Routine Care of the Neonatal Unit

• To ensure the cleanliness of the newborn
• To stimulate blood circulation
• To provide comfort and relaxation

Important Points Regarding Newborn Bathing:

• The newborn’s condition should be assessed, and body temperature should be stable before giving a bath. A bath can be given 4-6 hours after birth.
• A newborn weighing less than 1200 grams should not be bathed; instead, the face and diaper area should be wiped with a soft, warm towel inside the incubator during routine daily care.
• A full bath is given three times a week, but if the newborn's skin turns blue or muscle tone is weak, the bath should be avoided, and the doctor must be informed.
• The bath should be given before feeding the newborn.
• The bath can be done in front of the mother, if possible, so she can learn the steps, especially if it is her first child.
• The entire bath process should take between 3 to 5 minutes at most.

Required Materials:

Before starting the bath, ensure the following items are prepared:
✔ Baby bathtub or a large bowl
✔ Mild baby soap or antibacterial soap or baby shampoo
✔ 2 large towels and 2 medium towels
✔ Thermometer to check the water temperature
✔ Small basin with warm water
✔ Small pieces of cotton
✔ Clean diaper
✔ A container with warm water at a temperature of 37-40°C
✔ 70% ethyl alcohol
✔ Baby oil or diaper rash cream, if needed
✔ Waste bin

Bathing Procedures:

First: Bathtub Bath

Precautions Before Starting:

• Ensure the newborn's vital signs are stable.
• Warm the room.
• Close windows and doors to prevent drafts and avoid opening them during the bath.
• Ensure adequate lighting to observe the newborn’s skin color.
• Prepare all materials before taking the baby out of the incubator.
• Turn on the warming device and place a sterile towel on it.

Note: It is preferable to weigh the newborn without clothes just before the bath to minimize exposure to cold.

Bathing Steps:

✔ Fill the baby tub or large bowl halfway with warm water and check the temperature with a thermometer.
✔ Wash hands routinely and wear clean gloves, then proceed to clean the diaper area first.
✔ Wrap the newborn's head and body with a large towel and carry them out of the incubator if their condition allows.
✔ Test the water temperature using the wrist.
✔ Hold the newborn face-up, supporting the head and torso properly.
✔ Clean each eye separately using a small cotton piece soaked in warm water, wiping from inner to outer corners, then dry using the same method.
✔ Clean each nostril separately with a small cotton piece moistened with warm water.
✔ Move the towel slightly to expose the ear and wipe the outer part without letting water enter the ear to prevent infections.
✔ Wet your hands with warm water and wipe the face (forehead, cheeks, chin), then dry with a small towel.
✔ Unwrap the towel from the head and body, then gradually lower the newborn into the tub.
✔ Wet the head, apply a small amount of shampoo, and gently massage the scalp, including behind the ears and neck folds.
✔ Rinse the hair, around the ears, and neck folds with water.
✔ Dry the hair, around the ears, and neck folds with a towel.
✔ Apply a small amount of shampoo to clean the chest, belly, and arms, paying special attention to the underarms, then rinse well.
✔ Apply shampoo to the lower body, including the legs and genital area. Pay special attention to skin folds between the thighs, then rinse well.
✔ Turn the newborn on their belly to clean the back and buttocks, then rinse well and return them to their original position (face-up).
✔ After the bath is complete, let the newborn briefly float supported in the water for a few seconds to allow muscle movement and relaxation.
✔ Lift the newborn from the tub and wrap them in a large towel, then place them under the warmer to complete drying.
✔ Complete nursing care procedures (apply baby oil or cream, care for the umbilical cord, and apply eye drops).

Final Steps:

✔ Return the newborn to the incubator, wearing a clean diaper.
✔ Clean and store all equipment properly.
✔ Record the following observations:

• Bath time
• Skin color
• Any visible abnormalities
• Umbilical cord condition, if present
• Any discharge from the genital area or rectum

Second: Sponge Bath (Using a Soft Towel)

In the first few days of life, when the newborn’s condition is unstable or until the umbilical cord falls off, a sponge bath is recommended. This involves using a soft towel or sterile cotton moistened with warm water (40°C) to gently wipe the baby’s body from top to bottom, without rubbing vigorously, as the newborn's skin is very delicate. Pay special attention to skin folds, then dry the newborn thoroughly with a dry towel.

Steps:

✔ Wipe each eye separately using a small piece of sterile cotton soaked in warm distilled water, wiping from inner to outer corners, then dry using the same method. Observe the eyes for redness or discharge.
✔ Wipe the forehead, cheeks, and chin, then dry.
✔ Wipe each nostril and ear separately with a small piece of cotton moistened with warm water.
✔ Wipe and dry the head, then the rest of the body, paying attention to skin folds.