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Effects of Underrunning Water Bathing and Immersion Tub Bathing on Vital Signs of Newborn Infants

A Comparative Analysis

Ar, Işıl, MSc, RN; Gözen, Duygu, PhD, MSc, RN

Section Editor(s): Dowling, Donna PhD, RN; ; Thibeau, Shelley PhD, RNC-NIC;

doi: 10.1097/ANC.0000000000000484
Original Research

Background: Newborn infants are susceptible to hypothermia during bathing due to environmental conditions.

Purpose: This study examined the effects of 2 common newborn bathing methods used in Turkey, underrunning water bathing (URWB) and immersion tub bathing (ITB), on infant heart rate (HR), oxygen saturation, and body temperature.

Methods: In this randomized controlled study, 44 newborns were allocated to the ITB group and 36 newborns to the URWB group. Body temperature, HR, and oxygen saturation values of the newborns were compared between groups every hour during 4 hours before the bath to evaluate infants' vital sign stability. All measurements were compared at 10, 20, 40, and 60 minutes after the bath too.

Results: No statistically significant differences were found in vital signs performed prior to bathing as compared with after bathing; however, changes in oxygen saturation at 20 minutes after the bath were significantly higher in the ITB group (P < .05).

Conclusion: Although both bathing methods decreased overall infant body temperature, ITB positively affected newborn oxygen saturation and HR to a greater degree compared with URWB.

Implications for Practice: ITB facilitated maintenance of oxygen saturation and HR during the bath and should be preferred for newborn infants to feel more relaxed.

Implications for Research: These findings indicate a need for additional studies with larger sample sizes to further evaluate the effect of different bathing methods on newborn comfort.

Pediatric Nursing Department, Florence Nightingale Faculty of Nursing, Istanbul University, Şişli, Turkey.

Correspondence: Duygu Gözen, PhD, MSc, RN, Pediatric Nursing Department, Florence Nightingale Faculty of Nursing, Istanbul University 34381 Şişli, Istanbul, Turkey (,

This study was conducted as a Master Thesis Study of Pediatric Nursing Department, Institute of Health Sciences in Istanbul University.

This study was presented as a poster in the 6th Congress of the European Academy of Paediatric Societies EAPS on October 21 to 25, 2016, in Geneva, Switzerland. The abstract of the article was published in the European Journal of Pediatrics in the supplement volume of EAPS Congress (doi:10.1007/s00431-016-2785-8).

The authors declare no conflicts of interest.

© 2018 by The National Association of Neonatal Nurses