Booby Traps Series: Why the newborn bath should wait

by Tanya Lieberman, IBCLC | February 29, 2012 6:07 am

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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