Bathing Babies

Bathing your newborn baby for the first time is one of the sweetest, and for some, one of the most anxiety-provoking milestones of parenthood. Although parents may be nervous at first, they'll soon grow confident and competent as they learn what works best for them and their baby.

Until a baby starts crawling on the floor, a daily bath is not necessary. As long as adequate cleansing is done during diaper changes and after feedings, a bath two or three times a week in the pre-crawling months will keep a baby fresh smelling and presentable.

Just about any time of day can be the right time for a bath. Some parents feel bathing just before bedtime helps create a more relaxed state conducive to sleep. It is best to avoid baths just after or just before a meal, because so much handling on a full tummy could result in spitting up, and the baby may not be cooperative on an empty stomach. Give a baby time for the bath, so it need not be hurried, and there won't be a temptation to leave the baby unattended even for a second to take care of something else. Plan on not answering the phone during the bath time. If it's necessary to leave the room, take the baby along.

A sponge bath is recommended until the umbilical cord has fallen off (a couple of weeks, more or less). A baby should not be submerged in water because it increases the time for the umbilical cord to fall off. Instead, use a washcloth or sponge to keep the baby clean.

A baby is ready for a tub bath (or in a portable tub or sink) as soon as the umbilical cord stump has dried up and fallen off. If the circumcision was done with a ring (plastibell) allow for the ring to fall off, too, before tub baths. A circumcision will heal during the week following the procedure and generally before the umbilical cord has fallen off. Sponge bathing during the healing process is not an issue.

• Young infants lose heat quickly, so make sure the room is warm (around 75 F, 24 C) before undressing a baby.
• Check the temperature of the water before putting the baby in the tub. Use the inside of the wrist or the elbow to test the water, which should be warm but not hot. Inexpensive bath thermometers can be purchased at a local baby store or drugstore. These simple devices change color to indicate safe and unsafe heat levels.
• Hot tap water accounts for 17% of scald burns, requiring hospital admission of children younger than 4 years of age. Turn down the hot water heater to no higher than 120 F. Lowering the setting prolongs the time to burn and reduces serious scald injuries.
• Never leave a baby alone in the bath -- even for a minute. A baby can drown in 2 inches of water.

Bathing supplies may include these items.

• Two to three clean washcloths
• Mild baby cleanser -- try an unscented baby soap such as Dove, Basis, or Neutrogena
• Baby shampoo -- not adult shampoo (the no-tears advertisements for baby shampoos are accurate)
• Soft towel, preferably with a hood
• Diapers
• Clean clothes or pajamas
• Ointment for diaper rash, if needed -- avoid talcum or baby powder because it can harm a baby if inhaled
• Warm water

1. Select a safe and flat surface on which to work. Make it comfortable for the baby by putting down a soft, clean towel.
2. Place any supplies within easy reach of the bathing area.
3. Get baby ready. If the room is warm, remove all of  the baby's clothing before beginning, covering him or her loosely with a towel during the sponge bath. If it is cool in the room, undress each body part of the body right before washing it. Do not remove the baby's diaper until it's time to cleanse that area.
4. Always keep one hand on the baby for his or her safety.
5. If someone else is available, have them take a picture to commemorate this very tender milestone of the baby and parenthood.
6. Begin washing. Take time to admire the baby's body -- all too often people bundle up babies and never adore those precious feet or that soft bottom. It is a good idea to wash a newborn's hair near the end of bath time. This will help prevent him or her from losing too much body heat.
   
   Face. Using a soft cloth moistened in warm water, clean around the baby's eyes, wiping gently from the nose outward. No soap is needed. Wipe around the baby's mouth, nose, forehead, cheeks, and chin. Wipe around the outer ears but not inside. Dry all parts of the face.
   
   Neck and chest. Again, soap is not necessary unless baby is sweaty, smelly, or dirty. Be sure to get into those abundant creases where spit-up is likely to collect. Dry.
   
   Arms. Open the arms to get into the elbow creases, and press the palms to open the fist. The hands will need a bit of soap, but be sure to rinse them well before they are back in baby's mouth. Dry.
   
   Back. Turn baby over on the tummy with the head to one side, and wash the back, being sure not to miss the neck folds. Dry, and dress the upper body before continuing if the room is chilly.
   
