by Melissa Clark Vickers
October 06, 2011
The first bath is a rite of passage, but it is also cause for concern. Sink or tub? Sponge or washcloth? Soap or no soap? Hot, warm, or cool water? Although baby bathing is best learned through trial and error, a little bit of knowledge can take the fear out of bathtime.
How-to: the sponge bath
It’s called a sponge bath, but no sponge is needed. The American Academy of Pediatrics (AAP) recommends sticking to sponge baths for the first week or two until the umbilical cord stump falls off and the belly button heals. Choose a time of day when your baby is wide awake and a place that is comfortable for you and safe for your baby. Wet babies can chill down quickly, so make sure the room is warm and draft-free. A wet baby is wiggly and slippery, so be sure to have everything you think you might need within reach.
Step 1: After undressing your baby, wrap her in a towel. Unwrap only the parts you are cleaning, so that she stays warm and comfortable during the bath. Place your baby on a soft towel. With a damp cloth, wash one section of your baby’s body at a time.
Step 2: Starting with her face and head—gently wipe her cheeks and her chin with a soft, damp washcloth. Unless your baby is truly dirty, there is little need for soap. If you use soap, choose one that is gentle on baby’s sensitive skin and use it sparingly. Using a clean, moist cotton ball for each eye, wipe from the inside corner to the outside edge of the eye.
Don’t forget the ears! Use a moist cotton ball to clean the outer surface of each ear and behind the ears. Be careful not to stick anything inside the ears in an attempt to remove earwax. Earwax actually keeps dirt, dust, and debris from making its way down the ear canal, so there is no need to remove it from the inner ear. Earwax usually moves to the outer part of the ear on its own and falls out or gets washed away. Any effort to remove earwax with a cloth or instrument can damage the ear.
Step 3: Make your way from head to toes, unwrapping and re-wrapping as you go. Seek out skin creases where oil and dirt can collect (like under the neck!). Gently clean the genital area as well. For girls, use a moist cotton ball and gently wipe between the labia (the skin flaps between the legs) from front to back. For boys, gently wipe all the creases around the scrotum, groin, and penis. Ask your baby’s health care provider for instructions on cleaning the penis of circumcised and uncircumcised babies, since the care is very different.
The umbilical cord stump usually requires no special care; simply keep it clean and dry. Soap and water can be used if necessary. In the past, parents were told to clean the area with alcohol during diaper changes, but alcohol is no longer recommended.
Step 4: Have a dry towel ready to rewrap your baby after her bath. There is no need to apply creams, lotions, or oils. Babies come with their own sweet smell.
How-to: the tub bath
Once the umbilical cord has fallen off and the belly button has healed, you can give your baby her first real bath. The basic principles of warmth and comfort still apply, and supplies should still be within reach. Aim for an every-other-day bath; a daily bath is more apt to dry your baby’s delicate skin.
In the beginning, you may want to use a baby bath tub designed to hold your newborn in a semi-reclining position. Portable tubs come in all shapes and sizes—some are even made to fit inside the kitchen sink to make it easier for parents to bathe their newborns without having to bend over a large tub. As your baby grows and more space is needed, you can move her into an adult bath tub, but you may still want to use a plastic insert, a baby tub designed to fit inside an adult tub. A baby should not be placed in an actual adult bath tub until she can sit up without support. In May 2010, the U.S. Consumer Product Safety Commission approved a new federal safety standard for infant bath seats, but the American Academy of Pediatrics warns parents that bath seats are no substitute for adult supervision. Drowning continues to be the second leading cause of death for children starting at age one. Never leave your baby alone in the tub, even for a second. Telephones and doorbells can go unanswered. If you have to interrupt your baby’s bath for any reason, wrap your baby in a towel, and take her with you.
Step 1: Fill the tub with 2–3 inches of warm water. Place a warm, wet washcloth on your baby’s chest and belly during the bath to keep her warm.
Step 2: Clean your baby from head to toes, paying special attention to the creases and folds where oil and dirt can collect. A dab of unscented baby soap on a soft washcloth should be enough to wash her entire body.
Step 3: Gently tip your baby forward against your arm to wash her back and buttocks. Once your baby has good head control (around 3 months of age), you can place her on her tummy while you wash her backside. The tummy position should only be used if your baby is in a plastic, semi-reclining, infant bath seat that supports her chest and head above the water.
Step 4: Wash your baby’s hair with a drop or two of baby shampoo. Scrub gently with a soft bristle toothbrush (it’s perfect for removing oil and dead skin cells!). Rinse thoroughly. If your baby shows signs of cradle cap (scaly patches on the scalp), wash her head daily until the scales disappear. In severe cases, massage a small amount of pure natural oil into the scalp; wait 10–15 minutes, then gently comb out the white flakes. Shampoo the head and rinse well. Rub the head with a soft, dry towel, and brush the hair gently. Cradle cap will eventually go away without treatment.
Step 5: While supporting your baby’s head and back, gently scoop her up and place her on a dry hooded towel. Place the hood over her head for warmth and pat her dry with the sides of the towel. Put a clean diaper on and voila! Unless otherwise directed by your baby’s doctor, avoid all powders, oils, lotions, and creams, which can irritate a baby’s sensitive skin.
For most babies and parents, bathtime is synonymous with fun—singing songs, identifying body parts, counting fingers and toes. It’s important to be safe and vigilant. But it’s equally important to know that these moments together are precious (and fleeting!). Don’t waste them worrying!
Melissa Clark Vickers is a west Tennessee IBCLC, and child and family health editor. She is mom to Dan and Merrilee, and mom-in-law to Sunny and Alex.
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