Jan
11
2010
A parent of a preemie asks, “Once we get home, I’m a little nervous about bathing my baby. He is so small! It’s one thing to do it with you all here in the NICU, but I’m feeling a little nervous about bathing the baby at home. Any suggestions?”
Dear Preemie Parent,
Good question! Here is an article I crafted just for you (and a version of it is featured in the new consumer magazine, Healthy Mom and Babies, and the new AWHONN websites Health4women.org and Health4Mom.org ) on Bathing Your Preemie. Special thanks to the Farmer family and Annie Tao Photography for permission to use their photos.
Feel free to share this article with your friends, but please let people know you got it here! I welcome your questions and comments.
Yours for better parenting,
Candy
Bathing Your Preemie
(Reprinted with permission)
Congrats! You’re home!
You’ve done the bath in the hospital; but wait! What did they say again?? Here are 6 steps to help you complete the bath in a stress-free manner.
1. Be the Boy Scout
Be prepared.
Just as you would gather supplies before making your favorite recipe, get those bath things assembled in a warm environment. Most bathrooms will serve for this activity. Avoid drafty kitchens, unless you mean to intentionally cool the baby. Silence the phone, or better yet, have an extra pair of hands to help in case…since parenting seems to invoke Murphy’s law.
Assuming your preemie’s umbilical cord has healed, you will dunk as opposed to swipe n’ wipe. Place the baby bathtub on a firm surface. Make sure articles remain away from baby’s reach. Prepare the after-bath area for drying by padding with extra clean towels. Better grab an extra diaper, since bathing often stimulates babies to relax and let it rip!
Before you begin, toss clean clothes and bath towels in the dryer on “delicate” to warm them for a special touch. (Never use the microwave or convection oven to warm clothes.) Remove and place towels on the prepared surface.
2. Test the Water
Baby’s bath should be warmer than lukewarm, so she doesn’t get chilled. Body temperature is 98.6 F, so figure about 99F-100F for bath water. A wise old maxim says to test by putting your elbow in the water, as our hands are used to warmer temperatures.
Use a non-glass container, and fill with rinse water before you begin.
Supporting head and shoulders
3. The Dunk
Spread your fingers and grasp the base of the skull and the shoulder girdle with one hand. Concentrate on supporting the upper body and allow the lower torso to float freely.
If your baby doesn’t relax into the bath, she may be telling you the water is too hot or cold, you are holding her at the wrong angle, or that she doesn’t feel well.
Wiping inner to outer corner
4. The Eyes Have It
Cleanse from top to bottom. Beginning with the eyes, use cotton balls or a corner of a clean washcloth in plain water. Squeeze out the excess water and with one swipe, move from the inner to the outer corner. Then change cotton balls, or rotate to another corner of the cloth. The principle here is to avoid cross-contamination; any bacteria housed in one eye is easily transfered to the other. With this in mind, also avoid back and forth swipes on the same eye.
Continue to wash the rest of the body with mild baby soap. (Note: For boys with fresh circumcisions, do a sponge bath until your baby’s doctor or healthcare provider confirms it is completely healed.)
Give extra attention to the neck folds and creases in the arms and legs.
Rinse, using the plastic pitcher. It will be helpful to have an extra pair of hands!
5. How Dry I Am!
Lift baby out of the tub, keeping the head and spine in alignment, and place on her back on those nice warm towels. Dry quickly, blotting, into the nooks and crannies of the neck, arms, and legs.
You may use a cotton swab to dry behind the ear or in the curlycues of the outer ear, but avoid entering the ear canal except to soak up what moisture is visible. (A cloth wrapped around a finger may do just as well.)
The skin, our largest organ, is a semi-permeable membrane, and clogs easily. Preemie skin is delicate, owing to the fact they have fewer layers beneath the surface, and it dries easily. Know that if you use lotions, creams, or powders, you will need to bathe more often. Lotion is not needed for most babies, but if you do so chose, use it sparingly, and avoid the face and genitalia.
6. When to Shampoo?
Applying water to the head causes an immediate cooling effect. If baby is feverish or the weather outside is hot, you may cool your baby with water to the head first. In most cases, plan to shampoo last.
The process of applying soap and doing an actual shampooing is not a daily need for baby (or most adults, for that matter). Once or twice a week should be sufficient.
