Effects of Swaddle Bath in Preventing Temperature Loss Among Preterm Infants: A Systematic Review and Meta-Analysis

BACKGROUND: Swaddle bathing is one of the recommended bathing techniques for infant according to Association of Women's Health, Obstetric and Neonatal Nurses guidelines. PURPOSE: The study was conducted to evaluate the effects of swaddle bathing in preventing temperature loss among preterm infants. METHOD: Comprehensive search was conducted on PubMed, Cochrane Library, EMBASE, CINAHL, and Airiti Library databases. Methodological quality was assessed using RoB 2 for randomized controlled trials, randomized crossover trials, and ROBINSI for nonrandomized controlled trials. In addition, Comprehensive Meta-Analysis version 2.0 was used to conduct the meta-analysis. RESULTS: Total of 4 randomized controlled trials, 2 randomized crossover trials, and 2 nonrandomized controlled trials, involving 424 preterm infants, were included. Overall effect size of the body temperature in the swaddle bathing (SMD = 1.17, 95% CI [0.61, 1.73], P < .001). Subgroup analysis was performed based on the body temperature measurement intervals and bathing duration; these findings indicate that swaddle bathing is effective in preventing body temperature loss among preterm infants. LINKING EVIDENCE TO ACTION: Swaddle bathing is a recommended intervention to prevent body temperature loss in preterm infants. Neonatal nurses are encouraged to integrate this technique as a standard practice in neonatal intensive care units and special care nurseries. Clinical implementation should ensure a bathing duration of 4-11 minutes, room temperature 24°C-28°C, relative humidity 50%-60%, and bathwater temperature 37°C-39°C to optimize thermoregulation. These findings highlight the importance of individualized care planning, incorporation of swaddle bathing into nursing protocols, and ongoing staff education to ensure consistency.