Bathing Your Preemie: Learn Some Bathtime Basics in the NICU

June 12, 2023

I'm katie, OTD, OTR/L, NTMTC, CNT & founder of blooming littles

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Bathing is an activity that all babies and their families engage in throughout infancy, but what does this look like for a baby in the NICU?! In this post, we will discuss why bathing is important, bath safety, a few types of baths your infant may receive in the NICU, and how you can be involved while your baby is in the NICU.

Why are baths important for NICU babies?

Bathing is an important activity that helps keep babies hygienic and clean (keep reading if you’re curious about using soaps/cleansers on your baby’s skin!).

It helps reduce risk of infection, but can also simply be a calming or soothing activity for your child to experience. Plus, it’s an amazing way for NICU caregivers and their baby to bond!

Family involvement during bathtime in the NICU is really important! If you have a baby in the NICU, bathtime is an amazing time to get involved in their care. 

By gettting involved in bathtime, you may find yourself…

  • Feeling more confident caring for your baby
  • Growing more competent and capable doing their care or handling and maneuvering them
  • Building a stronger connection and bond with your baby.

Most NICUs recognize these amazing benefits to your involvement and will encourage you to be present for bathtime! But if not, don’t hesitate to ask to be involved in any way that you can. Always remember that you are your (and your baby’s) best advocate!

Bathing is an activity that many parents are interested in being a part of (of course!)…but as important as baths are, there are some special things to consider…

Bathing should be a calm and relaxing activity in the NICU. But sometimes, it can actually be a very stressful experience for newborns, especially medically fragile babies in the NICU.

And there are actually some reasons why that is…

First, preemies have a harder time regulating their body temperature, so if they don’t stay warm during the bathtime experience, they can experience some cold stress. Preemies also have more sensitive sensory systems, which can make all the touch and transitions that come with bathtime more difficult to tolerate.

Because even the simplest activities can be stressful for preemies and other babies requiring medical care, it’s important to make sure the bathtime experience is as supportive and positive as possible! 

If you’re wondering whether your baby is showing you these signs of stress or overstimulation during their bathtime, feel free to peek at this blog post all about the unexpected stress signs babies can show us.


What options are there for bathing babies in the nicu?

There are a lot of different methods used to clean and wash babies in the NICU. But, it’s important to remember that the goal isn’t only to “get that baby clean”…it’s also important to focus on creating a warm, positive sensory experience that leaves you and your baby feeling confident and comfortable.

There are 2 main ways babies in the NICU get baths.

1) An immersed bath in a tub

2) A “sponge” or “wipe-down” bath.

In both types of baths, one of the best things we can do to help babies cope with the bathtime experience is to swaddle them for the bath.

Swaddled bathing is a developmentally supportive care practice that has been studied extensively in the literature and has some amazing benefits for babies who need care in the NICU. leads to improved infant and caregiver outcomes, especially in the cognitive and psychosocial areas.

Please note: Swaddled bathing techniques and methods will likely vary from one NICU to the next, and not all babies are safe to be immersed in the tub. It’s important to follow the direction and guidance of your unit’s policies and procedures.

why are swaddled baths the most developmentally supportive & preferred bathing method in the nicu?

Research has studied the differences between babies being swaddled during bathtime in the NICU and not. There is a lot of evidence showing us that babies are more stable and show  more positive responses when swaddled during bathtime.

Swaddling your baby during a bath can…

  • decrease your baby’s stress
  • promote your baby’s feelings of security and positive attachment
  • stabilize your baby’s temperature
  • decreases negative responses like, crying, grimacing, pulling arms/legs away from touch, and/or the “stop hand” (you can learn more about these stress cues here!

If you’re looking for a cheatsheet that will help you understand your baby’s cues a little bit better during activities like bathtime, you can grab one here

Swaddled bathing helps your baby stay calm, warm, contained, and physically supported during the bath.

How do I know if my baby is safe and ready for a bath?

Great question! Most babies are bathed in some form within the first few days after birth. Your NICU providers will be able to guide you as to the type of bath of your baby can have.

And don’t worry, this isn’t an activity you’ll be learning to do on your own. Your team (especially your unit’s developmental therapist!) are skilled in teaching parents how to calm and support their babies during bathtime while on the unit.

If you’re interested in giving your baby a bath where they are immersed in the tub, there are some criteria that your baby must meet.

Here are some general guidelines below. **Remember, your unit may have slightly different criteria.

  • If they were born premature, they should currently be older than 32 weeks old.
  • Unable to have any lines or tubes that are unable to be immersed in water
  • No open or partially healed incisions
  • Must be stable enough to tolerate the transition into a tub

If your baby doesn’t meet these criteria, that’s okay!

You can always provide your baby with a comforting swaddled “wipe-down” bath in their bed.

No matter the type of bath you give your baby, it’s a special memory you get to share together. We’re in your corner no matter where you are on the bathtime journey. 

Looking for some extra bathtime tips & tricks for your NICU baby? Try some of these.

  • Make a plan to hold your baby skin-to-skin after their bath. Research has shown immediate skin-to-skin following bathtime can continue to support their temperature stability (plus…post-bath cuddles will nourish that bond and connection you’re building!) Unsure if this is an option? Ask your baby’s nurse BEFORE you give your baby a bath.
  • Before and after bathtime, provide some comforting touch with slow and gentle movement transitions. Ask your unit’s developmental therapist about massage options, or…you can always start and end with a hand hug.
  • If you’re planning to use a cleanser or soap, look for one that is “ph balanced”, to protect your baby’s developing skin. Your baby may not even need soap, water alone can be an appropriate option. *Always check with your NICU providers to ensure what is best and safest for your baby’s age and condition!

It’s important to pay attention to your baby’s cues to determine if they seem to enjoy or are agitated by bathing (do they seem relaxed and in a calm state (or maybe even sleepy!) vs. are they crying, grimacing, trying to give a “stop” hand, etc).

Bathtime doesn’t have to be an uncomfortable or foreign activity during your NICU experience. This activity might even become one of your favorite things to do with your baby in the NICU!

Continue navigating this journey one day and one step at a time, and always remember: You and your baby are both doing your best, and that is enough.

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