Bathing Babies

Bathing your newborn baby for the first time is one of the sweetest and, for some, one of the most anxiety-provoking milestones of parenthood. Although you may be nervous at first, you’ll soon grow confident and competent as you learn what works best for you and your baby.

How often should babies be given a bath?

Until your baby starts crawling on the floor, a daily bath is not necessary. As long as adequate cleansing is done during diaper changes and after feedings, a bath 2 or 3 times a week in the precrawling months will keep your baby fresh smelling and presentable.

When is the best time to give babies a bath?

Just about any time of day can be the right time for a bath. Some parents feel bathing just before bedtime helps create a more relaxed state conducive to sleep. It is best to avoid baths just after or just before a meal, because so much handling on a full tummy could result in spitting up, and baby may not be cooperative on an empty stomach. Give your baby time for the bath, so it need not be hurried, and you won't be tempted to leave baby unattended even for a second to take care of something else. Turn on the telephone answering machine or simply plan on not answering the phone during the bath time. If you must leave the room, take the baby with you.

What type of bath should I give my baby?

The sponge bath. Until the umbilical cord and circumcision, if one was performed, are healed (a couple of weeks, more or less), baby should not be submerged in water because it increases the risk of infection. Instead, use a washcloth or sponge to keep your baby clean.

A baby is ready for a tub bath (or in a portable tub or sink) as soon as both the umbilical cord stump has dried up and fallen off and the circumcision, if any, are healed.

Health and safety

• Young infants lose heat quickly, so make sure the room is warm (around 75°F, 24°C) before you undress your baby.
  
  
• Check the temperature of the water before putting your baby in the tub. Use the inside of your wrist or your elbow to test the water, which should be warm, but not hot. 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.
  
  
• Hot tap water accounts for 24% of scald burns requiring hospital admission of kids younger than 4 years. If you haven't already done so, you need to turn down your hot water heater to no higher than 120°F. Lowering the setting prolongs the time to burn and reduces serious scald injuries.
  
  
• NEVER, EVER leave a baby alone in the bath—even for a minute. A baby can drown in 2 inches of water.

Bathing supplies may include these items.

• 2-3 clean washcloths
  
  
• Mild baby cleanser—try an unscented baby soap such as Dove, Basis, or Neutrogena
  
  
• Baby shampoo—not adult shampoo (the no-tears advertisements for baby shampoos are for real)
  
  
• Sterile cotton balls for cleaning around the eyes
  
  
• Soft towel, preferably with a hood
  
  
• Diapers
  
  
• Clean clothes or pajamas
  
  
• Ointment for diaper rash, if needed—avoid talcum or baby powder because it can harm your baby if inhaled
  
  
• Rubbing alcohol and cotton balls or alcohol pads for the umbilical cord, if you wish to use them
  
  
• Warm water, if you won’t be within reach of the sink

1. Select a safe and flat surface on which to work. Make it comfortable for your baby by putting down a soft, clean towel.
   
   
2. Place your supplies within easy reach of the bathing area.
   
   
3. Get baby ready. If the room is warm, you can remove all of baby’s clothing before beginning, covering him or her loosely with a towel while you work. If it is cool in the room, undress each body part of the body as you are ready to wash it. Do not remove baby’s diaper until you are ready to cleanse that area.
   
   
4. Always keep one hand on your baby for his or her safety.
   
   
5. If someone else is available, have them take a picture to commemorate this very tender milestone of baby and parenthood.
   
   
6. Begin washing. Take time to admire your baby’s body—all too often we bundle up our babies and never adore those precious feet or that soft bottom. It is 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.

   Face. Using a sterile cotton ball moistened in warm water, clean your baby’s eyes, wiping gently from the nose outward. Use a fresh cotton ball for each eye. No soap is needed. Wipe around your baby’s mouth, nose, forehead, cheeks, and chin. Wipe around the outer ears, but not inside. Dry all parts of the face.

   Neck and chest. Again, soap is not necessary, unless baby is sweaty, smelly, or dirty. Be sure to get into those abundant creases where spit up is likely to collect. Dry.

   Arms. Open the arms to get into the elbow creases, and press the palms to open the fist. The hands will need a bit of soap, but be sure to rinse them well before they are back in baby’s mouth. Dry.

   Back. Turn baby over on the tummy with head to one side, and wash the back, being sure not to miss the neck folds. Dry, and dress the upper body before continuing if the room is chilly.

   Legs. Extend the legs to get the back of the knees. If your baby seems up to it, massage the feet or play “This little piggy” with your baby’s toes. Dry.

   Head. Once or twice a week, use soap or baby shampoo, rinsing very thoroughly. On interim days, use just water. A football hold at the sink's edge can be the easiest and most comfortable way to rinse baby’s head. Before proceeding, dry your baby’s hair, then place the hood of the towel or an infant cap on his or her head to help maintain body heat.

   Cord care. To prevent infection, health care practitioners have long recommended cleaning off the base of the stump with a cotton swab or gauze pad dipped in a little rubbing alcohol, and the American Academy of Pediatrics (AAP) still supports that practice. But a recent Canadian study suggests that gently cleaning around the base of the cord with warm water alone actually may help the cord heal faster. When rediapering your baby, fold the diaper down so it doesn’t cover this area. When the stump dries out, usually between 1-4 weeks after birth, and the wound heals, usually within a few more days, you will be able to give your baby a tub bath.

