Bathing Method for Preterm Infants: A Systematic Review
Abstract
Background: Current research suggests that routine daily bathing for preterm infants can render many adverse effects on physiological responses and comfort distress of the infant. Repeated stress on premature babies can have destructive longterm effects on brain development. Objectives: To identify the best current evidence regarding bathing method for preterm infants in enhancing neuro developmental care by using atraumaticcareapproach. Methods:Acomprehensiveliteraturesearchwasperformed in PubMed, ScienceDirect, Wiley Online Library, EbscoHost, Proquest from year of 2008 – May 2019 with the search strategy keywords: bathing, behavioral responses, physiological parameters, premature babies, preterm infants. Inclusion criteria for this study were an original research or systematic review about preterm/premature infants with gestational age is 30 – 37 weeks. PRISMA guideline was applied as a search strategy tool, compared to the used of another conceptualizing tool.
Results: A total of 883 of records were identified. After removal of duplicates and initial screening, nine articles met the inclusion criteria of bathing methods for preterm infants. There are several bathing methods were identified: sponge bath, conventional/immersion tub bath, and swaddle bath which is related to physiological responses and behavioral distress during and after bathing intervention. This systematic review showed that swaddle bath had a positive effect on physiological measurement and behavioral responses to preterm infants compared to conventional tub bath and sponge bath which can increase physiological and behavioral discomfort to the preterm infants.
Conclusion: This study showed that some of the processes actually reduce negative effects of bathing on the health of the preterm infants. Swaddle bath has proven to be the best and safest type of bathing method for preterm infants during hospitalization that produces fewer changes regarding physiological and behavioral distress to the preterm infants. It is recommended that swaddle bath should be used for preterm infants during they are hospitalized and to be considered as a standard operating procedure in the perinatology unit and neonatal intensive care unit or pediatric intensive care unit.
References
[1] Datta,P.(2018).Pediatric Nursing(4thed.).NewDelhiIndia:JaypeeBrothersMedicalPublishers(P)Ltd.
[2] World Health Organization. (2017). Recommendation on Newborn Health Guidelines Approved by Review Committee. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/259269/WHOMCA-17.07-eng.pdf?sequence=1.
[3] Hockenberry, M.J., & Wilson, D. (2015). Wong’s Essential of Pediatric Nursing (10th ed.). St. Louis Missoury: Mosby Inc.
[4] Rustina, Y. (2015). Bayi Prematur: Perspektif Keperawatan. Jakarta: CV. Sagung Seto.
[5] Abusaad, F.E., Aziz, R.A.E., & Nasef, N.A.E. (2017). The Effectiveness of Developmentally Supportive Positioning on Preterm Infants’s Pain Response at Neonatal Intensive Care Units. American Journal of Nursing Science, 6(1), 63.
[6] Peng, N.H., Bachman, J., Jenkins, R., Chen, C.H., Chang, Y.C., Chang, Y.S., & Wang, T.M. (2009). Relationships between environmental stressors and stress biobehavioral responses of preterm infants in NICU. Journal of Perinatal and Neonatal Nursing, 23(4), 363–371.
[7] Mediani, H.S., Duggan, R., Chapman, R., Hutton, A., & Shields, L. (2017). An exploration of Indonesian nurses’ perceptions of barriers to paediatric pain management. Journal of child health care: for professionals working with children in the hospital and community, 21(3), 273–282.
[8] Vinall, J., & Grunau, R.E. (2014). Impact of repeated procedural pain-related stress in infants born very preterm. Pediatric Research, 75(5), 584–587.
[9] Smith, G.C., Gutovich, J., Smyser, C., Pineda, R., Newnham, C., Tjoeng, T.H.,... Inder, T. (2011). NICU Stress Is Associated with Brain Development in Preterm Infants. Annals of Neurology, 70(4), 541–549.
[10] Newnham, C.A., Inder, T.E., & Milgrom, J. (2009). Measuring preterm cumulative stressors within the NICU: The neonatal infant stressor scale. Early Human Development, 85(9), 549–555.
[11] Bryanton, J., Walsh, D., Baret, M., & Gaudet, D. (2004). Tub bathing versus traditional sponge bathing for the newborn. Journal of Obstetric, Gynecologic & Neonatal Nursing, 33(6), 704–712.
