Bathing babies: current practices in UK neonatal intensive care units

Impact of daily octenidine skin washing versus nonwashing on antiseptic tolerance of coagulase-negative staphylococci in two neonatal intensive care units with different skin cleansing practices

“…Whilst there are national evidence-based guidelines for antiseptic use in children, there is no UK standardised guidance in place for preferred antiseptics infants who are less than 2 months old, [ 19 ] nor regarding routine washing or bathing practices. A national UK survey of tertiary-level NICUs done in 2019-20 found that 3/57 (5%) units virtually never bathe their NICU babies, while 44/57 (77%) bathe regularly once the baby is out of NICU/high-dependency; of those practising bathing, 67% used tap water and 33% used sterile water; 14% were using adjunct antiseptic agents or cleansing products [ 20 ]. There is presently therefore a wide range of practices in operation regarding antiseptic choices for pre-procedural local skin disinfection prior to catheterisation [ 21 , 22 ], and also in respect of body washing and bathing practices [ 20 ].…”

“…A national UK survey of tertiary-level NICUs done in 2019-20 found that 3/57 (5%) units virtually never bathe their NICU babies, while 44/57 (77%) bathe regularly once the baby is out of NICU/high-dependency; of those practising bathing, 67% used tap water and 33% used sterile water; 14% were using adjunct antiseptic agents or cleansing products [ 20 ]. There is presently therefore a wide range of practices in operation regarding antiseptic choices for pre-procedural local skin disinfection prior to catheterisation [ 21 , 22 ], and also in respect of body washing and bathing practices [ 20 ]. The most common antiseptics used in Europe are alcohol-and aqueous-based CHX, octenidine (OCT), and povidone iodine, but there are very wide variations in CHX concentrations being used in the NICU (0.015–2%) [ [21] , [22] , [23] ].…”

“…Very few studies have examined the use of OCT within a neonatal population, however there is evidence that it is effective at reducing hospital acquired infection amongst adults and older children [ [28] , [29] , [30] ]. In some centres OCT has been introduced as a whole-body wash [ 20 ], as it is reportedly mild and suitable for patients with vulnerable skin.…”

Development of educational videos about bathing in bed newborns admitted to a neonatal unit

“…Immersion bath is indicated for those NB who have a GA of over 36 weeks, clinical stability and absence of devices such as peripheral or central venous access, drains, oral and nasotracheal tube and non-invasive ventilation ( 3 ) . When NB do not fit these criteria, the bath should be performed in the bed ( 3 ) .…”

Impact of daily octenidine skin washing on antiseptic tolerance of coagulase-negative staphylococci in two neonatal intensive care units with different bathing practices

“…Whilst there are national evidence-based guidelines for antiseptic use in children, there is no UK guidance in place for infants who are less than two months old [16]. Due to this lack of UK standardised guidance for topical antiseptic use within NICUs, there are a large range of practices in operation, from regular full body bathing to just local site decontamination before insertion of indwelling devices [17]. There is also a wide disparity between different antiseptics and frequency of bathing, with the most common antiseptics used being octenidine (OCT), povidone iodine and alcohol-/aqueous-based CHX which is frequently used in widely varying concentrations depending on hospital protocols [18,19].…”