Maternal and child factors associated with late neonatal bathing practices in Nigeria: Evidence from a national survey

Abstract

Background Two-hundred and seventy out of every thousand live births died in Nigeria in 2019. These deaths are attributable to infections, complications of preterm birth and intrapartum-related conditions. The World Health Organization and Save the Children recommend withholding bathing of neonates until 24 hours after birth or until their vital signs become stable to prevent hypothermia. Despite the link between neonatal bathing and thermal control, the subject is understudied in Nigeria. This study aimed at investigating the maternal and child factors associated with late neonatal bathing practices in Nigeria. Methods The study adopted a cross-sectional survey design and extracted data from the women’s file of the 2018 Nigerian Demographic and Health Survey (2018 NDHS). The unit of analysis was limited to 12,972 women aged 15–49 who had complete data for the study. The outcome variable for the study was “late neonatal bathing (LNB)” conceptualized as delaying bathing of newborns until 24 hours after birth. At 95% confidence interval, two logistic regression models were built with Model I consisting of only maternal factors whilst Model II contained both maternal and child factors. The results of the final model were presented as adjusted odds ratio (aOR). Results Descriptively, 12% (CI = 0.122–0.134) of the women aged 15–49 bathed their neonates after 24 hours of delivery. Inferentially, women with secondary/higher education [AOR = 1.30, CI = 1.05–1.61], the rich [AOR = 1.24, CI = 1.03–1.50], those with access to mass media [AOR = 131, CI = 1.15–1.50], women that professed other religions [AOR = 9.28, CI = 4.24–17.56], those who delivered in a health facility [AOR = 1.93, CI = 1.66–2.25], whose child was small in size at birth [AOR = 1.46, CI = 1.21–1.77] and delivered by caesarean section [AOR = 2.50, CI = 1.97–3.18] had higher odds of bathing their neonates 24 hours after birth. The likelihood to bath neonates 24 hours after birth decreased among women who were into sales [AOR = 0.71, CI = 0.52–0.97], women with parity two [AOR = 0.75, CI = 0.61–0.92] and rural residents [AOR = 0.83, CI = 0.74–0.96]. Conclusions The proportion of women aged 15 to 49 who practiced late neonatal bathing was generally low. To improve the practice of late neonatal bathing, much concerted effort should be directed to women's education and approaches of increasing receptivity of late neonatal bathing among pregnant women through the media. The Nigerian’s Ministry of Health should incorporate routine counseling on the risks of bathing newborns prematurely into ANC and PNC.