Bathing your Kids & Infants

Most babies are over washed. In reality, newborns don't get very dirty. The toddler/mud puddle friendship has not yet begun.

First Baths

When to give baby her first bath is a matter of some debate. It is still general practice to advise parents to sponge bathe baby until the cord falls off and the circumcision heals. Some physicians question the necessity of this advice, feeling that an immersion bath does not increase the risk of infection. Check with your doctor. Our own personal recommendation is to sponge bathe baby until the cord falls off and the circumcision is well healed. We advise sponge bathing if there is discharge around the base of the cord or the circumcision site or if a putrid odor emanates from the cord. If both sites are reasonably clean and dry, we see no harm in going directly to an immersion bath.

Sponge bathing

• Select a bathing area. Try the kitchen or bathroom counter next to the sink. The room should be warm and draft-free. Take the phone off the hook so that you will not be tempted to leave baby unattended "just for a moment."
• Have your bath kit ready in the bathing area before you start. You will need:
  • Two wash cloths
  • A mild soap
  • Baby shampoo
  • Cotton balls
  • A hooded towel
  • Rubbing alcohol
  • Cotton-tip applicators
  • Diapers
  • Clean clothes
• A sponge bath. While some babies like to be bare, most don't, so remove all clothing except the diaper and swaddle baby in a towel. Hold baby on your lap while sitting in a chair with your bath kit on an adjacent table, or stand up at the counter with baby lying on a pad of thick towel.

Have your swaddled baby's head and face exposed. Begin washing his face with warm water, especially behind the ears, in the ear crevices, and in the neck creases. Unless baby's skin is sweaty, oily, or dirty, plain water is enough; otherwise use a mild soap.

Hold baby in the clutch hold. Squeeze a bit of warm water on top of baby's head, apply a dab of baby shampoo, and gently massage the entire scalp. Use no special caution over the soft spot. It's really tough underneath. (If baby's scalp is flaky or crusty, see cradle cap. Rinse over sink with running water. Blot dry with a towel hood. Meanwhile, baby is still swaddled in a towel, with only his head and face exposed, not getting cold. As you proceed with the rest of the body, cover the head with a towel hood.

Unswaddle baby, remove his diaper, and wash the rest of his body. Extend the arms and legs to wash the groin, knee, and elbow creases, where there are like to be oily collections. Clean around the base of the cord with a cotton-tipped applicator dipped in rubbing alcohol.

Turn baby over on his tummy and clean the crevice just above his buttocks and around the diaper area. Or you can lift both feet up and clean the lower back and buttocks while baby is lying on his back. To keep baby from getting cold and upset, cover the rest of the body while cleaning the diaper area.

Clean the genitalia. Hold baby's legs outward like a frog. For girls, spread the labia and using a moistened cotton ball, gently wipe between the labia. When cleaning around the vagina always wipe from front to back. You may notice that secretions and diaper creams collect and cake between the vulva and the outer labia. This area requires the most cleansing. A normal egg-white vaginal discharge is common between the inner labia and vagina. It is not necessary to clean away this normal discharge. For boys, clean the creases beneath the scrotum the skin of the groin and buttock, and around the base of the penis. Clean the circumcision area, if necessary. Do not retract the foreskin if uncircumcised. Quickly diaper baby and dress in clean clothes before he has a chance to get cold and upset.

Tub Bathing

After the sponge-bath stage, the real fun begins. First, choose the right tub that's safe and easy to use. There are many types of baby tubs on the market, or you can simply use the kitchen sink. The kitchen sink is easy to use because it is the right height. If using the kitchen sink, observe the following safety tips: Purchase an insert-type plastic or rubber tub that fits into your sink, or line the bottom of the sink with a folded towel or sponge mat to keep baby from slipping. There are even inflatable baby bathtubs. If you have a movable faucet, be sure to turn it away from baby.

Before the splash begins, make sure the water is comfortably warm, but not too hot. Tie a towel around your neck (like a bib) to keep yourself dry during the bath and in case baby needs to be picked up quickly and cuddled. Most newborns do not eagerly await their bath. Singing a few songs, making eye-to-eye contact, and gently massaging baby during the bath often relaxes the reluctant bather.

Additional Bath Tips

• As you move from one area of the body to another, change the parts of the washcloth in order to keep clean cloth on cleaner parts of the body.
• Pat the skin with a washcloth and blot dry with a towel rather than vigorously scrubbing, which may irritate baby's sensitive skin.
• Spot-cleaning works best for babies who do not like either a total sponge bath or an immersion bath. Clean the areas that get the most oily, sweaty, or dirty.
• Clean the eyes on an as-needed basis rather than during the regular bath. Babies often protest eye cleaning, which may set off a protest for the entire bath. Using cotton balls and warm tap water (always squeeze a few drops of the water from the cotton ball on the inside of your wrist to make sure it is not too hot), wash accumulated discharge out of the corners of baby's eyes.
• Cotton-tipped applicators are handy when cleaning little crevices in and behind the outer ear, but never try to clean inside the ear canal, as you may damage the canal or eardrum.

