Non-immediate

Newborn Care
Bathing, Diapering,
Dressing up, Swaddling
and Burping a Baby

Prof. Almeida A. Nierves, MAN,RN

Bathing a
Newborn
 Bathing a Newborn
 Purpose
 To cleanse the skin and interact with the newborn

 The WHO recommends delaying baby's first bath until 24 hours after birth
to allow the newborn to regulate his/her own body temperature. Sponge
baths can be given before the cord falls off without risk of infection.
 Vernix should not be washed off immediately, because it has antibacterial
properties and it protects the newborn’s delicate skin as they become
accustomed to dry air.
Special Considerations
• Give bath between feedings at most convenient time for baby and family.
• Complete baths are not necessary more than two or three times a week
because specific area are washed after diaper changes and when milk is
spit up.
• A bath should not be given immediately after feeding, because excessive
handling may cause regurgitation.
• Carefully wash and dry each area to prevent heat loss.
• Keep the baby warm by exposing only the area you are washing.
Sponging a Newborn

The supplies for a sponge bath is different

than supplies for a regular bath
 Soft washcloth
 Gentle baby wash
 Dry towel
Steps of Sponging a Newborn
1. Test bathwater – 37.2° to 38° C (99° to 100.4° F)
2. Proceed from the cleanest to the most soiled area of the body
Sponging a Newborn

a. Wash the baby’s face with clear water. Use a separate clean area
of the washcloth (or use a cotton ball) to wipe each eyelid. Use a
clean area to wash the outer ear (do not put anything inside the ear
or nose).
b. Wash behind the ears, where milk that is spit up may accumulate.
c. Clean the nose with a clean corner of the washcloth.
d. Put one hand under the baby’s shoulders and lift slightly. This
allows the creases of the neck to be washed.
Sponging a Newborn

e. Wash the vulva of a female newborn by wiping from front to back

to prevent contamination of the vagina or urethra by rectal content.
In the male newborn, do not force back the foreskin of the
uncircumcised penis. Clean the penis and scrotal area gently. Clean
under the scrotum and the folds of the scrotum.
f. The easiest way to wash the hair is to hold the baby (wrapped in a
towel to prevent chilling) in one arm, using the football hold, over
the basin of water. Soap the hair and rinse by pouring water from a
container over the head. Then dry the hair to prevent chilling.
Giving a Tub Bath to a Newborn
Supplies:
 Baby bathtub
 Soft towel
 Ultra-soft washcloth
 Gentle Cleansing Gel
 Gentle Shampoo
 Plastic cup
 Clean diaper and pair of clothes
Giving a Tub Bath to a Newborn
1. Use a plastic tub or a clean sink for the bath.
2. Place a small blanket or pad on the bottom of the tub for comfort and to
prevent slipping.
3. Place approximately 3 to 4 inches of warm water in the tub – the water
temperature should be 36.6° to 37.2°.
4. Using a clean, dampened washcloth, wash the eyes and face with plain
water.
5. Place the baby in the tub. The baby maybe frightened and cry when first
put in the water. Holding the baby securely and talking with a soft voice
will often help the infant adjust to the bath.
 Giving a Tub Bath to a Newborn

6. Wash Your baby’s arms, legs, and torso

7. Concentrate on the areas with skin folds and
rolls.
8. Be sure all soap is rinsed off the baby before
removing from the tub.
9. Remove the newborn from the tub and
immediately wrap in a dry towel.
10. With the baby wrapped in a towel and held
in a football hold, gently shampoo the hair;
rinse thoroughly with warm water and dry
with a clean towel.
Giving a Tub Bath to a Newborn

