To clean your baby, they can either have a top ‘n’ tail wash or a full immersion bath.
Top and tail washes can be stressful and lead to temperature instability, especially if your baby is premature or small. If they are able to have a full immersion bath this is always preferable. Discuss with your nurse what is best for your baby.
Bath time should be relaxing and enjoyable for both you and your baby. It is a lovely time to bond with your baby and get to know them. Remember to talk to your baby to reassure them about what you are going to do and to be sure that you are reading their cues.
Choose a time of the day that is not rushed and when your baby is not tired. Reading and knowing your baby’s engagement cues will help you to determine the right time to give them a bath. While on Butterfly, it is good to start doing a bath regularly at the same time of day and following the same routine. This will help your baby to anticipate what is going to happen and how to cope when it does.
Some babies enjoy bath time from their very first time while others will find it overwhelming and get upset. It is a new sensation for their skin so it is important to make sure they have as pleasant an experience as possible. We will provide you with some ideas and strategies to make the most of the bath time experience for both of you.
Full immersion bath – swaddled bathing
As with any daily routine, it is important to be sure your baby is ready to participate by reading their cues. Having a bath on the unit requires some preparation and time. Babies with feeding tubes and some breathing support can often still be bathed, just ask your nurse if your baby is well enough to participate.
Before you begin, make sure the room is warm and that you have everything you need.
- Bath (should be kept in the store room on the ward, ask your nurse)
- Towels (ask your nurse to help you find some if you do not know where they are kept)
- Face washers
- Wrap to swaddle baby
- Clean nappy
- Change of clothes
- Lotions
- Nappy creams
Environment
- Make the environment quiet and calm, especially if you are trying to assist your baby to go to sleep.
- Soft, gentle music can also be used to help relax you and the baby
- The baths on Butterfly are height adjustable so ensure the bath is at a comfortable working height to reduce stress on your back
The bath
Swaddling your baby during a bath gives their body additional support and will help them keep calm so they (and you) can enjoy the experience.
- The bath should be warm and deep enough to cover your baby’s shoulders.
- Swaddle your baby in a light cloth. Let their arms bend up under their chin so they feel nice and cozy.
- Transfer your baby into the bath and hold them for a minute or two, to allow them to become accustomed to the new sensations.
- You can now start to wash them by exposing one body part at a time, washing then re-swaddling before moving on to the next. Start from the top and work your way down.
- Let their feet reach the end of the bath to allow for foot bracing to provide more containment.
- The bath should last no longer than 8 minutes to ensure they don’t get too cold.
- When finished leave the wet swaddle behind in the water, transfer back to the bed and wrap immediately in a towel.
Supporting your baby if they do not like the bath
- If at any stage your baby becomes unsettled pause washing, return their hands close to their face and let them recover.
- Make sure baby is not tired or hungry.
- Offer them a dummy, use your voice to soothe them or modify their environment.
- Swaddling your baby in a cloth nappy or wrap.
- Some babies like to have a warm wet face washer left on their chest.
After the bath
- Wrap baby in towels to keep warm.
- Pat rather than rub to dry baby’s sensitive skin - Go slowly and be thorough.
- Baby may cry when lifted out of the bath. This is just the transition and they often settle quickly when wrapped in the towel.
- Placing them on their tummy while cream is being applied down the baby’s back will help to increase active head lifting.
- If your baby requires a stretching program, is it nice to do this following a bath when your baby is more relaxed.
- Babies are often tired after a bath so prepare them for sleep or finish with a feed.
Top’n’Tail wash
This can take place in your baby’s bed if your baby is unable to have a full bath due to lines or tubes.
Before you begin, make sure the room is warm and that you have everything you need:
- A bowl of warm water
- Cotton balls for washing the face
- Face washer (muslin washers are good for getting into little creases)
- Clean towels
- New nappy
- Clean clothes if your baby is wearing clothes
- Place a clean towel under your baby and undress them
Topping
This means washing the face, neck, hands and top half of the body.
- Start by washing your baby’s eyes: using warm, damp, cotton-wool start by wiping your baby’s eyes. Gently wipe from the corner of the eye, near their nose, and wipe outwards.
- Use a clean cotton ball for each eye to avoid cross contamination.
- Next, clean your baby’s ears in front and from behind. These areas can sometimes get milk in them if the baby dribbles or has lots of secretions.
- Do not place anything in the ear as this could damage the eardrum.
- Use a face washer to wipe your baby’s face, neck (especially underneath), their armpits and hands.
Tailing
This means washing your baby’s bottom and genitals. Be sure to remove any poo that has gotten into the baby’s creases. Please see the nappy changing mini-module for the full description of cleaning and caring for this area.
Ensure to dry your baby as you go so they don't get cold. Respond to their cues and if its too stressful for your baby: stop, calm them or try again another day.