Stress Level, Skin Moisture and Physiological Parameters in the First Bath of Newborns

Istanbul University - Cerrahpasa

Status: Completed

Conditions: Infant Behavior

Treatments: Behavioral: Showering Bath; Behavioral: Wiping Bath; Behavioral: Wrapping Bath

Study type: Interventional

Funder types: Other

Identifiers

NCT07109908

Kastamonu Unıversity

Details and patient eligibility

About

Objectıve: The aim of this study was to determine the effect of wipe (WG), shower (SG) and tub bath (TG) on stress level, skin moisture and physiological parameters used during the first bath in newborns hospitalized in the Neonatal Intensive Care Unit (NICU).

Hypotheses of the Research

Hypothesis 01,2,3: There is no difference between wiping baths, wrapping baths and shower baths in terms of their effects on thermoregulation, stress level, skin moisture and physiological parameters of newborns.

Hypothesis 11: Newborns who are given a wrap-up bath have a lower stress level than if they are swept and showered.

Hypothesis 12: Newborns who are given a wrap-up bath have better skin moisture levels than newborns who are wiped and showered.

Hypothesis 13: Physiological parameters (body temperature, heart peak, respiratory rate, oxygen saturation) of newborns who are given a wrap bath are less affected than wiping and showering.

Full description

Bathing in newborns is an important midwifery/nursing practice that not only cleans the baby's skin, but also relaxes the baby (Tambunan and Mediani, 2019; da Fonseca Filho et al., 2017), supports immune system development (Burdall et al., 2019), and contributes to the preservation of skin integrity (Lima et al., 2020). If the appropriate method is not chosen in bathing in newborns and the bath is not performed under appropriate conditions, it may adversely affect the adaptation of the newborn to the extrauterine environment, physiological parameters and stress level. Therefore; the bath should be applied in a warm environment, in a safe and peaceful way, and with the appropriate method (Lima et al., 2020). In addition to performing bathing in the appropriate way, midwives/nurses should take appropriate precautions by observing the physiological parameters and stress responses of infants (Huang et al., 2022; Tambunan et al., 2022).

In newborns, wrap-around bath, wipe bath and shower bath methods are frequently used. Wiping bath is the process of wiping the baby's skin. The wrap-around bathtub bath method is to clean the baby by wrapping it with a soft towel or blanket and placing it in a bathtub filled with water at the appropriate temperature, preserving the flexion and midline position. A bath in the form of a shower is the process of bathing the newborn under running water (Ceylan and Bolışık, 2022; Karakul and Dogan, 2020).

Enrollment: 72 patients

Sex: All

Ages: 1 to 2 months old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Birth weight of 2500 g or more
• Body temperature within the normal range (36-37.3°C)
• Respiratory rate between 30-60 breaths per minute
• Oxygen saturation above 85%
• Absence of neurological problems (e.g., hypotonia, hypertonia)
• Absence of congenital defects
• No dermatological problems
• Parental consent and voluntary participation in the research

Exclusion criteria

• Presence of respiratory failure or distress
• Requirement for ventilator support
• Continuous need for high-concentration oxygen via methods such as hood or CPAP
• History of convulsions
• Clinical evidence of infection

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: Single Blind

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72 participants in 3 patient groups

Wiping Bath

Experimental group

Description:

The babies in this group were given the first bath in the form of wiping baths. The bathing application was carried out by the midwife working in the unit and experienced in bathing newborns. The newborn's clothes except the diaper are removed, the newborn is wrapped in a towel, the newborn's face and body are wiped clean with a skin cleanser and cotton cloth compatible with the baby's skin, the diaper is removed and the genital area is wiped, the baby's body is wiped with a cloth moistened with water (37-39 oc), the body is dried, the baby's body is wrapped in a dry towel, the baby's head is washed with a shampoo compatible with the baby's skin, the baby's head is dried and a hat is put on, The newborn was dressed in clothes.

Treatment:

Behavioral: Wiping Bath

Wrapping Bath

Experimental group

Description:

The first bath of the babies in this group was in the form of a wrap-up bath, in which the baby was wrapped and placed in the bathtub. The bathing application was carried out by the midwife working in the unit and experienced in bathing newborns. The newborn's clothes were removed, the newborn was wrapped in a towel, the newborn was slowly immersed in water wrapped in a towel in a bathtub with a maximum of 7 cm of water at the appropriate temperature (37-39 oC), the towel was gently opened and the baby's body was gently cleaned with a suitable cleansing product and a cotton swab, including the torso, legs and genital area, the baby's head was wetted and washed with a shampoo compatible with the baby's skin, the baby's head was rinsed by pouring water from the hairline, The baby's torso was gently removed from the bathtub and rinsed, the newborn baby was dried and then dressed in clothes.

Treatment:

Behavioral: Wrapping Bath

Showering Bath

Experimental group

Description:

The first bath of the babies in this group was in the form of a shower bath. The bathing application was carried out by the midwife working in the unit and experienced in bathing newborns. The newborn's clothes are removed, the newborn's body is soaked with water at the appropriate temperature (37-39 oC) under running water, the body is washed with the appropriate skin cleanser and cotton cloth, the head is washed with the appropriate shampoo for the baby's skin, the whole body is rinsed under running water, the whole body is dried with a towel and the clothes are dressed.

Treatment:

Behavioral: Showering Bath