The first time I did the new swaddle for naptime, both babies were frustrated at first but calmed down quickly and actually slept for once. Reducing neonatal pain during routine heel lance procedures. The results indicated that the body temperature after the bath in the conventionally bathed group was less than in the swaddle bathed group.
The cry recording sheet was compiled by the researcher according to the relevant studies. The crying time in 10 second intervals, the total bath time, and the total crying percentage were recorded in the sheet for each newborn. This method of assessing behavioral responses during the bath was utilized in studies by Liaw et al.
These studies are cited as evidence to support the validity of the infant's crying as a behavioral response in this study. To improve the reliability of the recorded crying data, Inter-rater reliability was used.
After observation of the video recordings by the first observer and recording the total crying time, 20 video recordings were randomly selected and interpreted by an independent trained person blind to the study hypotheses and the intervention type.
Data were reported as mean and standard deviation SD for quantitative variables and frequency percentage for qualitative variables. The qualitative variables were compared using the chi-square test.
The Kolmogorov-Smirnov test was used to confirm the normal distribution of the quantitative variables. The results of this test indicated that all the quantitative variables except crying time during the bath showed a normal distribution. In addition, a paired t-test was used to compare the mean body temperature changes in the infants of each group. The findings of the study showed no significant difference between the two groups regarding gender, birth type, mother's age, gestational age, postnatal age, birth weight, weight at bath time, and 1-minute and 5-minute Apgar scores Table 1.
Confidence Interval, b Independent t-test; c Paired t-test. This study was conducted to compare the effects of swaddled and conventional bathing methods on body temperature and crying duration in premature infants. The results indicated that the body temperature after the bath in the conventionally bathed group was less than in the swaddle bathed group.
Changes in the body temperature were also less in the swaddle bathed group than in the conventionally bathed group. This result supports the first hypothesis of the study. Therefore, swaddle bathing is more effective in maintaining body temperature and preventing heat loss in premature infants compared to conventional bathing.
One advantage stated for this bathing method is the reduction of temperature variations in neonates. The results of the present study are consistent with those of the other studies on the effect of tub bathing on infant body temperature. For instance, Bryanton et al. Moreover, newborns seem to be more exposed to air-flow in the conventional bathing method used in most of our NICUs and this very factor probably has a major impact on infant heat loss after the bath.
In the swaddle bathing method, covering and immersing the newborn can reduce heat loss through radiation, conduction and evaporation. Another finding of this study indicated that the crying time during the bath was significantly lower in the newborns of the swaddle bathing group than in those of the conventional bathing group. This result supports the second hypothesis of this study. An advantage of this bathing method stated by Fern et al.
However, Liaw et al. Bathing techniques varies among NICUs, but as mentioned previously bathing is considered as a stressful experience for infants.
A study by Peters indicated a significant increase in stress behaviors in sponge bathing. In the tub bathing method, being immersed in warm water is comforting to newborns.
Because of the numerous inclusion criteria, there were few participants included in the study and it was not feasible to access more samples within the time limit. It is therefore suggested to conduct this research on a larger number of samples. Although the newborns were only filmed in close-up to record the crying time during the bath and the observers were kept uninformed about the objectives and type of intervention, the nature of the study was such that the observers may have been unintentionally made aware of the method used and the purpose of the study.
One suggestion to reduce this potential bias in future studies is to record infant crying time during the bath through the use of a voice recorder device. The presence of unwanted environmental stimuli was another limitation of this study. Since environmental stimuli can influence the infant's behavior, an attempt was made during the research to have the baths performed in a calm and stimulus-free environment. However, it was not possible to fully control all the environmental stimuli in NICU environment.
Because each newborn is unique, behavioral responses caused by stress vary among infants. Therefore, this can somewhat affect the results of the study. The findings of this study indicate that swaddle bathing can help to maintain body temperature and reduce stress in preterm infants during the bath. This bathing method, which includes in itself the components of developmental care, offers an appropriate, low-stress and safe method for preterm and ill infants and can be used as a routine bathing method in NICUs.
It is hoped that the results of this research will help to improve the short- and long-term developmental outcomes caused by the hospitalization of preterm infants in NICU and increase the quality of nursing care.
Further studies are suggested to be conducted on the effect of swaddle bathing on other behavioral responses causes by stress, sleep pattern, feeding pattern, sucking efficiency, and weight gain in premature infants, as well as the effect of this bathing method on mother-infant attachment, parental stress, confidence in parental skills, and parents' contentment.
