Research on the practice of massaging the head of a baby with hot water and ointments in Ghana. By Dzamesi Yael (Ph.D. in Science Education)
​
Phase 1 - Doll.
On a doll all fears and restrictions from the side of the women were dropped away and we could check the following temperatures using a laboratory thermometer:
1. The temperature of the water in the bucket that is used for the bath (Picture 1.1).
2. The temperature between the head of the doll and the towel that was placed on the head. The chosen place for checking temperature was the assumed anterior fontanelle spot on the head of the doll (Picture 1.2). This temperature could not be measured on a baby because it would disturb the routine of the bath and elongate the exposure time of the baby to the heat. In that way, we would increase both, the suffering of the baby, and the risk of the baby to have a brain damage. For results see "Phase 1-A bath to a doll" page.
​
Picture 1: Temperature measurement methods in Phase 1.
​
​
​​
​
​
​
​
​
​
​
​
​
1.1
1.2
Phase 2 - Babies.
A laboratory thermometer was not used in order not to elongate the time the towel was placed on the head. Also the temperature of the water was not checked to avoid raising awareness of how hot the water in the bucket was. An infra-red thermometer was used to check the temperature of the head. The thermometer was held 5 centimeters above the chosen spot as instructed in the manual of the thermometer (‘Nuvita’ no contact thermometer, model 2091, Picture 2). The temperature of the head of the baby was checked in 3 different spots: anterior fontanelle, neck, and the forehead (picture 3), from the following reasons.
Picture 2: Nuvita infrared thermometer Picture 3: The three spots on the head of the baby
model 2091 [p9]. that the temperature was measured.
The methods of temperature measurements.
​
Entering a private home and interfering in the routine of a local bath by pushing a thermometer here and there is not something to be accepted and especially when a foreigner interferes.
Many women are being advised in the hospital not to use hot water in the massage of the head of a baby. However, the women do not follow this advice because the advice is hardly accompanied by an explanation or an adequate explanation that can convince them.
After visiting a few women that were located by a nurse working in the public health office of Accra hospital, we realized that even if the women accepted the observation of the bath, their attitude was changed. They tended to reduce the temperature of the water as they were instructed in the hospital. They used lukewarm water for the bath, and they answered our questions very shortly and unwillingly. All these considerations led us to conduct the research in two phases.
Phase 1 - Demonstrating the hot water massage on the head of a plastic doll that is in a size of a baby, see the results in "Hot water massage to a doll" page.
Phase 2 - Observing the hot water massage on the head of a baby, see the results in "Observation of a daily bath of babies" page.
​1. Anterior fontanelle - Under the skin of the anterior fontanelle there is no bone and therefore the heat of the towel passes directly to the brain. The temperature of the skin at this spot can give us an estimate of the temperature of the brain. However, the temperature dropped by a full degree every second once the hot towel is removed from the head. Therefore, the actual temperature between the towel and the head at the anterior fontanelle was higher than what was measured.
2. Neck - The temperature behind the ear where the artery that supplies the blood to the brain and the vein that carries away the blood from the brain pass. The hot towel was never placed on the neck and therefore the heat checked on this spot reflected an internal heat inside the neck that was affected mainly from the vein carries away the blood that was heated in the head to the body.
3. Forehead – The center of the forehead above the eyebrows is the usual place to check fever in a sick baby. Temperature in this spot could reflect change in the whole-body temperature during the bath. However, the head of a baby is small and many times the hot towel touched the forehead of the baby, thus the temperatures in this spot reflected only the temperatures of the skin heated by the towel and not internal temperatures. Under the skin of the forehead there is a bone which prevents the easy passage of heat into the head. As a result of the method of massaging the head of a baby the temperatures measured in the forehead became irrelevant and did not add any important information, therefore they do not appear in the results. For the results see the following pages: A bath to Vincentia (which deals with the effect of lukewarm water on the baby), a bath to Kofi and a bath to Kwesi (which both deal with the effect of hot water on the babies).