FAQ'S About Bath Time

How often should we bathe our baby?Bathing is primarily playtime. Babies don't get dirty enough to need a daily bath. For busy parents this is good news. Twice a week (especially in the winter) is enough bathing, providing you clean your baby's diaper area sufficiently well each time there is a bowel movement. Daily spot-cleaning in areas that get particularly sweaty, oily, or dirty, such as behind the ears, in the neck folds, in the creases of the groin, and in the diaper area are helpful.

Which soap and shampoo should I use when bathing our baby?Baby's skin, especially a newborn's, is sensitive, and all soaps are mild irritants. The function of soap is to suspend particles and oils on the skin surface so that they can be more easily removed from the skin with water. Without soap, some oils, dirt, and surface secretions would simply stick to the skin and require vigorous rubbing with a cloth and water to remove them, which in itself would irritate the skin. Every baby's skin has an individual tolerance to different soaps. How much soap, how often, and which kind can be determined only by trial and error, but here are some general guidelines:

• Use soap only on areas that are caked with secretions, (such as oil or sweat) which are not easily removed with plain water.
• When first using soap, try a test rub on one small part of the body. If over the next few hours the skin reddens, dries, or noticeably changes in any way relative to other areas, ban that soap and try another.
• Use mild soap. Baby soaps are regular soaps with fewer additives such as anti-microbials, fragrances, or abrasives. In our practice, we have found Dove acceptable for the skin of most babies.
• Limit the soap's time on the skin to less than five minutes to avoid drying or irritating the skin. Wash it off as soon as possible and rinse the skin well.
• Above all, avoid vigorous scrubbing of any area of the skin with soap.

If your baby is prone to eczema or has allergic dermatitis, use as little soap as possible, and give as few baths as possible. A special soap formulation prescribed by a dermatologist may be helpful. Babies with particularly sensitive skin should spend very little time in a bathtub immersed in water and are best showered and spot cleaned.

Shampoos are similar to soaps and if overused can irritate the scalp and rob the hair of natural oils. Shampooing once a week is enough for most babies. Use mild baby shampoo; like baby soaps, baby shampoos contain fewer additives than other commercial shampoos. It is seldom necessary to massage shampoo deep into the scalp. If your baby's scalp is covered with the flaky, crusty, oily substance called cradle cap, after shampooing massage a bit of vegetable oil into the crust to soften it, and then remove it with a soft comb.

Here is a final thought about soaps and shampoos that many mothers have expressed to me over the years. Sensitive mothers feel that too much soap and shampoo (and scented oils and powders) camouflage natural baby scents that mothers find irresistible. Also, it is better not to mask the mother's natural scent, which baby needs, and perfume is irritating to some babies.

Should I use powders and oils on our baby's skin?Gone are the days when a baby was sprinkled with perfumed talcum after every bath. Powders and oils are unnecessary since your baby's skin is naturally rich in body oil and they may be irritating and even harmful. Emollients (cold-pressed vegetable oil or Soothe and Heal by Lansinoh) may be used only on patchy areas of dry skin; otherwise, they are unnecessary. Powders easily cake and build up in skin creases and can actually contribute to skin irritation and rashes. Also, powders, if inhaled, can irritate baby's nasal and air passages. Cornstarch is not recommended as it can serve as a medium for the growth of harmful fungi.

My baby screams every time I try to give her a bath. How can we both enjoy bath time more?If your baby screams every time you try to put her into the water, it either means that she is hungry, the water is too hot or cold, or you have a baby who doesn't like to be alone in the water. Her security may be threatened. Here's how we have enjoyed bathing our babies. Take your baby into the bathtub with you. Get the water ready and undress yourself and baby. Hold her close to you as you get into the water and then sit back and enjoy the warm skin-to-skin contact. If your baby still protests, sit in the tub first and show her how much you are enjoying the bath. Then have someone else hand your baby to you while you are sitting in the bathtub. Mothers, don't be surprised if your baby wants to breastfeed at this time. It is the natural result of being close to your breast. In fact, if your baby still fusses upon entering the water in your arms, relax her by putting her to your breast first. Slowly ease your way into the tub. Then gradually lower baby into the water as she continues to suck. This is a special way to enjoy mothering and bathing your baby. As your baby gets older, bath toys such as the traditional rubber ducky may entice the reluctant bath taker. When bathing together in a tub, take special precautions to avoid slipping. While you are getting used to bathing with baby, it is safer to hand baby to another person or place her on a towel as you get out of the tub.

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