[12] Gunay,U.,&Coskun,D.(2018).TheEffectofTubBathingontheNewborns’Pain:ARandomizedClinical Trial. International Journal of Caring Sciences, 11 (2), 1132-1140.
[13] Coughlin,M.E.(2014).Transformative nursing in the NICU traumainformed age-appropriate care.New York: Springer Publishing Company, LLC.
[14] Edraki, M., Paran, M., Montaseri, S., Nejad, M.R., & Montaseri, Z. (2014). Comparing the effects of swaddled and conventional bathing methods on body temperature and crying duration in premature infants: a randomized clinical trial. Journal of Caring Sciences, 3(2), 83–91.
[15] Paran, M., Edraki, M., Montaseri, S., & Nejad, M.R. (2016). Comparing the effects of swaddle and conventional bathing methods on behavioral responses in preterm neonates. Iranian Journal of Neonatology, 7(4), 37–40.
[16] Swapna, G., Nandhini, P., Ruthrani, P.J., Kanchana, S., & Celina, D. (2017). Relative Effectiveness of Swaddle Bath and Conventional Bath on Level of Thermal Stability and Crying Duration among Preterm Infants at Selected Hospital in North India. International Centre For Collaborative Research Journal Of Nursing Research (ICCR-JNR), 2(1), 34–54.
[17] DeFreitas,P.,Bueno,M.,Holditch-Davis,D.,Santos,H.P.,&Kimura,A.F.(2018).BiobehavioralResponses of Preterm Infants to Conventional and Swaddled Tub Baths. The Journal of Perinatal & Neonatal Nursing, 00(00), 1-8.
[18] Ceylan, S.S., & Bolisik, B. (2018). Effects of Swaddled and Sponge Bathing Methods on Signs of Stress and Pain in Premature Newborns: Implications for Evidence-Based Practice. Worldviews on Evidence-Based Nursing, 15(4), 296–303.
[19] De Freitas, P., Munhoz, M.M.B., Costa, P., & Kimura, A.F. (2018). Effect of Two Immersion Bathing Tecniques on the Axillary Temperature of Preterm Newborn: A Pilot Study. Texto Contexto Enferm, 27(1), 1–8.
[20] Lund, C. (2016). Bathing and Beyond: Current bathing controversies for newborn infants. Advances in Neonatal Care, 16(5S), 13–20.
[21] Elmeida, I.F. (2015). Asuhan Kebidanan Neonatus: Bayi, Balita dan Anak Pra Sekolah. Jakarta: CV. Trans Info Media.
[22] Kuller, J.M. (2014). Update on newborn bathing. Newborn and Infant Nursing Reviews, 14, 166–170.
[23] Fernandez, D., & Antolín-Rodriguez, R. (2018). Bathing a Premature Infant in the Intensive Care Unit: A Systematic Review. Journal of Pediatric Nursing, 42, e52–e57.
[24] De Freitas, P., Marques, S.R., Alves, T.B., Takahashi, J., & Kimura, A.F. (2014). Changes in physiological and behavioral parameters of preterm infants undergoing body hygiene: A systematic review. Revista Da Escola de Enfermagem Da USP, 48 (Special Issue), 178–183.
[25] Loring, C., Gregory, K., Gargan, B., LeBlanc, V., Lundgren, D., Reilly, J.,... Zaya, C. (2012). Tub Bathing Improves Thermoregulation of the Late Preterm Infant. JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing, 41(2), 171–179.
[26] Blume-Peytavi, U., Lavender, T., Jenerowicz, D., Ryumina, I., Stalder, J.F., Torrelo, A., &Cork, M.J. (2016). Recommendations from a European Roundtable Meeting on Best Practice Healthy Infant Skin Care. Pediatric Dermatology, 33(3), 311–321.
[27] Blume-Peytavi, U., Cork, M.J., Faergemann, J., Szczapa, J., Vanaclocha, F., & Gemletti, C.(2009). Bathing and cleansing in newborns from day 1 to first year of life: recommendations from a European round table meeting. Journal of the European Academy of Dermatology and Venereology, 23(7), 751–759.