Wrap baby in a warm, dry towel and place in the football hold, tucking her legs under your arm. Angle her head down slightly, to avoid getting water down her neck. Hold baby over the sink and use your hand or the plastic pitcher to wet the hair.
Next, add a small amount (about a dime-size) of baby shampoo to the back of the scalp. Proceed to stimulate the sebaceous glands beneath the scalp with your finger pads (or by using a soft baby brush), in a circular motion, until all the hair has been covered. This will help keep oil from accumulating in the pores. (Note: a condition known as sebaceous dermatitis or “cradle cap” may appear at first as scaly skin or dandruff. You may apply a small amount of natural oil and work into the scalp with a gentle massage, to loosen these flakes a few minutes prior bathing.) Be sure to rinse thoroughly.
Timing is everything
Remember, your preemie will likely be fatigued and sleep longer after the bath. Do make sure to begin about 30 minutes prior a feeding, to avoid stomach upset. Preemies, in particular, need to digest while unstressed.
If you feel overwhelmed at the prospect of bathing your preemie, you are not alone. Trust that you have grown to know your child and that you have the skills to parent her well. With practice, soon you’ll be recalling these 6 simple steps with ease, and baby bath time will be a fun and relaxing time for all!
Farmer triplets- all clean!
Candace Campbell, RN, MSN, has practiced as a NICU nurse, and educator for 20 years. Her documentary film, Micropremature Babies: How Low Can You Go? plus her delightful children’s books, My Mom Is A Nurse, and Good Things Come In Small Packages (I Was A Preemie), are available on Amazon.com or at: www.candycampbell.com or www.candythenurse.com. A percentage of the profits of each sale goes to our friends at the March of Dimes.
Nov
25
2009
Happy Thanksgiving, All!
This year is flying by, as opportunities for speaking/writing accelerate over here.
The latest film review is from another professional source, the Journal of Neonatal Nursing.
The reviewer writes, “…this video is an excellent source for parents to find hope in shared experiences. By watching this film, parents new to dealing with prematurity could encounter a little less fear in the whirlwind of decisions and procedures. Hearing that at least one family struggled to bond through the tangle of wires and tubes, or another mother suffered by not being able to hold the child separated from her womb too soon, or a couple felt confusion arriving home with no child in arms, new parents could anticipate and perhaps better weather the journey of assisting their premature infants to their best possible future.”
Click here for the whole article:
Oct
16
2009
Hello out there, and welcome back~
This past month, I have been finishing up writing a few magazine articles and doing research on empowering families of premature babies.
Meanwhile, the Association of Women’s Health, Obstetrics and Neonatal Nurses (AWHONN) has invited me to join their Editorial Advisory Board for
Health4women and Health4Mom.org. Yes, they will feature the articles I have been writing. (I urge you to sign up for these email magazines!) on the other had, if your email box is already FULL, just return here and I will reprint (with permission) the articles.
Enjoy the beautiful fall season and stay tuned for November special interest articles surrounding National Premature Baby Awareness Day, November 17th.
To your good health!
Candy
Sep
11
2009
Maureen and Candy at conference
Hello out there,
It has been a few weeks since this happy blogger has found time to post. I hope you have been enjoying your summer vacations! If you are a new parent, you may have found “staycation” has another meaning altogether. If you are a new parent of a preemie, I hope you find this site helpful.
This month we feature Neonatal Nurse Practitioner, Maureen Shogan, from Spokane, WA.
In this 9 minute podcast, you will hear us discuss the latest in recommendations regarding nutrition for both the pregnant mom and especially nursing mothers of (one or more!) preemies.
Enjoy!
Jul
6
2009
Yes, the interviews keep us busy! I am so pleased to be on the other end of the line once more with this wonderful radio talk show hostess and southern belle, Barbara Dooley. (Don’t let that southern belle moniker fool you, she’s no reticent eyelash-batting gal, but an outspoken one, with a wit to match.)
Barbara Dooley, WGAU Atlanta
Jul
4
2009
Dr. Alex Espinoza
Listen to Part 1 of our conversation about changes in Neonatology, preemies, NICU stress, and parental guilt, with Alex Espinoza, Neonatologist and High Risk Infant Follow Up Clinic Doctor.
click here: Alex Espinoza part-1
Part 2 includes a discussion of cost of neonatal care, kangaroo care, cultural differences in neonatal care.