11. Remove newborn from the bathtub and set them on a clean, soft towel.
Use the towel to gently pat the baby dry with the same order that you
washed their body, do this quickly.
12. Put a new diaper on the newborn and dress them in a warm outfit.
Dressing and Undressing a Baby
 Dressing and undressing a baby is wonderful face-to-face time that can
spend interacting with each other. Talking to the baby calmly can help
keep her relaxed during the process. When putting clothes on or taking
clothes off from baby:
1. Handle baby carefully and gently.
2. Work slowly and tell what you are going to do.
3. Remove clothes with care.
4. Choose the correct size clothes.
5. Make sure baby's clothes are safe.
6. Place baby on a safe, flat surface.
Dressing and Undressing a Baby
Dressing a Baby
1. When putting a shirt over baby's head, gather the entire shirt like an
accordion up to the neck. Holding the opening of the neck, carefully place
the shirt over baby's head and slowly pull the shirt over her body.
2. Gather the sleeves up to the cuff and put your baby's hand through the
opening. Carefully work the sleeve up the rest of her arm.
3. When putting on pants, start at baby's feet and gradually work the outfit
up her body.
4. Fasten the back of an outfit, gently turn
your baby on to her tummy or sit her up
with support.
5. Put the bonnet, mittens and shoes.
Dressing and Undressing a Baby

Undressing a Baby
1. Begin at baby's head and carefully loosen and slide the outfit down over
the body.
2. Be sure to support baby's head and body with one hand as you lift him
to reposition clothes. Remember to avoid twisting or jerking any of
baby's limbs at any time.
3. Carefully unsnap each snap and loosen or rearrange the item until it can
be easily removed. Use two hands to remove the socks gently rather
than pulling them off the feet.
4. If you need to turn the baby on his side, be sure to support his body
weight.
Diapering a Baby

Purposes
1. To assess signs of skin irritation and infection
2. To assess characteristics of urine and feces output of the baby
3. To provide comfort measures to the baby
4. To provide adequate time for mother-baby bonding
5. To prevent rashes and skin irritations
Special Considerations in diapering a newborn:
To reduce diaper rashes:
 Keep the skin dry by changing diapers as soon as they are wet or soiled.
 Wash with water only, do not use soap.
 Remove the diaper and expose to the air for 10 to 15 minutes, three or four times
a day.
 Rub on a thin layer of petroleum jelly, or zinc based
cream on a diaper area that is clean and dry
 Avoid using airtight plastic pants over the diaper.
 Try switching to cloth diapers if you are using
disposables.
Causes of diaper rash:
1. Irritation from dampness
2. Allergic reaction to soaps, perfumes, or oils that
touch the skin.
3. Yeast infection spread from stool
Materials

 Diapers (cloth or disposable) in the correct size

 Diaper cream or ointment
 Wipes
 Change of clothes for your baby (in case of a blowout)
 Disposable bag
 Changing table or changing pad
Procedure

1. Wash hands.
2. Gather supplies. Have everything needed in arm's reach (but out of your
baby's reach).
3. Lay the baby down. Gently place the newborn on their back on the
changing surface.
4. Unfasten the diaper tabs. Raise baby’s bottom off
of the diaper by gently grasping their ankles and
lifting. If there is a lot of stool in the diaper, use
the upper half of the diaper to gently sweep it
toward the lower half.
Procedure
5. Slide the diaper away. Place it nearby, but out of reach of baby.
6. Wipe the baby clean. When wiping a girl, always go from front to back
to prevent infection. Cleanse the area with wipes or moistened cotton
balls.
7. Set aside trash. Place any used disposable cleaning supplies on top of
the soiled diaper.
8. Slide a clean diaper under baby's bottom. Make sure the tabs are on the
side located under the baby’s bottom.
9. Before closing the diaper, apply products that doctor has recommended
for rashes.
Procedure
10. Close the new diaper. Pull the front between the baby’s legs and up
over their stomach. Then pull the diaper tabs open and around to the front,
making sure the diaper is snug but not too tight. Fold the diaper down to
avoid irritation of the umbilical stump until it falls off.
11. Roll up the used diaper. Firmly roll the diaper up and wrap the tabs all
the way around it. Place the diaper in a bag, diaper bin, or garbage can.
12.Clean the changing surface.
13. Wash hands and the baby's hands.
Swaddling
a Newborn
Swaddling a Baby
 Purpose: To provide warmth and a sense of security to the newborn

 A blanket wrapped snuggly around your baby’s body can

resemble or mimic the mother’s womb and help
soothe the newborn.
 Can be an effective technique to help calm infants and
 promote sleep.
 Stop swaddling once the baby starts trying to roll
over at 2 to 4 months of age.
Different types of swaddling cloths:

