Re-Warming Baby after First Bath: A Non-Randomized Clinical Trial

Friday, 25 July 2014

Sino S. George, MSN, APRN, RNC-OB, WHNP-BC
Department of Nursing, Emory Healthcare, Atlanta, GA


 To evaluate two methods of re-warming newborns, radiant warming (RW) and skin to skin (S2S). The research question is, “In a population of healthy, full-term newborns, is S2S contact with mother as effective as RW in restoring the newborn’s temperature after the first bath?”


 Newborn temperatures were taken immediately prior to the bath (T1), and 30 minutes (T2) and 60 minutes (T3) after the bath. Descriptive statistics and -tests were used to determine differences between groups and between time points.


 Because 96 of the first 100 mothers chose S2S re-warming, we concluded the study early and analyzed the data. Of the 96 mothers who chose S2S, 92 successfully re-warmed and 4 required rescue re-warming under the RW. Careful review of newborns requiring rescuing showed inadequate skin to skin contact or removal of protective covering. Incidental findings: a) African American mothers were significantly younger, had smaller babies and had lower temperature than non-African American babies.

Conclusion: Given a choice mothers overwhelmingly preferred S2S re-warming. Newborns can safely re-warm S2S if staff pay special attention to how they are positioning the baby and re-check mother and baby frequently. This study has profound clinical significance for nursing practice. First, we’re failing to provide an option for re-warming that many of our mothers would choose. Second, S2S re-warming adds opportunities for mothers to nurse their newborns. Promoting breastfeeding is also in line with the Healthy People 2020 goals for increasing breastfeeding rates. Unexpected finding of racial differences in maternal and newborn characteristics will require further investigation.