A nurse at the Cleveland Clinic launched the initiative after mothers asked to delay their newborns' baths to increase their ability to take to nursing.
Giving a newborn a bath right after birth has been the norm for most hospitals for decades. But it turns out that waiting several hours may help promote breastfeeding, according to results from the Cleveland Clinic, which took its cues from new mothers.
A study published Monday in the Journal for Obstetrics, Gynecologic, and Neonatal Nursing finds that delaying baby’s first bath by about 12 hours increased the rate of breastfeeding exclusively while in the hospital, which in turn increases the likelihood that a baby will receive breast milk at home. Breastfeeding is known to boost children’s health over their lifetimes; for mothers, it reduces the first of breast and ovarian cancer and postpartum depression.
The American Academy of Pediatrics recommends that breastfeeding exclusively until babies are 6 months old, with other foods added to the diet until children reach 12 months. However, data from the CDC show that only about a quarter of mothers are able to do this, and about 57% of babies are breastfed through the sixth month. Still, this is an improvement from the mid-1900s, when commercial infant formula manufacturers marketed aggressively to mothers in the United States, and breastfeeding declined to all-time lows by the 1970s.
At the Cleveland Clinic, Heather DiCioccio, DNP, RNC-MNN, nursing professional development specialist for the Mother/Baby Unit at the clinic’s Hillcrest Hospital, designed the study after new mothers began asking to delay their newborn’s first bath. In a statement from the clinic, she said these women had read that the smell of the amniotic fluid was similar to a mother’s smell, and this “may make it easier for the baby to latch.”
But when DiCioccio looked into these reports, she found almost no research on the topic, so she decided to do one herself.
Almost 1000 pairs of healthy mothers and newborns took part in the study; 448 babies were bathed shortly after birth in January and February 2016, and 548 had delayed baths in July and August 2016. The findings showed exclusive breastfeeding rates increased from 59.8% before the intervention to 68.2% after the delayed baths. The newborns with the delayed baths were more likely to have a discharge plan that included getting breast milk at home.
The mothers’ theory about the similar smell making it easier for babies to figure out nursing is just one reason the delayed bath helps, DiCioccio said. Holding off on the bath increases skin-to-skin contact between mother, which has many benefits and is considered standard of care, according to the article. Babies with delayed baths also stayed warm. “They weren’t as cold as the babies who were bathed sooner after birth, so they may not have been as tired trying to nurse,” she said.
Her findings led to a change in hospital policy—unless the mother objects, newborn baths are delayed at least 12 hours. In all cases, DiCioccio’s hospital urges new mothers to wait at least 2 hours, and Cleveland Clinic is trying to enact the change across its other hospitals.
In time, DiCioccio hopes that the practice will become the norm everywhere. Difficulty getting an infant to latch early on can discourage a mother from working through early challenges with breastfeeding, given the many other barriers women face. A 2011 call to action by the US Surgeon General found that many Americans still believed that bottle feeding was the “normal” way for infants to be fed; 45% believed that a nursing mother would be significantly inconvenienced by breastfeeding.
DiCioccio said more work is needed to learn what happens to mothers and infants after they go home. “Future research is needed to learn more about exclusive breastfeeding after hospital discharge when mothers no longer have the support provided during the hospital stay,” the article concludes.
DiCioccio HC, Ady C, Bena JF, Albert NM. Initiative to improve exclusive breastfeeding by delaying the newborn bath [published online January 21, 2019]. J Obstetr Gynecol Neonatal Nurs. DOI: doi: 10.1016/j.jogn.2018.12.008 .