In healthy full and late pre-term babies, does delaying the first bath until at least 24 hours of life effect in-hospital breastfeeding rates, thermoregulation and glycemic control?

Objective: To determine if delaying a newborn’s first bath until at least 24 hours of life, as recommended by the World Health Organization, effects in-hospital breastfeeding rates, infant hypothermia rates and/or infant hypoglycemia rates. Methods: Retrospective cohort study comparing 680 infants bathed before 24 hours to 545 infants bathed after 24 hours. The primary outcome was comparison of the rates of in-hospital breastfeeding initiation and exclusive breastfeeding at discharge. Secondary outcomes were a comparison of rates of infant hypothermia and hypoglycemia. Results: Exclusive breastfeeding rates were 33% higher in the delayed bathing cohort compared to the early bathing cohort (AOR 1.334, 95% CI 1.049-1.698, p=0.019). No significant difference in breastfeeding initiation rates were observed in the total population or high-risk subgroup but in the average risk subgroup there was a significant 43% increase in breastfeeding initiation rates when bathing was delayed (AOR 1.433, 95% CI 1.008-2.039, p=0.045). Infants bathed after 24 hours were 2.5 times more likely to experience a hypothermic event than those bathed before 24 hours (AOR 2.524, 95% CI 1.239-5.142, p=0.011). No significant differences in rates of hypoglycemia were observed (AOR 0.916, 95% CI 0.421-1.994, p=0.826). Conclusions: Delaying newborn bathing was associated with increased likelihood of exclusive breastfeeding at discharge and increased rates of hypothermia.