1. Baseball diamond swaddle - simple square or rectangle blankets

2. Halo sleep Sack-like - allow you to zip the baby up.
3. Ollie swaddle - with flaps on the side that wrap across the
baby’s body and are secured with sticky strips
4. Swaddle me swaddle – a sack type with velcro snap.
 Benefits to swaddling a baby
1. Protects the baby against their natural startle reflex that provide a
better sleep for both mother and baby.
2. Helps calm a colicky baby.
3. Helps eliminate anxiety in the baby by imitating the mother’s
touch
4. Keeps baby’s hands off her/his face and helps prevent
scratching
5. Helps baby sleep longer and better
6. Helps prevent SIDS by keeping unnecessary items
like pillows, blankets, and stuffed animals out of your
baby's crib
7. Keeps the baby on his back while he sleeps
Disadvantages of swaddling

1. Increased risk of SIDS.

 SIDS is associated with problems in the ability of the baby to arouse from sleep,
low levels of oxygen, or a buildup of carbon dioxide in the blood. When babies
sleep face down, they may re-breathe exhaled carbon dioxide.
2. Loose bedding.
 Baby can wriggle out if swaddling is not done properly.
3. Overheating.
 Swaddles produces warmth in the baby’s body.
 Check baby’s temperature and be aware that on hot days they may need a light
comfortable linens.
Disadvantages of swaddling

4. Affect a newborn's healthy weight.

 A delay in breast-feeding may cause a swaddled newborn not have an
adequate weight.
5. Interfere with beginning breast-feeding
6. Developmental dysplasia of the hip.
 Hip dysplasia is when the hip socket does not fully cover the ball portion
of the thighbone which can cause the hip joint to more easily dislocate.
First step: Getting started

1. Place a small blanket flat

on the bed in the shape
of a diamond, with the top
corner folded down slightly.
Second Step: Covering the Body
2. Place the newborn with the shoulders at the upper edge of the
blanket. The arm may be placed at the infant’s side or positioned so
the hand is not near the mouth. Wrap the right corner of the
blanket around the newborn and tuck
it under the left side of the infant.
Fold the left corner of the blanket
over the newborn and tuck it under
the right side of the infant.
Third Step: Covering baby's feet

3. Pull the bottom of the

blanket up to the infant’s
chest and secure each
corner around the newborn
and under the back (snugly,
not tightly).
Fourt step: Completing the swaddle

While holding the baby in place, pick up the other corner of the
blanket and wrap it across baby's body. The swaddle will leave only
baby's head and neck exposed.

Swaddling a baby in a way that prevents his or her hips or knees

from being able to move freely within the blanket can lead to
developmental dysplasia of the hip — a condition in which the hip
joint has not formed normally and might be easy to dislocate.
Last step: Keeping a swaddled baby safe

After swaddling, be sure to practice safe sleep habits by

placing on his back back to sleep.
Burping a
Neonate
Burping a Neonate
 Burping a baby is a key part of baby’s feeding routine. When a baby
swallows, air bubbles can become trapped in the stomach and cause
discomfort. Burping allows the baby to remove some of the gas to
relieve the pain and helps prevent spitting up.

 Signs of trapped gas

 Irritable and crying
 arched back
 drawing legs into the tummy
 clenching the fists.
Burping a Neonate
Techniques in burping a baby:
1. Over the shoulder
 Hold the baby upright with the head
resting on your shoulder. Put a cloth over
your shoulder. Put baby over your shoulder
and support baby with your hand on the
same side. When baby is upright, pat the
back or gently rub baby’s back with
your other hand. Cupping your hand
slightly is gentler than a flattened palm.
Burping a Neonate
2. Sitting on your lap
 Let the baby sit upright on your lap. Lean baby
forward with baby’s tummy against your
hand. The pressure of the hand on baby’s
tummy can bring up air. Rub baby’s back
gently with other hand. Use repeated,
gentle pats on your baby’s back.
Burping a Neonate
3. Lying across your lap
 Place baby face down on your lap or
your forearm looking sideways
and is supported by your knee or hand.
Rub baby’s back gently with your other
hand. Keep a cloth nearby in case
baby spits up.
Burping a Neonate
Still showing signs of trapped gas?
4. Lay baby on the back and
gently massage the tummy. Try moving
baby’s legs back and forth, like riding
a bike. If ineffective, talk to
the healthcare provider to advise
on alternative options.
Thank you