by Alan Greene, MD, FAAP
Most of us have some sort of a picture collection from our childhood -- maybe a baby book, or a family scrapbook, or even a box of pictures and memorabilia from our first few years of life. In that collection there are several common pictures. There's the wonderful shot of those tenuous first steps; the picture of a grinning baby covered ear to ear in not only a smile, but green peas, yellow squash, and smashed banana; and the snapshot of a baby sitting in a bathtub, hair slathered with shampoo and piled on her head complete with Cupie Doll curl. Bath time is an important part of childhood.
Most babies get a first mini-bath a short time after delivery. Hopefully the parents will be able to spend some time with her right after she was born. Then, what seems all too soon for most parents, she is taken into the nursery for a few tests, her first immunization, and her first bath.
In the nursery, a skilled nurse carefully laid her on a table (not unlike a kitchen or bathroom sink counter top that is very, very clean) and cradled her head in one hand. With the other hand, he or she gently washed baby with a warm (not hot) washcloth. As soon as the bath was over, the nurse put a clean diaper on your baby and wrapped her in a warm blanket. Until the umbilical stump has fallen off, and the belly button is dry, you can follow this pattern. (If your child is a son, I have given you pointers for boys.) For circumcised boys, you can follow this pattern until his penis has healed from the surgery.
Practical Bathing Tips
• Plan a special time for your baby's first bath at home. It doesn't matter what time of day it is (babies adapt well to different times of the day for baths, though many enjoy a bath right before bed), but you will want to select a time, when both you and your husband are home.
• Get out the camera. It's not time for that Cupie Doll shot just yet, but you will want a picture to record this event.
• Select a convenient place. I mentioned using a kitchen or bathroom counter. You may also want to try a changing table or bed. Cover the area with a thick towel or waterproof pad if needed.
• Get everything you will need ready before you start! The list includes water (of course), washcloth, alcohol pads, bath towel (with hood if you have one), clean diaper, any items you routinely use during a diaper change (for little circumcised boys this would include Vaseline and gauze squares), and fresh clothes. I do not recommend using soap or shampoo on babies this age. Newborns do not get sweaty or dirty except in the diaper area or if they spit up. Even these messes can be easily cleaned with water, which is so much better for most babies' sensitive skin than soap.
• Babies lose body heat very quickly, so make sure the room is warm -- 75 to 80 degrees Fahrenheit is ideal.
• Gently cradle your baby's head in one hand and use the other hand to remove her clothing. Gently wash her with a soft, warm washcloth, and dry her off with a towel. Take time to admire her individual parts -- all too often we bundle up our babies and never adore those precious feet or that soft bottom. If you like, you can wash one area at a time and put a fresh item of clothing on as soon as an area is washed and dried. This is not necessary unless you are in a chilly room.
• It is a good idea to start with the "less dirty" areas first, i.e. leave the diaper area until last. As you go, be sure to gently wash behind her ears; the crevices in her neck, elbows, and knees; and in between her fingers and toes. I had a friend who would make her one-year-old giggle while bathing her by saying, "Got to wash between those digits!"
• It's a good idea to wash a newborn's hair near the end of bath time. This will help prevent him or her from losing too much body heat. Most newborns don't have much hair, so it is easy to sponge it with water much the same way you do the rest of the body. Almost all babies dislike getting their eyes wet. If you tip the head back just a bit and work your way from the front to the back, you can avoid getting water in your baby's eyes.
• When it's time to wash the diaper area, remove her diaper and sponge off the skin on her belly and bottom. Usually babies' genitals need only gentle cleansing. For little girls, wash from the front to the back. Don't be concerned if you see a white discharge or vaginal bleeding. These are both normal for newborn girls, and the discharge does not need to be wiped completely away. Leave whatever does not come off with one gentle pass. If you do have a son, do not retract or pull back the foreskin on an uncircumcised penis! Do not wash the head of a circumcised penis before it is healed.
• Before putting on a clean diaper, gently raise your daughter's umbilical stump and clean around the bottom of the stump with an alcohol swab.
• Dress your fresh, clean, and oh-so-cuddly baby.
Some babies love bath time, though that is unusual at this age. Most babies are a bit frightened by the experience of having their clothes taken off and being exposed to the air. If he falls into this category, you can comfort him by talking or singing to him during the bath. Your soothing voice will remind him that he is safe.
If she loves her bath, feel free to make it part of your daily routine. If she doesn't love it, it isn't necessary to bathe her daily. As long as you are changing her diaper regularly and cleaning her diaper area after poops (I don't recommend using prepared wipes that contain alcohol, soap, or perfumes), and spot cleaning after spit-ups, she shouldn't need to be bathed more often than every three or four days. Longer is okay for some babies -- if she starts to smell you will know it's time for a bath!
If your baby's skin is drying out too much you will want to cut back on the frequency of baths and apply an alcohol-free, unscented baby lotion daily -- and especially after each bath. After his umbilical stump falls off and his belly button is dry, you will be ready to give him a tub bath. By that time you will feel like a pro, and you will be able to adapt the ideas I've already outlined to the tub.
Essential Facts for Bath-time
• Never, never leave your baby alone in a bath! Not even long enough to answer the phone or turn off the stove. If you remember that you left the stove on in the middle of bath time, take Emily out of the bath, wrap her in a towel, and take her with you into the kitchen to turn off the stove. On your way back to the bath, grab a dry towel to use when her bath is complete.
• You only need to use a couple of inches of water in the tub, and make sure the water is warm -- not hot. Babies' skin is very sensitive to heat. If you are unsure about a safe temperature, you can buy an inexpensive bath thermometer at a local baby store or drug store. These simple devices change color to indicate safe and unsafe heat levels. (Note: If you haven't already done so, you need to turn down your hot water heater to no higher than 120 degrees Fahrenheit.)
• Use a tub that is the right size for your baby. Most baby tubs you purchase come with an insert for young babies. This makes it much easier for you to keep your child's head out of the water.
• Gentle soaps really are better for baby's skin during the first year or so. (Note: Ivory is not a gentle soap. Try an unscented baby soap or Dove, Basis, or Neutrogena.) Use soap sparingly and avoid scrubbing.
• Don't use adult shampoo on your baby. The no-tears advertisements for baby shampoos are for real.
• Make bath time fun. Use age-appropriate toys to engage Emily in the whole experience. At first this might be something as simple as giving her a clean washcloth to suck on during the bath. Later, plastic cups and bowls make excellent pouring toys.
Right now your little Emily is so tiny and fragile. When you look at her, it's hard to picture that Cupie Doll shampoo-do. When I was a child, I remember hearing adults talk about how "having kids makes time fly." Well, I'm an adult now, and I have pictures of my kids with Cupie Doll shampoo-dos. Time does fly; it won't be long before you have a picture of your Emily, in the bath, in that same time-honored pose.
Dr. Alan Greene, author of Raising Baby Green and Feeding Baby Greene, is the founder of Dr.Greene.com and the WhiteOut Movement. He is a frequent guest on such shows as Good Morning America, The Today Show, and the Dr. Oz Show. He is on the Board of Directors of Healthy Child Healthy World and The Lunchbox Project. Dr. Greene is a practicing pediatrician at Stanford University's Packard Children's Hospital.
Copyright © Greene Ink, Inc., all rights reserved. Permission to republish granted to Pregnancy.org. Reviewed by Khanh-Van Le-Bucklin M.D. & Liat Simkhay Snyder M.D. July 15, 2010.