When should a newborn's first bath be and what is the recommended bathing frequency?

From the Guidelines

A newborn's first bath should be delayed until at least 24 hours after birth, ideally waiting 48 hours if possible, to preserve the vernix and allow for skin-to-skin bonding and successful initiation of breastfeeding. After the initial bath, newborns only need to be bathed 2-3 times per week for the first year of life 1. Daily bathing is unnecessary and can dry out a baby's sensitive skin. When bathing your newborn, use warm water (around 100°F or 38°C) and mild, fragrance-free soap specifically formulated for babies. Keep baths short, lasting only 5-10 minutes, to prevent skin dryness.

Key Considerations for Bathing

• For neonates with birth trauma, swaddle and clean using a dabbing technique rather than rubbing, and clean limb by limb during wound care 1.
• Always include a dermatologist, an EB nurse, and pain medication in bathing management for neonates with epidermolysis bullosa 1.
• If adequate pain relief is available, wrap the neonate in a thin cloth, then soak in a deep padded bath, allowing dressings to come loose 1.

Frequency and Method

• Bathing frequency should be 2-3 times per week for the first year of life 1.
• Use a soft, gentle approach when bathing, and avoid rubbing or scrubbing the skin 1.
• After bath, wrap the neonate in towels (with loose dressings in place) and allow to dry while holding; do not rub dry 1.

Additional Tips

• Clean the baby's diaper area during changes and wipe their face, neck, and hands as needed 1.
• Once the umbilical cord stump falls off (typically within 1-2 weeks), you can transition from sponge baths to gentle immersion baths in a small baby tub 1.

From the Research

Newborn Bathing Recommendations

• The first bath for a newborn is a topic of debate, with various studies suggesting different timing and frequencies.
• A study published in 2024 2 found that delaying the first bath for at least 48 hours after birth reduces damage to the skin barrier, maintains body temperature, and makes the experience more comfortable for late preterm infants.
• Another study from 2022 3 suggested that delaying the first bath for at least 24 hours after birth may reduce the risk of infant mortality and hypothermia in term healthy newborns.
• A 2015 study 4 recommended sponge bathing for newborns until the umbilical cord falls off, as wetting the cord during tub bathing can delay its separation.

Bathing Frequency

• The optimal bathing frequency for newborns is not well established, but it is generally recommended to bathe them 2-3 times a week 5.
• A study from 2008 5 found that 40% of newborns in Sylhet District, Bangladesh, were bathed on the day of birth, highlighting the variability in bathing practices.
• Another study from 1981 6 compared bathing and washing of newborn babies and found that bathing made the babies calmer, quieter, and more comfortable, with no increase in infection rates.

Umbilical Cord Care

• Proper umbilical cord care is essential to prevent infections and promote healing.
• A study from 2015 4 found that sponge bathing can help reduce the time it takes for the umbilical cord to separate, while a study from 2008 5 highlighted the importance of promoting hand-washing, clean cord cutting, and avoiding unclean home applications to the cord.
• The use of topical chlorhexidine for umbilical cord cleansing has been shown to reduce neonatal mortality and omphalitis 5.