Abstract

Newborn bathing is an important aspect of newborn care and hygiene, but inappropriate bathing practices may expose newborns to risks such as hypothermia, skin irritation, accidental falls, burns, infection, and other preventable complications. Mothers in Nigeria may receive differing information about the appropriate timing, frequency, water temperature, bathing environment, cleansing products, cord care, and safe handling of newborns during bathing. Limited knowledge, cultural practices, inadequate access to skilled newborn-care education, and reliance on informal sources of information may contribute to unsafe bathing practices. Newborn bathing education provides an opportunity to improve mothers' knowledge and practical skills regarding safe preparation, handling, bathing, drying, and post-bathing care of newborns. Against this background, this study investigates the impact of newborn bathing education on safe newborn bathing practices among mothers in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Social Ecological Model. The Health Belief Model explains how mothers' perceptions of newborn health risks, perceived severity of bathing-related complications, perceived benefits of safe bathing, perceived barriers, self-efficacy, and cues to action may influence newborn bathing practices. Social Cognitive Theory emphasizes observational learning, behavioural modelling, practical demonstration, self-efficacy, reinforcement, and social support in developing safe newborn-care behaviours. The Social Ecological Model highlights the influence of mothers, families, healthcare providers, cultural practices, household conditions, socioeconomic circumstances, and community resources on newborn bathing practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how newborn bathing education may influence safe newborn bathing practices among mothers in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise mothers of newborns aged 0–28 days residing in selected urban, semi-urban, and rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, households, healthcare facilities, and eligible mothers. Newborn bathing education will be assessed using indicators such as exposure to educational sessions, frequency and duration of education, appropriate timing of bathing, preparation of the bathing environment, water temperature assessment, selection of suitable cleansing products, hand hygiene, safe handling of the newborn, appropriate bathing position, protection of the newborn from cold exposure, safe washing and rinsing techniques, appropriate drying and clothing, cord-care considerations, prevention of burns and falls, safe supervision, and recognition of situations requiring healthcare attention. Safe newborn bathing practices will be assessed using indicators such as appropriate preparation of the bathing area, hand hygiene before bathing, safe water temperature, appropriate bathing timing and frequency, safe newborn handling, prevention of immersion-related risks, appropriate cleansing and rinsing, protection from cold, thorough drying, appropriate clothing after bathing, safe cord-care practices, prevention of falls and burns, continuous supervision, and appropriate response to skin irritation or other concerning conditions. Data will be collected using structured questionnaires, newborn-care knowledge assessment tools, standardized bathing-practice observation checklists, practical skill assessments using appropriate newborn-care models where available, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize mothers' demographic and socioeconomic characteristics, newborn characteristics, previous newborn-care education, sources of information, and bathing practices. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of newborn bathing education on safe newborn bathing practices. Where a quasi-experimental design is adopted, bathing-practice scores before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that newborn bathing education has a significant positive impact on safe newborn bathing practices among mothers in Nigeria. Mothers exposed to structured, practical, evidence-based, and culturally appropriate newborn bathing education are expected to demonstrate safer bathing practices than mothers without comparable exposure. Education may improve mothers' ability to prepare a safe bathing environment, assess water temperature appropriately, handle newborns safely, prevent excessive heat loss, use suitable cleansing products, dry and dress newborns appropriately, and avoid practices that may increase the risk of burns, falls, skin irritation, or infection. Practical demonstrations may also improve mothers' confidence and ability to respond appropriately to newborn bathing difficulties. However, cultural beliefs, family influence, limited household resources, inadequate access to clean water, poor sanitation, financial constraints, limited access to skilled newborn-care education, and misinformation may reduce the effectiveness of education alone. The study therefore expects accessible, practical, culturally sensitive, and sustained newborn bathing education, supported by appropriate maternal and newborn healthcare services, to contribute significantly to improved safe newborn bathing practices among mothers in Nigeria. The study is expected to contribute to the literature on newborn care, newborn bathing, maternal health education, neonatal health, infant hygiene, maternal and child health, practical health education, injury prevention, infection prevention, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, hospitals, maternity facilities, primary healthcare centres, nurses, midwives, community health workers, maternal and newborn health programmes, development partners, and policymakers regarding strategies for improving essential newborn-care practices. The study will also provide evidence-based recommendations for integrating newborn bathing education into routine maternal and newborn-care services, strengthening practical newborn-care demonstrations, improving maternal access to skilled counselling, addressing harmful cultural practices, strengthening postnatal education, and developing sustainable community and facility-based newborn-health programmes that promote safe newborn bathing practices across Nigeria.

Keywords: Newborn bathing education, safe newborn bathing practices, mothers, newborn care, neonatal health, maternal and child health, infant hygiene, practical health education, injury prevention, postnatal care, Nigeria, public health.