   Legs. Extend the legs to get the back of the knees. If your baby seems up to it, massage the feet or play "This little piggy" with the baby's toes. Dry.
   
   Head. Once or twice a week, use soap or baby shampoo, rinsing very thoroughly. On interim days, use just water. A football hold at the sink's edge can be the easiest and most comfortable way to rinse baby's head. Before proceeding, dry the baby's hair and then place the hood of the towel or an infant cap on his or her head to help maintain body heat.
   
   Cord care. The American Academy of Pediatrics (AAP) has modified the guidelines for umbilical cord care. The new recommendations favor cleansing the stump with warm water if necessary. Rubbing alcohol cleaning is not indicated. When the stump dries out and falls off (usually between one to three weeks after birth), baby can have a tub bath.
   
   Diaper area. Grab a new washcloth to clean the genitals. Wash girls front to back, spreading the labia and cleaning gently with a washcloth dipped in soap and warm water. A white vaginal discharge is normal; don't try to scrub it away. Rinse gently with warm water. Wash boys carefully, getting into all the creases with soap and warm water. For the circumcised baby, while he is still healing, put a fresh application of petroleum jelly over the wound. For the uncircumcised baby, do not try to retract the foreskin. Dry the diaper area well and apply ointment if needed. Diaper the baby. Circumcisions generally take five to seven days to heal completely.
7. Babies generally do not routinely need application of body lotions.
8. Get the baby fully dressed.

1. Select a safe, flat surface for the portable baby tub. It might be best to omit soap the first couple of times the baby gets a tub bath because soapy babies are slippery babies.
2. Place any supplies within easy reach of the bathing area.
3. Put 2-3 inches of water into the baby tub. Test the water temperature with the wrist or elbow to be sure it is comfortably warm. Never run the water with the baby in the tub because a water temperature change might occur. Don't add baby soap or bubble bath to the water, because these can be drying to the baby's skin.
4. Undress the baby completely.
5. Gently slip the baby into the tub or sink. Support the neck and head with one hand securely in a semi-reclining position. With a free hand, wash the baby working from the cleanest to the dirtiest areas. First, use a soft cloth moistened in warm water: clean the baby's eyes, wiping gently from the nose outward. No soap is needed. Wipe around the baby's mouth, nose, forehead, cheeks, and chin. Wipe around the outer ears but not inside. Cleanse the abundant folds of the neck. Dry all parts of the face and neck.
6. Use soap on the hands and the diaper area daily. Use it every couple of days on arms, neck, legs, and abdomen as long as the baby's skin doesn't seem dry -- less often if it does. When the baby's front parts are clean, turn him or her over and wash the back and buttocks.
7. Once or twice a week, wash the baby's scalp using mild baby soap or baby shampoo. Rinse very thoroughly and towel dry.
8. Wrap the baby in a towel, pat dry.
9. Get the baby fully dressed.

• Keep bathroom doors closed at all times. Install a hook-and-eye latch, a doorknob cover on the outside of the door, or reverse the doorknob so that the lock is on the outside.
• Toilet lid-locking devices are extremely important once a baby begins to crawl, pull up, and walk. It's possible to prevent serious injuries and drowning by installing one of these simple devices.
• Cabinet and drawer latches are a necessity in the bathroom. Use safety latches that are available for kitchen cupboards and drawers.
• Medicine cabinets should be free of medications, vitamins, mouthwash, and eye-care products. Move them to a high shelf in a hall closet and insist on childproof caps for all medications, both over-the-counter and prescription drugs (ask the pharmacist to switch them). Special medicine lock boxes are available as well.
• Faucet covers fit directly over a protruding bathtub faucet. They are essential for bathing toddlers and older children because they often prevent scalding and head injuries.
• Hair dryers, radios, and other electrical appliances should not be kept in the bathroom. Store them in a safe place out of a child's reach.
• Be mindful of items left out such as razors on the edge of the bathtub or sink.
• For more information on bath safety and other nursery equipment, contact the Consumer Product Safety Commission at 800-638-2772 or visit the Consumer Product Safety Commission web site (http://www.cpsc.gov).