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Background
Recommendations for care in the first week of a newborn’s life include thermal care practices such as drying and wrapping, skin to skin contact, immediate breastfeeding and delayed bathing. This paper examines beliefs and practices related to neonatal thermal care in three African countries.
Methods
Data were collected in the same way i...
Context in source publication
Context 1
... for the narrative and IDIs were purposively sampled to ensure a range of maternal ages, parities and sex of child and, where these varied, place of delivery, education level, socio economic status, ethni- city and religion. The characteristics of the narrative women are shown in Table 2, no one refused to participate. Data were collected between July and November 2011 and data collection was guided by a study protocol; interview guides were developed by the research team and adapted for each site through pre-testing. ...
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Newborn care is of immense importance for the proper development and healthy life of a baby. Although child and infant mortality in South Asia has reduced substantially, the rate of neonatal mortality is still high, although these deaths can be prevented by adopting simple interventions at the community level. The aim of the study was to identify t...
Knowledge of key decision makers and actors in newborn care is necessary to ensure that health interventions are targeted at the right people. This was a cross-sectional study carried out in Lira district, Northern Uganda. Multivariable logistic regression was used to determine factors associated with mothers being the key decision maker regarding...
Citations
... Limited studies report variable results on practices related to bathing and use of soap or cleanser for a newborn. [202] [203]The study in Nepal evaluated usage and preference of soap use by women in community for neonates. It was observed that 1% of the first bath of newborns was performed using soap and wash. ...
... One woman reported that her baby was being cleaned using coconut oil and cotton sponge followed by bathing with warm water and soap. [202]The type of soap however was not discussed in the study. ...
... This is due to the fact that mothers do not believe that SSC is essential for their newborns. After all, newborns are usually taken from their mothers at birth [15][16][17]. Various studies have demonstrated a correlation between low levels of SSC practice and the quality of prenatal and postpartum care given to women and their children. Regular surveys like the Ethiopian Demographic and Health Survey (EDHS) have not identified several critical factors [18]. ...
Introduction
Even though skin-to-skin contact offers several advantages for the survival of the newborn, it is not often practiced in Ethiopia. For instance, hypothermia which increases the risk of neonatal mortality by five times is prevented by this practice. Despite this, there are inconsistent findings that can affect policymaking. Consequently, this metanalysis aimed to produce trustworthy national data regarding skin-to-skin care practice and its determinants among postpartum mothers in Ethiopia.
Methods
A search of the publications was conducted using MEDLINE, PubMed, Embase, Scopus, Web of Sciences, and Google Scholar. The program used for cleaning and analysis was STATA version 18.2. The random-effects model was utilized to estimate the pooled prevalence, which was then presented using a forest plot with a 95 % confidence interval. We evaluated heterogeneity using I2 and Cochrane Q statistics. Moreover, a visual examination of a funnel plot and Egger's regression test were used to evaluate publication bias.
Results
This study included eight studies with a total of 10410 postpartum mothers. The overall level of skin-to-skin care practices was 48 % (95%CI: 31, 65. I2=99.38 %, P = 0.001). Based on subgroup analysis by year of publication, studies published between 2017 and 2019 years showed that the level of skin-to-skin care practice among postnatal mothers was 52 % (95 % CI: 14–89, I² = 99.19). The knowledge of mothers about skin-to-skin care was significantly associated with practicing a level of skin-to-skin care.
Conclusions
The findings showed that in Ethiopia, comparatively less than half of the newborns received skin-to-skin care. Moreover, there was a substantial correlation between the mother's knowledge and practice of skin-to-skin care. Therefore, both the government and all stakeholders should take coordinated action to improve and expand skin-to-skin care practices through health education, so that all postnatal mothers can practice this vital newborn care.
... Despite the link between neonatal bathing and thermal control [14,15], and child-related health [16][17][18][19][20][21], the subject is understudied in Nigeria. Hence, this study seeks to investigate the prevalence and factors associated with late neonatal bathing practices in Nigeria, utilizing a nationally representative survey dataset. ...
