Stress Level, Skin Moisture and Physiological Parameters in the First Bath of Newborns

The Effect of Wiping, Showering and Wrapping Bath Used During the First Bath on Stress Level, Skin Moisture and Physiological Parameters in Neonates Hospitalized in the Neonatal Intensive Care Unit

Objectıve: The aim of this study was to determine the effect of wipe (WG), shower (SG) and tub bath (TG) on stress level, skin moisture and physiological parameters used during the first bath in newborns hospitalized in the Neonatal Intensive Care Unit (NICU).

Hypotheses of the Research

Hypothesis 01,2,3: There is no difference between wiping baths, wrapping baths and shower baths in terms of their effects on thermoregulation, stress level, skin moisture and physiological parameters of newborns.

Hypothesis 11: Newborns who are given a wrap-up bath have a lower stress level than if they are swept and showered.

Hypothesis 12: Newborns who are given a wrap-up bath have better skin moisture levels than newborns who are wiped and showered.

Hypothesis 13: Physiological parameters (body temperature, heart peak, respiratory rate, oxygen saturation) of newborns who are given a wrap bath are less affected than wiping and showering.

Bathing in newborns is an important midwifery/nursing practice that not only cleans the baby's skin, but also relaxes the baby (Tambunan and Mediani, 2019; da Fonseca Filho et al., 2017), supports immune system development (Burdall et al., 2019), and contributes to the preservation of skin integrity (Lima et al., 2020). If the appropriate method is not chosen in bathing in newborns and the bath is not performed under appropriate conditions, it may adversely affect the adaptation of the newborn to the extrauterine environment, physiological parameters and stress level. Therefore; the bath should be applied in a warm environment, in a safe and peaceful way, and with the appropriate method (Lima et al., 2020). In addition to performing bathing in the appropriate way, midwives/nurses should take appropriate precautions by observing the physiological parameters and stress responses of infants (Huang et al., 2022; Tambunan et al., 2022).

In newborns, wrap-around bath, wipe bath and shower bath methods are frequently used. Wiping bath is the process of wiping the baby's skin. The wrap-around bathtub bath method is to clean the baby by wrapping it with a soft towel or blanket and placing it in a bathtub filled with water at the appropriate temperature, preserving the flexion and midline position. A bath in the form of a shower is the process of bathing the newborn under running water (Ceylan and Bolışık, 2022; Karakul and Dogan, 2020).

Inclusion Criteria:

• Birth weight of 2500 g or more
• Body temperature within the normal range (36-37.3°C)
• Respiratory rate between 30-60 breaths per minute
• Oxygen saturation above 85%
• Absence of neurological problems (e.g., hypotonia, hypertonia)
• Absence of congenital defects
• No dermatological problems
• Parental consent and voluntary participation in the research

Exclusion Criteria:

• Presence of respiratory failure or distress
• Requirement for ventilator support
• Continuous need for high-concentration oxygen via methods such as hood or CPAP
• History of convulsions
• Clinical evidence of infection