The present systematic review of intervention trials and observational studies assessed the effect of delaying the first bath for at least 24 hours after birth, compared to conducting it within the first 24 hours, in terms of healthy newborns.

It searched MEDLINE via PubMed, Cochrane CENTRAL, Embase, CINAHL (updated till November 2021), and clinical trials databases and reference lists of retrieved articles. The study looked for outcomes including neonatal mortality, systemic infections, hypothermia, hypoglycemia, and exclusive breastfeeding (EBF) rates. It used the GRADE approach to assess the certainty of evidence.

The study observed-

• Inclusion of 16 studies (two trials and 14 observational studies) with 39 020 term or near-term healthy newborns.
• Variable definitions of Delayed and early baths in the studies, most commonly as >24 hours (six studies) and as ≤6 hours (12 studies), respectively. 

The study conducted a post-hoc analysis for studies that defined early bath as ≤6 hours and found-

• Low certainty evidence suggests bathing the newborn 24 hours after birth might reduce the risk of infant mortality and neonatal hypothermia compared to bathing within the first 24 hours.
• Very uncertain evidence on the effect on EBF at discharge.
• Delayed baths beyond 6 hours (at or after nine, 12, or 24 hours) after birth compared to that within 6 hours might reduce the risk of hypothermia and hypoglycemia and improve the incidence of EBF at discharge; with very uncertain evidence of the effect on neonatal mortality.

This study shows that a delayed first bath for at least 24 hours might reduce infant mortality and hypothermia. Furthermore, a delayed bath for at least 6 hours may prevent hypothermia and hypoglycemia and improve EBF rates at discharge. However, most of these findings are backed by low-certainty evidence.

Priyadarshi M, Balachander B, Gupta S, Sankar MJ. Timing of first bath in term healthy newborns: A systematic review. J Glob Health. 2022 Aug 17;12:12004. Doi: 10.7189/jogh.12.12004. PMID: 35972992; PMCID: PMC9380966.