Background Two hundred and seventy out of every thousand live births died in Nigeria in 2019. These deaths were
attributable to infections, complications of preterm birth, and intrapartum-related conditions. The World Health
Organization recommends withholding bathing of neonates until 24 h after birth or until their vital signs become
stable to prevent hypothermia. Despite the link between neonatal bathing and thermal control, the subject is understudied in Nigeria. This study aimed at investigating the factors associated with late neonatal bathing practices
in Nigeria.
Methods The study adopted a cross-sectional design and extracted data from the women’s fle of the 2018 Nigerian Demographic and Health Survey. The unit of analysis was limited to 12,972 women who had complete data
for the study. We applied chi-square test of independence to ascertain the association between the outcome variable
and explanatory variables. At 95% confdence interval, two logistic regression models were built with Model I consisting of only maternal factors whilst Model II contained both maternal and child factors, and results were presented
in adjusted odds ratio.
Results Descriptively, 12% (CI=0.122–0.134) of the women bathed their neonates after 24 h of delivery. Inferentially,
women with secondary/higher education [AOR=1.30, CI=1.05–1.61], the rich [AOR=1.24, CI=1.03–1.50], those
with access to mass media [AOR=131, CI=1.15–1.50], women that professed other religions [AOR=9.28, CI=4.24–
17.56], those who delivered in a health facility [AOR=1.93, CI=1.66–2.25], whose child was small in size at birth
[AOR=1.46, CI=1.21–1.77] and delivered by caesarean section [AOR=2.50, CI=1.97–3.18] had higher odds of bathing
their neonates 24 h after birth.
Conclusions The proportion of women who practised late neonatal bathing was generally low. To improve the practice of late neonatal bathing, much-concerted effort should be directed to women’s education and approaches
to increasing receptivity of late neonatal bathing among pregnant women through the media. The Nigerian Ministry of Health should incorporate routine counselling on the risks of bathing newborns prematurely into antenatal
and postnatal care services.
... The First Bath -Timing The first bath is often scheduled around the activities of the mother and newborn, the time and mode of delivery, competing for scheduling priorities (including discharges at, or, before 24 hours), and the availability of primary care nurses to guide the parents; cultural beliefs may also play a part. [42][43][44][45] Table 2 summarizes various studies comparing the effect of different timings of the first bath on neonatal thermoregulatory status. Studies have demonstrated no significant impact on infant axillary temperatures, when bathing healthy newborns at different time points, from 1 hour up to 9 hours after birth. ...
Purpose:
Neonatal skin care practices guided by personal experience and preferences might be substantially different across different hospital settings. The aim of this consensus recommendation is to provide clinical practice guidance to healthcare practitioners on evidence-based neonatal skin care practices from delivery-to-discharge, in hospital settings.
Patients and methods:
A Scientific Advisory Board meeting on "Evidence-based Neonatal Skin Care Practices and Protocols" was held in December 2020 with an expert panel comprising neonatologists, pediatricians, obstetricians and gynecologists and pediatric dermatologist. Comprehensive literature search was performed up to 23 March 2021 using PubMed and Google Scholar to retrieve relevant evidence.
Results:
Recommendations were developed on critical aspects of skin care in healthy full-term neonates including cleansing at birth, skin-to-skin care, cord care, diaper area care, initial and routine bathing, cleansers and emollients use, and criteria to choose appropriate skin care products. Recommendations include inclusion of skin assessment in routine neonatal care, first bath timing after cardio-respiratory and thermal stabilization, 6-24 hours after birth; bathing with water alone or adding a mild liquid cleanser could be considered appropriate as it does not impact the developing skin barrier; use of emollients is recommended for neonates with higher risk of development of eczema to maintain and enhance skin barrier function and integrity; and inclusion of skin care advice in neonatal discharge checklist. Importance of rigorous quality control, high-quality clinical trials for assessment of baby products, usage of products that are formulated appropriately for newborns, and full label transparency for baby products were highlighted. The panel identified gaps in literature and discussed the scope for future research.