   Diaper area. Grab a new washcloth to clean the genitals. Wash girls front to back, spreading the labia and cleaning gently with a washcloth dipped in soap and warm water. A white vaginal discharge is normal; don’t try to scrub it away. Rinse gently with warm water. Wash boys carefully, getting into all the creases with soap and warm water. For the circumcised baby, while he is still healing, put a fresh piece of petroleum gauze over the wound. For the uncircumcised baby, do not try to retract the foreskin. Dry the diaper area well and apply ointment if needed. Diaper your baby.

7. If your climate or your baby’s skin is prone to dryness, consider putting a gentle baby lotion on your baby. Remember to warm the lotion in your hands. If your baby seems up to it, spend a little extra time massaging the lotion into the skin.

8. Get your baby fully dressed.

1. Select a safe, flat surface for the portable baby tub. You might want to omit soap the first couple of times you give a tub bath because soapy babies are slippery babies.
   
   
2. Place your supplies within easy reach of the bathing area.
   
   
3. Put 2 inches of water into the baby tub. Test the water temperature with your wrist or elbow to be sure it is comfortably warm. Never run the water with baby in the tub because a water temperature change might occur. Don’t add baby soap or bubble bath to the water, because these can be drying to your baby’s skin.
   
   
4. Undress your baby completely.
   
   
5. Gently slip your baby into the tub or sink. Support the neck and head with 1 hand securely in a semireclining position. With your free hand, wash baby working from the cleanest to the dirtiest areas. First, use a sterile cotton ball moistened in warm water: clean baby’s eyes, wiping gently from the nose outward. Use a fresh cotton ball for each eye. No soap is needed. Wipe around your baby’s mouth, nose, forehead, cheeks, and chin. Wipe around the outer ears, but not inside. Cleanse the abundant folds of the neck. Dry all parts of the face and neck.
   
   
6. Use soap on the hands and the diaper area daily. Use it every couple of days on arms, neck, legs, and abdomen as long as baby’s skin doesn’t seem dry—less often if it does. When you have taken care of baby’s front parts, turn him or her over your arm and wash the back and buttocks.
   
   
7. Once or twice a week, wash your baby’s scalp using mild baby soap or baby shampoo. Rinse very thoroughly and towel dry.
   
   
8. Wrap baby in a towel, pat dry.
   
   
9. If your climate or your baby’s skin is prone to dryness, consider putting a gentle baby lotion on your baby. Remember to warm the lotion in your hands before placing it on your baby’s temperature-sensitive skin. If your baby seems up to it, spend a little extra time massaging the lotion into the skin.
   
   
10. Get your baby fully dressed.

• Keep bathroom doors closed at all times. Install a hook-and-eye latch, a doorknob cover on the outside of the door, or reverse the doorknob so that the lock is on the outside.
  
  
• Toilet lid locking devices are extremely important once your baby begins to crawl, pull up, and walk. You can prevent serious injuries and drownings by installing one of these simple devices.
  
  
• Cabinet and drawer latches are a necessity in the bathroom. Use safety latches that are available for kitchen cupboards and drawers.
  
  
• Medicine cabinets should be free of medications, vitamins, mouthwash, and eye care products. Move them to a high shelf in a hall closet and insist on childproof caps for all medications, both over-the-counter and prescription drugs (ask your pharmacist to switch them). Special medicine lock boxes are available as well.
  
  
• Faucet covers fit directly over a protruding bathtub faucet. They are essential for bathing toddlers and older children because they often prevent scalding and head injuries.
  
  
• Hair dryers, radios, and other electrical appliances should not be kept in the bathroom. Store them in a safe place out of your child's reach.
  
  
• For more information on bath safety and other nursery equipment, contact the Consumer Product Safety Commission at (800) 638-2772 or visit the Web site Consumer Product Safety Commission.

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1. About.com. Parenting: Babies & Toddlers, Bathing Babies. Parenting: Babies & Toddlers, Bathing Babies.

2. American Academy of Pediatrics. Bathing Your Baby. 2001. Bathing Your Baby. 2001. Medem.

3. Eisenberg A, Murkoff HE, Hathaway SE. What to Expect the First Year. Workman Publishing Co; 1994:73-76.

4. Kopetzky G. Bathing Your Little Beauty: How to Give Your Newborn Baby a Bath. 2000. Bathing Your Little Beauty: How to Give Your Newborn Baby a Bath. 2000.

5. Lansky V. Practical Parenting Tips: Over 1,500 Helpful Hints for the First Five Years. Meadowbrook Press; 1992:17-9, 67-72.

6. Leach P. Your Baby and Child From Birth to Age Five. Alfred A Inc; 1989:145-6.

7. Schmitt BD. Your Child's Health. The Parent's Guide to Symptoms, Emergencies, Common Illnesses, Behavior and School Problems. Bantam Books; 1991:110-11.

Author: Lisa Hardin Van Bramer, MD, Co-Chair, DMSKC and Research Committee Chair, Denver Metro Safe Kids Coalition (DMSKC); Staff Physician, Department of Emergency Medicine, Denver Health Medical Center.

Coauthor(s): Kim Feldhaus, MD, Associate Professor, Department of Surgery, University of Colorado Health Sciences Center.

Editors: Scott H Plantz, MD, FAAEM, Research Director, Assistant Professor, Department of Emergency Medicine, Mount Sinai School of Medicine; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, ; Anthony Anker, MD, FAAEM, Attending Physician, Emergency Department, Mary Washington Hospital, Fredericksburg, VA.