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Hypothesis

Late Preterm Infants who are bathed by immersion tub bath will maintain their body temperature within normal limits more consistently as compared to Late Preterm Infants who receive sponge bathing.

Literature Review

All newborns require an initial bath to remove various substances from their skin surface (amniotic fluid, blood, meconium). The act of bathing challenges even a normal, term infant’s ability to maintain body temperature since body heat is lost through the mechanisms of convection and evaporation (Bryanton et al, 2004). Late Preterm Infants (35-36 6/7 weeks gestation) are at even greater risk for hypothermia due to the fact that they have less brown fat and have less ability to thermoregulate (Wang et al, 2004). Failure of the Late Preterm Infant to maintain body temperature can lead to such complications as hypoglycemia, respiratory distress and failure to establish adequate feeding patterns (Darcy, 2009; Jorgensen, 2008). The purpose of this study is to test and compare the Late Preterm Infant’s ability to maintain his or her temperature after the initial bath, based on the bathing method (sponge or immersion).

Methodology

This is a randomized control study of 100 stable Late Preterm Infants from the normal newborn nursery. Inclusion criteria were gestational age of 35-36 6/7 weeks, birth weight greater than 2000 grams, and 24-36 hours of age. Exclusion Criteria were temperature instability in the first 24 hours, antibiotic administration and any maternal condition that prohibited informed consent. Informed consent was obtained from the infant’s mother. The subjects were randomized to one of two bathing methods: sponge or immersion. All baths were performed in the same area of the nursery using the same water temperature to maintain consistency of the environmental temperature. Axillary temperatures were taken at 3 points in time: within 10 minutes of initiating the bath, 10 minutes following the completion of the bath and 30 minutes following completion of the bath.

Data Analysis and Interpretation

Data will be analyzed using descriptive and multivariate statistical analysis when the data collection is complete. Since the beginning of data collection in February 2009 we have steadily recruited subjects at a rate of approximately 8 subjects per month which means that data collection should be completed in February 2010.

Implications

Preliminary results (on approximately 46 subjects) are showing the following trends: infants bathed by immersion are warmer at the 10 minute and 30 minute time intervals than the sponge bathed babies. Also, there may be less variation in the infant’s temperature at the 10 minute temperature if they are bathed by immersion. This would mean that the infant would have to expend less energy to maintain temperature stability. If these trends continue as the data collection is completed, the results could have significant implications for Late Preterm Infant bathing practices.