Conclusion:
These recommendations may help to standardize evidence-based skin care for healthy full-term neonates in Indian hospital settings to improve the quality of care that neonates receive in hospital and facilitate improvement in overall neonatal health outcomes.
... To protect a newborn from such consequences of hypothermia, delaying baby baths is essential. Qualitative studies have also shown that newborn bathing practices varied across studies, but cultural and traditional beliefs are still contributing to the practice of early newborn bathing (Adejuyigbe et al., 2015;Waiswa et al., 2008). Uneducated, no knowledge of hypothermia, being Primi para, have no antenatal care (ANC), poor knowledge about newborn danger signs, living in areas, vaginal mode of delivery, and whose birth were not attended by skilled birth attendants (SBAs) were found to have a positive influence on the practice of early baby bathing practice (Abebe et al., 2021;Alem et al., 2020;Brhane et al., 2017;Welay et al., 2020). ...
Background
Ethiopia has still suffered the highest burden of neonatal morbidity and mortality. The World Health Organization's practical guide for the thermal protection of newborns recommends delaying the bathing of newborns for at least 24 h following delivery, as it is crucial to prevent neonatal mortality and morbidity and to achieve 2030 sustainable development goals. However, little is known about delayed newborn bathing practices in Ethiopia. Therefore, the purpose of this study was to assess early baby bathing practices and associated factors among postpartum women.
Methods
A mixed community-based cross-sectional study was conducted among a total of 582 postnatal mothers. A multistage sampling technique was used to select study participants. A pre-tested and structured questionnaire was used to collect data. The data was entered into Epi-Data version 4.2.0 and exported into SPSS version 23 for analysis. Three focus group discussions with postnatal mothers were used for qualitative data. A purposive sampling method was used. Thematic analysis was used for qualitative data. Bivariate and multivariate logistic regression analyses were used in the analysis. To declare statistically significant, p-values of .05 were used.
Result
This study revealed that 250 (43%) mothers were practicing early newborn bathing. Early baby bathing was associated with antenatal care (ANC) follow-up (AOR = 5.1 = .95% CI = (2.6–9.9)), having no recent complications during birth (AOR = 1.9 = 95% CI = (1.02–3.6), having information about the time of baby bathing (AOR = 6.02, 95% CI = (3.9, 9.3)), knowledge of hypothermia (AOR = 3.3 = 95.6% CI (1.9–5.8), and poor knowledge about neonatal danger signs.
Conclusion and Recommendation
ANC follow-up, recent complications during birth, having information, knowledge about hypothermia, and neonatal danger signs were significantly associated with early baby bathing. Continuous health education on the appropriate time of baby bathing and neonatal danger signs and enhanced ANC service utilization are recommended.
... Ancak yenidoğanlar ince bir cilde ve düşük vücut ağırlıklarına karşın geniş yüzey alanına sahip olduklarından, çevre sıcaklığındaki değişikliklere son derece duyarlıdır. 28 Termal bir stres kaynağı olan banyo, yenidoğanlarda hipotermi geliştirerek metabolizmanın artmasına ve hipoglisemiye, doku perfüzyonunun azalmasına, iskemiye ve metabolik asidoza yol açar. Ayrıca ağlama gibi oksijen tüketimini arttıran bir davranışsal tepkiye neden olarak vital bulguları dengesizleştirebilir. 29 Kültürel nedenlerle toplumlarda farklı şekillerde uygulanabilen yenidoğan banyosunun zamanlaması hakkında henüz net bir görüş birliği bulunmamaktadır. ...
... Although it has been reported that immediate washing is associated with reduction of neonatal body temperature (Gunnlaugsson, Da Silva, & Smedman 1992;WHO, 1997), washing of the new-born soon after birth is common practice in some communities globally. In West Africa, some societies believe that immediate washing provides the neonate with good sleep and rest (Adejuyigbe, Bee, Amare, Omotaran, Ignus et al., 2015). We found a significant association between early weighing and bathing with hypothermia. ...
