“Why not bathe the baby today?”: A qualitative study of thermal care beliefs and practices in four African sites

Abstract

BackgroundRecommendations for care in the first week of a newborn’s life include thermal care practices such as drying and wrapping, skin to skin contact, immediate breastfeeding and delayed bathing. This paper examines beliefs and practices related to neonatal thermal care in three African countries.MethodsData were collected in the same way in each site and included 16–20 narrative interviews with recent mothers, eight observations of neonatal bathing, and in-depth interviews with 12–16 mothers, 9–12 grandmothers, eight health workers and 0–12 birth attendants in each site.ResultsWe found similarities across sites in relation to understanding the importance of warmth, a lack of opportunities for skin to skin care, beliefs about the importance of several baths per day and beliefs that the Vernix caseosa was related to poor maternal behaviours. There was variation between sites in beliefs and practices around wrapping and drying after delivery, and the timing of the first bath with recent behavior change in some sites. There was near universal early bathing of babies in both Nigerian sites. This was linked to a deep-rooted belief about body odour. When asked about keeping the baby warm, respondents across the sites rarely mentioned recommended thermal care practices, suggesting that these are not perceived as salient.ConclusionMore effort is needed to promote appropriate thermal care practices both in facilities and at home. Programmers should be aware that changing deep rooted practices, such as early bathing in Nigeria, may take time and should utilize the current beliefs in the importance of neonatal warmth to facilitate behaviour change.

Cultural Practices of Rearing Preterm Infants: a Qualitative Study in a Tertiary Care Hospital, Karachi, Pakistan

“…week (Joseph, et al, 2013). Whereas, bathing occurred soon after delivery in Nigerian, but was delayed for several hours or until the next day for most Tanzanian and Ethiopian narrative mothers (Adejuyigbe, et al, 2015). Present study also showed the ritual of massage which is consistent with finding of the study which also emphasized the practice of oil massage before bath by mothers (Joseph, et al, 2013).…”

Socioeconomic inequalities in exclusive breastfeeding, early initiation of breastfeeding, and skin-to-skin contact between mother and newborn in Nigeria: evidence from Demographic and Health Survey

“…Based on the ndings, early bathing of newborn was a very common practice especially in Nigerian sites due to a deeprooted belief that delay to bath the newborn would result in body odour. Worst still, when asked about keeping the baby warm, respondents across the sites rarely mentioned the recommended thermal care practices (SSC), suggesting that these were not perceived as salient (48). Such norms can clearly be responsible for poor coverage of SSC in the general population.…”

Skin care for healthy babies at term: A systematic review of the evidence

“…Table 6 illustrates the included qualitative study characteristics: seven studies included for review were conducted in the UK, Pakistan, Nepal, Nigeria, Ethiopia, Zambia and Tanzania. Three studies were qualitative only (Adejuyigbe et al 2015;Sacks et al 2015;Lavender et al 2009); four were mixed-methods of which for three (Shamba et al 2014;Fikree et al 2005;Mullany et al 2005) only the qualitative component fulfilled the inclusion criteria, and for one (Furber et al 2012) both components were included in the review.…”

“…There was a similar lack of evidence of thematic analysis and link between the data and conclusions in Sacks et al (2015); however this study was graded as moderate quality due to acknowledging reflexivity, ethical consideration and clear sampling and data collection strategies. Adejuyigbe et al (2015) was also graded as moderate quality. This study was well designed and conducted, but there was no acknowledgement of reflexivity and the sample size was unclear.…”

“…Due to the dearth of qualitative evidence with similar focus, metasynthesis was inappropriate. Only five studies were deemed to be sufficiently robust for synthesis (Adejuyigbe et al 2015;Sacks et al 2015;Shamba et al 2014;Furber et al 2012;Lavender et al 2009); however, their aims were not congruent. The three African studies focused on thermal care, limiting transferability to UK settings.…”