This study is extracted from the research by Maryam Paran. The authors would like to appreciate the clinical research development center of Namazi hospital and all the NICU staff of Hafez hospital as well as the parents who kindly participated in this research. National Center for Biotechnology Information , U. Journal List J Caring Sci v. Published online Jun 1. Received Mar 8; Accepted Apr This article has been cited by other articles in PMC. Bath, Body temperature, Crying, Infant, Premature.
Introduction Every year, 15 million preterm births occur across the world, which represents more than 1 out of every 10 births. This research is based on the following hypotheses: Materials and Methods This single-blind randomized clinical trial was performed on 50 premature infants hospitalized in NICU of Hafez hospital in Shiraz between July and January Open in a separate window.
Results The findings of the study showed no significant difference between the two groups regarding gender, birth type, mother's age, gestational age, postnatal age, birth weight, weight at bath time, and 1-minute and 5-minute Apgar scores Table 1. Table 3 Comparison of crying percentages during the bath in the experimental and control groups.
Discussion This study was conducted to compare the effects of swaddled and conventional bathing methods on body temperature and crying duration in premature infants. Conclusion The findings of this study indicate that swaddle bathing can help to maintain body temperature and reduce stress in preterm infants during the bath. Acknowledgments This study is extracted from the research by Maryam Paran.
Ethical issues None to be declared. Conflict of Interest The authors declare no conflict of interest in this study. World Health Organization; Level of NICU quality of developmental care and neurobehavioral performance in very preterm infants.
Maree C, Becker P. The effect of developmentally supportive positioning DSP on preterm infants stress levels. Practising developmentally supportive care during infant bathing: Effects of tub bathing procedures on preterm infants' behavior.
Variations of vital signs, skin color, behavior and oxygen saturation in premature neonates after sponge bathing. Am J Crit Care. Journal of Neonatal-Perinatal Medicine. Tub bathing improves thermoregulation of the late preterm infant. J Obstet Gynecol Neonatal Nurs. Waldron S, MacKinnon R. A protocol for swaddled bathing in the neonatal intensive care unit.
Newborn Infant Nurs Rev. Swaddled bathing in the newborn intensive care unit. I'm going to fully implement the schedule today, but have been gradually incorporating things like white noise and the swaddle the past couple days. The white noise is going really well, but the swaddle not so much. Someone on here suggested the batwing swaddle as an alternative.
I tried it, and my daughter still resists it. She grunts and strains and fights to get her arms out. I just can't see the benefit of insisting on doing it if she dislikes it that much.
It's actually sort of heartbreaking to watch. Anyone else have a baby that hates being swaddled? What did you do? I'm going to just comment on your post because I was going to ask something similar. We don't swaddle almost 9 weeks and haven't since about 3 weeks. She likes to sleep with her arms up. I'm also trying to get her to realize she can self soothe with her hands since she's sucking on them constantly. I tried to swaddle a few days after looking into MOC and she also fought, strained, grunted, and screamed until I took her out.
She wanted her arms out. Have u tried swaddling with one arm out or both arms? Might help give that comfort of swaddling but no so constricted Helps make it not feel so constricting.
We really liked those onsies, but we did swaddle a little blanket over them as well. My son didn't 'like' it at first - I would just do it anyway, nice and tight, hold and rock him a little until he calmed down or give him his paci and it got better over time. Your baby will honestly sleep better swaddled.
I want to answer this but my answer completely depends on how old baby is. I would say months, try the swaddle because though they seem uncomfortable, it's worth pushing through, they embrace it and most babies just don't know they like it, until a few stubborn days my opinion.
I would really push the bat wing consistently naps and bed time for a solid week no matter what. If that failed go with a sleep sac or something similar. I wish I swaddled earlier!
Bat Wings Swaddle. Baby struggling in swaddle? Baby trying to get arms out? Swaddling attempts seem to fail regularly? Swaddling seem too complicated? Need a simple system for twins or triplets that works the first time? Want to use Velcro swaddling system but the hands get out? One of the primary reasons for swaddling is to encourage babies to sleep safely on their backs, while parents sleep peacefully near them. One more thing to consider is . Yes! This was a game changer with my first who used to wriggle out of his swaddle. It would instantly calm him.