals aren’t always horrible and this is coming from someone who was adamant about a birth center birth. Best wishes for every mother to be that she may have a beautiful birth whether c section or vaginal, hospital or home, breast fed or formula. Your babies are the prize and they will love you no matter what

  21. Jenny says:

    Given that WHO’s recommendations are for a worldwide population, not all of whom would even have access to antibiotics, is it fair to assume that the recommendation to delay bathing 24 hours applies even to infants of GBS-colonized moms?

    • Tanya Lieberman, IBCLC says:

      Interesting question! I’ve never seen any recommendation about not not bathing babies due to untreated Group B Strep, but I’ll check to see what I can find out!

      Tanya

    • Tanya Lieberman, IBCLC says:

      Hi Jenny,

      I checked with one U.S. hospital (didn’t find any protocol related to this), and heard back that they treat mothers with untreated GBS the same as all other mothers in terms of bathing the newborn.

      Hope that helps!

      Tanya

  22. sarah says:

    My babies were all born via c-section. I didn’t get to spend time with them until after I was out of recovery (approximately 2 hours after birth). They were all bathed (except my 3rd) towards the end of the first day. My 3rd was bathed at the end of the beginning of the 3rd day because I just didn’t want to let her go… her birth was rough. I was pressured to have her bathed earlier though. Despite no skin to skin the first few hours, my kids have all nursed wonderfully. I have 4, and they’ve never had an ounce of formula. The nursing relationship really has nothing to do with bathing times or immediate skin to skin contact. The determination of the mother to make it work and the family support is what is important.

  23. Aubree says:

    My baby was brought to my chest and right after his first cry he latched on immediately, and stuck on while he was toweled off. When the nurse went to grab him for his first bath, like a ferocious mama bear, I snapped, “he doesn’t need to go anywhere, you can wait” (referring to all procedures, midwife already gave the ok that he was perfectly healthy)lol I know I could of been nicer but after a natural birth you don’t always have your wits about you. She completely forgot about the bath and he didn’t get a first bath till he was… about 3 weeks old?

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