BACKGROUND: Neonatal hypothermia is a major cause of mortality. This study determined the prevalence and factors associated with neonatal hypothermia in two regional referral hospitals in Dar es Salaam, Tanzania. METHODS: Cross-sectional study was carried out between March and May 2021 at the Mwananyamala and Temeke Regional Referral Hospitals. Simple random and stratified sampling procedures were used to select study sites and proportionate population samples from each hospital respectively. Body temperature was measured within 90 minutes post birth; knowledge of the WHO guidelines on thermal protection of new-borns was collected from the mothers and health care providers using questionnaires. Logistic regression was used to assess associations between variables. SPSS version 25 was used to analyse the data and p < 0.05 was considered significant. RESULTS: Total of 296 mother-new-born pairs and 41 health care providers were enrolled in the study. 26 mothers did not consent for the study. 25.6% of the 270 studied neonates were hypothermic. Lack of skin-to-skin contact with the mother; early neonatal weighing and bathing increased likelihood of neonatal hypothermia. Knowledge of neonatal thermal protection among mothers and care-providers was inadequate. CONCLUSIONS: The prevalence of neonatal hypothermia among neonates in the referral hospitals is high. The findings suggest knowledge gaps of the WHO recommended guidelines on neonatal hypothermia are associated with neonatal hypothermia. Efforts to increase awareness of the WHO recommended thermal protection guidelines are needed.
... Despite the link between neonatal bathing and thermal control [14,15], the subject is understudied, particularly in countries with limited resources and awareness like Nigeria. Studies in the SSA have largely focused on improving newborn care [16], neonatal care practices [17], sociocultural determinants of exclusive breastfeeding [18] and thermal care beliefs and practices [19]. Studies on neonatal bathing focused on the methods of bathing, procedures of cleansing agents to be used, water temperature and duration of bathing [20,21]. ...
Background
Two-hundred and seventy out of every thousand live births died in Nigeria in 2019. These deaths are attributable to infections, complications of preterm birth and intrapartum-related conditions. The World Health Organization and Save the Children recommend withholding bathing of neonates until 24 hours after birth or until their vital signs become stable to prevent hypothermia. Despite the link between neonatal bathing and thermal control, the subject is understudied in Nigeria. This study aimed at investigating the maternal and child factors associated with late neonatal bathing practices in Nigeria.
Methods
The study adopted a cross-sectional survey design and extracted data from the women’s file of the 2018 Nigerian Demographic and Health Survey (2018 NDHS). The unit of analysis was limited to 12,972 women aged 15–49 who had complete data for the study. The outcome variable for the study was “late neonatal bathing (LNB)” conceptualized as delaying bathing of newborns until 24 hours after birth. At 95% confidence interval, two logistic regression models were built with Model I consisting of only maternal factors whilst Model II contained both maternal and child factors. The results of the final model were presented as adjusted odds ratio (aOR).
Results
Descriptively, 12% (CI = 0.122–0.134) of the women aged 15–49 bathed their neonates after 24 hours of delivery. Inferentially, women with secondary/higher education [AOR = 1.30, CI = 1.05–1.61], the rich [AOR = 1.24, CI = 1.03–1.50], those with access to mass media [AOR = 131, CI = 1.15–1.50], women that professed other religions [AOR = 9.28, CI = 4.24–17.56], those who delivered in a health facility [AOR = 1.93, CI = 1.66–2.25], whose child was small in size at birth [AOR = 1.46, CI = 1.21–1.77] and delivered by caesarean section [AOR = 2.50, CI = 1.97–3.18] had higher odds of bathing their neonates 24 hours after birth. The likelihood to bath neonates 24 hours after birth decreased among women who were into sales [AOR = 0.71, CI = 0.52–0.97], women with parity two [AOR = 0.75, CI = 0.61–0.92] and rural residents [AOR = 0.83, CI = 0.74–0.96].
Conclusions
The proportion of women aged 15 to 49 who practiced late neonatal bathing was generally low. To improve the practice of late neonatal bathing, much concerted effort should be directed to women's education and approaches of increasing receptivity of late neonatal bathing among pregnant women through the media. The Nigerian’s Ministry of Health should incorporate routine counseling on the risks of bathing newborns prematurely into ANC and PNC.
