Comparing the Effects of Swaddle and Conventional Bathing Methods on Behavioral Responses in Preterm Neonates

Background: The newborn’s first bath, performed in Neonatal Intensive Care Units (NICU), is believed to be a stressful situation, especially for the premature infants. As a developmental care approach, swaddle bathing is a low-stress bathing method for vulnerable preterm neonates. Given the limited number of the studies examining this bathing method, the present study was conducted with the aim of comparing the effects of swaddle and conventional bathing methods on some behavioral responses in premature infants. Methods: This study was a randomized clinical trial conducted on 50 premature neonates admitted to NICU. The neonates, who met the inclusion criteria, were randomly assigned into experimental and control groups. The infants in the experimental group received swaddle bathing and those in the control group were given conventional bathing. To record the behavioral responses, the infants' faces were filmed in close-up during the bathing. The data were analyzed, using Chisquared test, independent samples t-test, and Mann-Whitney U test. Results: The results demonstrated that the occurrence rates of such behaviors as facial grimace (P<0.001), mouthing/yawing movements (P<0.001), tongue extension (P=0.017), eyes open (P=0.027), and fussing/crying (P<0.001) were significantly lower in the experimental group than those in the control group. In addition, the percentage of eyes closed was higher in the experimental group, compared to the control group (P=0.006). Conclusion: According to the findings of this study, swaddle bathing can reduce the neonatal stress during bathing. Consequently, this kind of bathing can be used as an appropriate, low-stress, and pleasant method for the preterm neonates in NICU.