Bathing a Newborn

The safety rules first

The AAP says the same about bath seats — they can tip over and a child can fall into the water — and adds the reason this matters more than it sounds: "Most child drownings inside the home occur in bathtubs, and more than half of bathtub deaths involve children under 1 year of age."

How often

Far less often than most people assume. The NHS: "You don't need to bathe your baby every day. You may prefer to wash their face, neck, hands and bottom instead. This is often called 'topping and tailing'."

The AAP is more specific: "Newborns don't need a bath every day. They rarely sweat or get dirty enough to need a full bath that often. Three baths per week during baby's first year may be enough. Bathing more frequently can dry out your baby's skin."

The NHS adds the sensible exception: if your baby really enjoys it, there is no reason not to bathe them more often.

The first bath

The AAP notes that hospital practice has changed. "The World Health Organization recommends delaying baby's first bath until 24 hours after birth — or waiting at least 6 hours if a full day isn't possible for cultural reasons."

Three reasons, all from the AAP:

• Temperature and blood sugar. Babies bathed straight away "may be more likely to become cold and develop hypothermia", and the stress of an early bath can make a drop in blood sugar more likely.
• Bonding and breastfeeding. An early bath interrupts skin-to-skin care. The AAP cites a study showing a 166% increase in hospital breastfeeding success after a 12-hour delay in the first bath compared with babies bathed within the first couple of hours.
• Skin. Vernix, the waxy white coating, "acts as a natural moisturizer and may have anti-bacterial properties", and the AAP advises leaving it on for a while to stop delicate skin drying out. The HSE says the same: vernix absorbs into the skin during the first week.

Sponge baths until the cord goes

The AAP: "Only give your newborn sponge baths until the stump of the umbilical cord falls off, which usually happens by about one or two weeks of age."

How to do one, from the AAP:

• Get everything ready first — a basin of water, a damp washcloth, a dry towel.
• Lay your baby on a flat, comfortable surface, padded if it is hard. If they are above floor level, always keep one hand on them.
• Wash the face first, avoiding water in the eyes and mouth. Then the body, then the nappy area last.
• Keep your baby wrapped in a dry towel and uncover only the part you are washing. Pay attention to the creases under the arms, behind the ears and around the neck.

Topping and tailing

The NHS's method, which is the everyday alternative to a bath:

• Hold your baby on your knee or lay them on a changing mat. Undress them apart from vest and nappy, and wrap them in a towel.
• Dip cotton wool in the water — not too wet — and wipe gently around each eye from the nose outward, using a fresh piece for each eye, so you do not transfer stickiness or infection from one to the other.
• Use fresh cotton wool around the ears, but never inside them. The NHS: "Never use cotton buds to clean inside your baby's ears."
• Wash the face, neck and hands the same way, and dry gently.
• Take off the nappy and wash the bottom and genital area with fresh cotton wool and warm water. Dry carefully, including between the skin folds.
• Only wash around the umbilical cord "if it's dirty with pee or poo."

Bathing properly

The NHS's sequence, once you are ready for a real bath:

• Get the water right first. "The water should be warm, not hot. Run the cold water first and then add hot water. Check it with your wrist or elbow and mix it well so there are no hot patches."
• Use just water, or a liquid cleanser suitable for babies. The HSE recommends plain water for the first four weeks or so.
• Clean the face on your knee first, then wash the hair with plain water while supporting them over the bowl, and dry the hair.
• Take off the nappy, wiping away any mess.
• Lower your baby in gently, one hand holding their upper arm and supporting head and shoulders, using the other hand to swish water over them. Keep their head clear of the water.
• Lift out, pat dry — "paying special attention to the creases in their skin" — and dress them once dry.
• Empty the bath water as soon as you have finished.

The AAP adds two numbers worth knowing. Fill the basin with about 5 cm (2 inches) of water that feels warm, not hot, to the inside of your wrist or elbow. And "the hottest temperature at the faucet should be no more than 120 degrees Fahrenheit" (about 49C) — many water heaters can be adjusted to that limit. Tap water that is too hot can cause burns serious enough to need hospital treatment.

Two AAP "nevers": never bathe your baby in running water, and do not use a sprayer attached to the tap. Water temperature fluctuates as it moves through household pipes, and small changes can scald. If you use a sink, turn the tap off before your baby goes in.

Timing and mood

The NHS: "It's best not to bathe your baby straight after a feed or when they're hungry or tired." Make sure the room is warm, choose a moment when your baby is awake and content, and have everything to hand before you start.

If your baby is frightened of the bath and cries, the NHS suggests bathing together — easier if someone else holds the baby while you get in and out. The AAP suggests going back to sponge baths for a week or two and trying again.

Bath time is also a good moment for baby massage, which the NHS notes can help babies relax and sleep. Check any oils or lotions are suitable for babies first.

Nails

The NHS: some babies are born with long nails and it is worth cutting them so they do not scratch themselves. Use special baby nail clippers or small, round-ended safety scissors — safer than adult ones — or file them with a fine emery board. "It's best to cut your baby's nails when they're asleep or relaxed."

When to call

Speak to your GP, health visitor or public health nurse if:

• Your baby's skin is very dry or cracked and does not improve with an emollient. The HSE says you can use a moisturiser on dry patches from 4 weeks old, and to wait at least 6 weeks if your baby was premature.
• You notice redness, discharge or a bad smell around the umbilical stump while bathing.
• A rash appears that you are unsure about. The HSE advises always getting skin rashes checked, "particularly if your baby is unwell."

Seek emergency help for any scald or burn, and for any incident where your baby has been submerged, even briefly, even if they seem fine afterwards.