... Os recém-nascidos a termo apresentam uma maior quantidade de escaleno e ésteres de colesterol do que os de prétermo devido a sua maior produção sebácea. Confere, ainda, um sistema de defesa poderoso e uma barreira mecânica contra bactérias (Adejuyigbe et al., 2015.;SBP, 2015). ...
... Ainda há crenças em que o vérnix é visto como algo "sujo e fedorento" como o resultado encontrado no artigo 02 (Adejuyigbe et al., 2015). Este estudo revelou que os profissionais de saúde compartilharam essas visões negativas do vérnix em todos os locais, com exceção da Tanzânia, onde foi descrito como bom para a pele, com função protetora contra infecções e ajudando a manter o RN aquecido. ...
O presente trabalho teve como objetivo, identificar a importância da enfermagem nos primeiros cuidados com a pele do bebê. O vérnix caseoso, uma cobertura presente em RN a termo, sendo composta por lipídeos, proteínas e água com importantes funções na pele. Essa substância facilita a formação e a maturação da pele e sua ausência traz alterações importantes para a pele do RN, principalmente aos classificados como pré-termo. Este estudo apresenta uma revisão integrativa da literatura, com busca nas bases de dados. Os resultados demonstram a importância de se executar educação continuada com os profissionais da área da saúde, sejam eles profissionais de enfermagem ou não. A consciência e conhecimento sobre o vérnix caseoso poderá ofertar uma melhor assistência ao RN quanto aos cuidados térmicos (secagem e acondicionamento), contato pele a pele, amamentação imediata e o banho de forma tardia.
... The rst bath is often scheduled around the activities of the mother and newborn, the time and mode of delivery, competing for scheduling priorities (including discharges at, or, before 24 hours), and the availability of primary care nurses to guide the parents; cultural beliefs may also play a part [27][28][29][30]. Table 2 summarizes various studies comparing the effect of different timings of the rst bath on neonatal thermoregulatory status. ...
Background: Neonatal skin care practices that are often guided by personal experience and preferences result in substantial variation in the practices being followed across hospital settings. The objective of this consensus recommendations was to provide guidance to health care practitioners on evidence-based neonatal skin care practices for adoption in hospitals: from delivery to discharge.
Methods: A Scientific Advisory Board meeting on “Evidence-based Neonatal Skin Care Practices and Protocols” was held in December 2020 with an expert panel comprising neonatologists, pediatricians, obstetricians and gynaecologists and a pediatric dermatologist were invited. A comprehensive literature search was performed using the PubMed and Google Scholar databases to source relevant evidence.
Results: Recommendations were developed on critical aspects of skin care in healthy full-term neonates, including cleansing at birth, skin-to-skin care, cord care, diaper area care, initial and routine bathing, use of cleansers and emollients, and the criteria to choose appropriate skin care products. The newborn’s first bath should occur only once cardiorespiratory and thermal stability have been achieved, anywhere between 6 to 24 hours after birth. Bathing with water alone or water with a mild liquid cleanser demonstrated appropriate for newborn does not impact the developing skin barrier. The use of emollients to maintain and enhance skin barrier function was encouraged for neonates with risk factors that can affect skin barrier integrity. Skin assessment should become an integral part of routine neonatal care. Skin Care Advice with “Do’s and Don’ts” should be a part of the neonatal discharge checklist. The importance of rigorous quality control, high-quality clinical trials to evaluate the safety and efficacy of baby products, usage of products that contain only ingredients and which are formulated appropriately for newborn babies, and full label transparency for baby products were highlighted. The panel further identified gaps in the existing literature and discussed the scope for future research.
Conclusions: The consensus recommendations may help standardize evidence-based skin care for healthy full-term neonates in Indian hospital settings. This may also improve the quality of care that the neonates receive in the hospital and facilitate improvement in overall neonatal health outcomes.
