Care of the infant born to an HIV-positive mother

Variation in Newborn Skincare Policies Across United States Maternity Hospitals

OBJECTIVE

Newborn skincare influences levels of beneficial factors from vernix and vaginal secretions but also the emergence of potential skin pathogens. However, evidence-based national guidelines for newborn skincare do not exist, and actual hospital practices for newborn skincare have not been described. In this study, we test the hypothesis that US maternity hospitals follow differing policies with regard to newborn skincare.

METHODS

A 16-question survey querying skin care practices was distributed to nursery medical directors at the 109 US hospital members of the Better Outcomes through Research for Newborns network. Data from free text responses were coded by 2 study personnel. Survey responses were analyzed by using descriptive statistics and compared by region of the United States.

RESULTS

Delaying the first newborn bath by at least 6 hours is a practice followed by 87% of US hospitals surveyed. Discharging newborns without a bath was reported in 10% of hospitals and was more common for newborns born in nonacademic centers and on the West Coast. Procedures and products used for newborn skincare varied significantly. Parental education on tub immersion and soap use was also inconsistent and potentially contradictory between providers. Evidence cited by hospitals in forming their policies is scant.

CONCLUSION

In this study, we identify similar and strikingly different newborn skincare policies across a national network of US maternity hospitals. Research is needed to identify effects of differing skincare routines on skin integrity, infection rates, and childhood health outcomes to improve the evidence base for the care of newborn skin.

Care of substance-exposed infants: the current state of practice in Canadian hospitals

Many practices related to care of infants exposed to drugs and alcohol during th e prenatal period have been developed on an anecdotal basis. There are few available research studies to validate these interventions. This study describes current practices used in daily care, discharge planning, and community support for drug- and alcohol-exposed infants, their families, and alternate caregivers in one country. A survey of Canadian hospitals with annual birth rates of greater than 500 was conducted with a 51% return rate. Variations were noted in the perception of the importance of the issue of perinatal substance use, nursery care, discharge planning, and community support. Nurses are encouraged to consider these results within the context of their own communities to evaluate and develop standards of practice for substance-exposed infants and their families and caregivers.