Top NICU Discharge Questions About Bathing Your Baby

NICU Growing Home Series

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In the neonatal intensive care unit (NICU), your baby is typically placed on a bathing schedule. As you transition to home, you can adjust this schedule to meet your needs.

Your baby does not have to have a full tub bath every day if you are keeping the diaper area clean with each diaper change and using a barrier cream. (Vaseline or a zinc-based cream are good options as a preventive for skin breakdown.) A complete submersion tub bath once or twice a week is sufficient in the early days and even months after discharge while your baby is immobile and sleeping most of the time.​

When Should I Wash Their Face and Hands? 

Your baby’s hands and face should be washed every day with a washcloth and warm water. Pay close attention to the folds in their neck where dribbles of milk may have collected. Also, clean the creases of the hands where a baby tends to keep their fingers tightly gripped inward.

Your baby may not like to get these areas of their body cleaned, especially if the water is cool or if you are abrupt and forceful with the washcloth. It’s not uncommon for your baby to wiggle, squirm, fuss, or even cry. It may help to keep your baby calm if you wash one side of the face at a time, gently moving to the other side with fresh warm water. 

How Do I Clear Their Nose

It is not uncommon for your premature baby to sound stuffy or be a noisy breather. You can help alleviate some of the discomfort your baby may be feeling by clearing your baby’s nasal passages with a bulb syringe and a few drops of over-the-counter nasal saline drops. The saline helps to liquefy congestion, making it easier to suction out with the bulb syringe.

Be sure to squeeze the air out of the aspirator before placing it into your baby's nose. Do not use force or squeeze air into your baby’s nose. Be sure to clean your bulb syringe out after each use with warm, soapy water and let it air dry. Replace the bulb syringe often, as they are prone to growing mold inside them after multiple uses. 

Do not over-use the bulb syringe on your baby. If you only hear secretions and do not see anything, simply wiping your baby’s nose with a soft tissue will usually help remove and clean the nose. Over-use of the syringe will cause swelling in the nostrils leading to irritation, more noise, and difficulty breathing. 

How Do I Bathe My Baby?

Supplies you need:

  • Baby bathtub or wash basin
  • Warm towels to place your baby on after the bath
  • A couple of warm towels and soft washcloths to use for bathing your baby
  • Mild baby soap or body wash and baby shampoo
  • New clean diaper
  • Clean clothes, such as a sleeper, and a blanket

1. Begin by filling the bathtub or wash basin with warm water. Always test the water temperature with your inner wrist to make sure that it is not too hot or too cold for your baby. A lot of baby basins have temperature strips that will guide you in this process. 

2. Keeping your baby dressed or swaddled in a blanket, take a washcloth and wet it with warm water only (no soap). Squeeze out the excess water. Gently wipe out your baby’s eyes from the nose outward. Proceed with cleaning your baby’s cheeks, forehead, and chin by washing with warm water only, one side of the face at a time. Use a warm towel to gently dry off your baby’s face, again one side at a time. 

3. Use a clean, warm, wet washcloth to wipe the outer and inner folds of your baby’s ears as well as behind the ears.

Never stick anything in your baby’s ears, including cotton swabs (such a Q-tips), as this may damage your baby’s eardrums.

4. Most premature babies prefer a swaddle bath. Remove all your baby’s clothes and diaper and swaddle your baby in a blanket. Place your baby (in the blanket) in the warm bathtub water. Be sure to hold and protect your baby’s head and neck. Begin by undoing each quadrant of the blanket in turn to wash one extremity at a time, starting with the arms and moving down towards the legs and feet. Be sure to re-swaddle your baby once you have cleaned each area. This will help to keep your baby feeling warm and protected throughout the bath. A swaddle bath should typically take about 7 to 10 minutes to prevent your baby from getting cold. 

5. Keeping your baby bundled in a new dry and warm swaddle blanket, position your baby in the football hold, wet your infant’s head with a warm, wet washcloth. Using a small amount of baby shampoo, massage your baby’s head with your hand or a soft baby brush. Rinse thoroughly and pat your baby’s head dry with a warm towel.

6. Unbundle your baby, and dress them in a clean diaper and clothes. Swaddle your baby in a clean, dry blanket.

Never leave your baby unattended in the bathwater, even if it’s just to quickly get missing supplies. Do not get distracted by your phone or text messages. Give your baby your full and undivided attention.

What Else Should I Keep in Mind?

  • Remember to wash your baby’s hands and face daily, but full tub baths are not necessary every day. 
  • Wash under your baby’s chin and folds of the neck after feedings.
  • Always check the temperature of the bathwater before placing your baby in the tub.
  • Pick a baby shampoo, soap, or body wash that is gentle and baby-friendly.
  • You may use baby lotion but avoid using it on your baby’s hands or face.
  • Baby oils and powders are not recommended for use. The particles from powder are tiny and become airborne, which can enter your baby’s lungs. 
  • Check your baby’s skin for any changes or breakdowns. You may use petroleum jelly or a zinc-based cream with diaper changes to act as a skin barrier.
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