When baby wash isn’t being used to wash babies -Sourcing and implementing an appropriate product for newborn hearing screening

Ms Alison Jagger1,2, Dr Melinda Barker1,2,3,4

1Victorian Infant Hearing Screening Program, Parkville, VIC, Australia

2Royal Children’s Hospital, Parkville, VIC, Australia

3Murdoch Childrens Research Institute, Parkville, VIC, Australia

4The University of Melbourne, Parkville, VIC, Australia

Introduction and Aim:
The Victorian Infant Hearing Screening Program (VIHSP) has used undiluted baby wash as an electrode conductive gel since screening commenced in 2005. Although the origins of its use are unclear, it quickly became an entrenched practice to manage impedance levels during newborn hearing screening statewide. However, by using this product ‘off label’ in this way, VIHSP inadvertently placed babies at risk of an adverse reaction, and raised concerns regarding potential liability.

Following the identified need for an alternative, VIHSP consulted widely to identify suitable electrode conductive gels to trial. Data was collected from trials at a number of sites. Implementation of the replacement product was systematically rolled-out alongside training and monitoring.

Products were trialed on over 200 babies and the results indicated similar impedance levels and screening times with the chosen alternative product. After systematic rollout across the state, VIHSP is now using a more appropriate product that is fit for purpose and complies with manufacturer recommendations at all sites.

Using a product ‘off label’ violates TGA approval and places both the patient and organisation at risk. VIHSP identified a product which had been used in such a way since commencing screening in 2005 and was successfully able to source and implement an alternative, despite challenges to maintain the status quo. The education program surrounding the product trials and roll-out of the product was integral to the success of practice change.


Dr Melinda Barker is a senior clinical neuropsychologist who commenced with the Centre for Community Child Health at the Royal Children’s Hospital in 1995. She was instrumental in the administration and evaluation of the original Victorian Infant Hearing Screening Program, which has been running since 1992. Melinda has worked on a variety of research projects and programs relating to children’s health, learning and development. Melinda has been Co Director of the current Victorian Infant Hearing Screening Program since it commenced predischarge screening in 2005 and also works clinically in the Department of Rehabilitation at the Royal Children’s Hospital.