Research Information System
JOURNAL OF PEDIATRIC NURSING-NURSING CARE OF CHILDREN & FAMILIES, vol.87, pp.50-57, 2026 (SCI-Expanded, SSCI, Scopus)
Background: The sequence of neonatal bathing may significantly influence an infant's ability to maintain homeostasis. Traditional methods begin with the head, but deferring head washing to the final stage may reduce thermal loss and procedural distress. Purpose: This study compared the effects of two swaddle bathing sequences head-first versus body-first on the stress levels and physiological parameters of term newborns. Design and methods: This randomized controlled trial (RCT) included 104 term infants born in a Training and Research Hospital in Istanbul between July 18 and September 20, 2023. Infants were randomly assigned to Group 1 (head washed first, then body; n = 52) or Group 2 (body washed first, then head; n = 52). Stress levels, calming durations, and physiological parameters (body temperature, oxygen saturation, heart rate) were systematically analyzed. Findings: Baseline measurements were similar between groups (p > 0.05). During and after the procedure, Group 1 exhibited significantly higher stress levels (p < 0.001) and longer calming times (p < 0.001) than Group 2. Post-procedure body temperature and O-2 saturation were significantly lower (p < 0.001), while heart rate was significantly higher (p = 0.001) in Group 1. Conclusion: Washing the body before the head minimizes neonatal stress, accelerates recovery, and preserves physiological stability. Deferring head washing is recommended to enhance neonatal care (RCT ID: NCT06166485). (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.