A Protocol for Swaddled Bathing in the Neonatal Intensive Care Unit

Karyn Quraishy, MSPT, CEMI, CST; Susan M. Bowles, DNP, RNC-NIC; James Moore, PhD, PT, PCS

Disclosures

NAINR. 2013;13(1):48-50. 

In This Article

Proposed Swaddle Bathing Procedure

Note that the infant should not be in the water for more than 8 minutes.

While parents are completing steps 1 to 4, fill wash basin with water temperature between 100°F and 101°F until it is almost full. Place wire frame with mesh covering that supports the infant into the tub (see Fig 1–3).

Figure 1.

Place baby in the tub, with the head toward the top of incline so water is just below the shoulders. Parents provide support to the baby on the mesh cover under the baby's shoulders/neck throughout the entire bath. Feet may be braced on the side of the tub for additional comfort of the baby.

Figure 2.

Unswaddle leg, wash with mild soap, rinse, and reswaddle—repeat for all extremities. (Do not use soap on the head of the penis because it does sting.)

Figure 3.

End bath with hair washing. When using the irrigation bottle, remember to have the flow of the water going toward the top of the head so you do not squirt water into the baby's eyes.

  1. Take baby's axillary temperature.

  2. Disconnect leads and pulse oximeter from monitor and leave nasogastric tube in place.

  3. Remove all clothes, diaper, and pulse oximeter. (Leads may be removed during the bathing process.)

  4. Wrap baby in a blanket with hands to face and arms and legs flexed.

  5. Have parents clean the infant's face using a washcloth or gauze and no soap. Start with the eyes by gently wiping from nose to ears using a new washcloth or piece of gauze for each eye and then gently clean around entire face.

  6. Place baby in the tub with the head toward the top of mesh incline, so water is just below the shoulders.

  7. Parents should provide support to the baby on the incline under the baby's shoulders and neck throughout the entire bath.

  8. Have parent place soap on his/her wrist.

  9. Have parent gently unwrap one of the infant's arms and use soap to wash the baby's arm.

  10. Rinse and reswaddle the arm.

  11. Repeat step 9 and 10 for all extremities including the stomach, genital region, and back, one at a time. (When washing the stomach, remove leads with soap. Do not use soap on the head of the penis because it does sting.)

  12. Reswaddle the baby and end bath with hair washing.

  13. Gently rinse hair with irrigation bottle. When using the irrigation bottle, remember to have the flow of the water going toward the top of the head so water is not squirted into the baby's eyes. Shampoo hair and rinse again with irrigation bottle.

  14. Once bath is complete, place a warm dry blanket up against the parent's chest.

  15. Unswaddle the baby.

  16. Remove the infant from the tub, and leave the wet swaddle blanket in the tub.

  17. Place the baby on the parent's chest using the previously placed blanket for drying.

  18. Dry baby and dress with a hat and clean diaper.

  19. Place new leads and pulse oximeter on the baby and reattach to monitor.

  20. Prepare for feeding or skin to skin care.

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