Immersion Swaddle Bathing Compared to Traditional Sponge Baths for the First Newborn Bath in the Hospital and Thermoregulation.

Abstract

Purpose: The purpose of this quality improvement project was to promote newborn thermoregulation.

Background: Thermoregulation is a primary concern in the newborn population because poor thermoregulation contributes to impaired metabolic functioning, specifically glucose and respiratory regulation. In severe cases, if untreated, impaired thermoregulation can lead to increased risk of morbidity and mortality.

Methods: Two types of newborn bathing methods were evaluated for their effects on thermoregulation in a sample of healthy newborns: traditional sponge baths and immersion swaddle baths. Nurses monitored newborn temperatures pre- and postbathing. Temperatures were taken immediately prebath then postbath for each bathing technique until the infants were warm. Weekly data were collected over the course of 6 weeks, with 2 weeks of sponge and 2 weeks of swaddle baths for comparison. The goal was to decrease the amount of time infants spent under the warmer after their first bath. Three Plan-Do-Study-Act cycles were initiated throughout this project to monitor existing bathing methods as well as successful implementation of the change.

Results: Ninety newborns were enrolled; 30 preintervention and 60 newborns per postintervention (30 per cycle). Postintervention, significant improvements in thermoregulation were found among immersion swaddle bath infants in shorter return times to baseline prebath temperatures (p = .001).

Conclusion: In this project, introduction of immersion swaddle bathing positively correlated with improved thermoregulation in newborns. Using swaddle bathing instead of traditional sponge bathing may potentially have positive implications in other newborn settings. More research is needed on types of newborn bathing techniques.