Jul
3
2009
According to the National Center for Health Statistics, preterm birth in this country has risen 36% since the 1980’s, resulting in roughly 540,000 preterm births in 2006. That number rose in 2007 and decreased slightly (0.1%) in 2008, despite the March of Dimes’ excellent program (began in 2003) highlighting the problem and funding research to combat it.
Certainly, the alarm bell should be sounding, nationwide! Why is this happening?
For years, it has been known that certain physiological events will trigger a preterm birth: trauma or injury to the mother is one, infection is another, incompetent cervix, a third, congenital anomalies, another (although in the past, those problems were often discovered at time of term delivery). We are only beginning to pull back the curtain on the complete range of possible answers.
For decades, statistics have shown preterm birth happens most frequently among those of African American descent, or women who’ve had a prior preterm delivery. Also, women of low socio-economic status, who lack prenatal care, overexert themselves physically or have stress induced low or high BMI, are more prone to premature delivery. Tobacco, alcohol, drug, or other substance abuse, prior induced abortion, prior cervical surgery, periodontal disease (!) , uterine overdistention (i.e., multiples, polyhydraminos), vaginal bleeding during pregnancy (placenta previa), uterine anomalies, anemia and reproductive tract infections also cause a woman to go into premature labor (Medscape, 2007).
Specifically, the newest studies show three main drivers of prematurity in the U.S.: increased maternal age, increased number of multiples, and increased number of cesarian sections (MOD, 2008). Looking at the list, it is obvious that the first begets the second, and hence the third. Behind the Big Three is the newest cause: Artificial Reproductive Technology (ART). Parents who delay childbearing are now able to conceive after age 35, which has been traditionally known as ‘too late to party.’ Some centers now guarantee a pregnancy by implanting multiple embryos. Some offer “Build a Baby” workshops where specific gender, hair and eyecolor selection is available. Indeed, it is a brave, new world in which we live. Now, don’t get me wrong. I’m not against ART (I’m an artist myself and enjoy the creative process), just cautious. The whole subject raises important questions we need to be asking, like : Have we taken liberty with our ability? Should tougher medical standards be in place? Where do we draw the line between what seems right for one, and what is right for society? Somewhere the call for bioethics sounds like the muffled drone of the town crier, overtaken by automatic technological invention.
The irony remains that despite our high rate of premature infants, we are a nation of incredible scientific prowess. We can send a man to walk on the moon, we can maintain the lives of infants born so small their skin is transparent and their eyes are fused. (Indeed, I have spent the past 20 years of my career dedicated to these young persons.) But yet, we cannot predict exactly when a baby will be born, or why. Priorities.
Jul
3
2009
Another busy week of interviews ! Listen to this one with Nancy Darland, a Perinatal Clinical Nurse Specialist for 23 years when her daughter gave birth to a 28 week preemie. Her family is a March of Dimes Ambassador Family for Lincoln Parish in Louisiana. Nancy discusses the challenges Bankston has overcome in his young life; truly another miracle story. Here is his photo, the bright and vivacious 6 year old.
Bankston-poster child for The March of Dimes
(photo courtesy N.Darland)
Jul
2
2009
Greetings~
So sorry this post was accidentally missed on May 11, 2009 prior to the part 2 podcast. Those of you who wrote to let me know this, I thank you!
And here’s the photo of John Rothmann and I the night of the broadcast (it was 0100 am!). John is a champion of The March of Dimes (he and his wife had a preemie),the nursing profession, as well as my work. Listen to our conversation as we discuss his experience having a preemie, the nursing shortage, and the book, My Mom Is A Nurse.
Enjoy! kgo-podcast-1a-5-10-09
Candy and KGO's John Rothmann
Jul
1
2009
Joy and Candy at March for Babies 2009
May 2009- the March of Dimes sponsored March For Babies walk in California was a great success! My team, from the John Muir Health systems NICU, numbered a baker’s dozen, and we brought in quite a respectable amount of donations. This arm of the event was held in San Ramon on a gorgeous San Francisco East Bay morning. Several team members and their families attended, and we all had an invigorating walk and fellowship.
Team John Muir NICU
In these days of strife and pain around the world, it is exciting to be a part of such a large, diverse group of people working for a common cause to bring some relief and happiness to others. Each of us felt we were doing so little, but taken all together, the results were amazing. See YOU there next year!