Blog

The prevalence and impact of neonatal hypothermia mean it is essential for appropriate healthcare professionals to have sufficient knowledge, confidence and tools to avoid or manage the situation effectively. The following article explores the incidence of the condition, common symptoms and ways to overcome the challenges of treating affected patients. 

Defining neonatal hypothermia

Hypothermia can commonly affect babies shortly after birth and it is defined as a core temperature below 36.5ºC.ⁱ  Heat loss can occur in several ways, putting infants at risk:ⁱⁱ 

• Radiant – bare skin exposed to a cooler environment
• Evaporative – as the amniotic fluid on babies dries
• Conductive – neonate is in contact with a cooler surface or object
• Convective – flow of cool ambient air

Prevalence of neonatal hypothermia 

The global prevalence of neonatal hypothermia is estimated to range between 32-85% for children born in hospitals and 11-92% for children born at home – though the numbers are skewed, being higher in developing countries. Determining the exact impact on mortality is difficult. However, it has been suggested that 36% of all neonatal deaths are caused by infection, 29% due to problems related to prematurity, 23% due to asphyxia and 19% due to congenital malformations and other related causes. All these conditions are associated with neonatal hypothermia.ⁱⁱⁱ 

It is essential to combat hypothermia in infants, because the condition can cause hypoglycaemia, hypoxaemia, acidosis and reduced cardiac output. It is an even greater concern for preterm infants, because they have a large surface area relative to immature physiological development and poor thermoregulatory control.^iv 

Key signs and symptoms

Some of the symptoms of neonatal hypothermia can be difficult to spot, so it’s important that healthcare professionals are confident in knowing what to look for. Signs may include vasoconstriction presenting as pale, cold or mottled skin; lethargy; feed intolerance or vomiting; increased oxygen requirement or respiratory distress; apnoea; hypotonia; and hypoglycaemia.  

Assessment and challenges

Comprehensive assessments should be completed to eliminate the risk of hypothermia in neonates, and enable professionals to act quickly if heat loss is occurring. For healthcare professionals, everything from evaluation of the immediate environment to the avoidance of bathing in the first 24 hours of life, the heating and humidifying of required inspired gases, and the proper transport, must be considered and managed carefully.^v 

The delivery room, for example, should be at least 25ºC, though this may be difficult to consistently achieve in winter months or rural areas, especially with the regular opening and closing of doors. Immediate drying of the baby is also essential, so the appropriate cloths should be to hand at time of birth. WHO recommendations also highlight the importance of appropriate clothing and blankets for the infant, as well as warm transportation devices, all reducing the risk of hypothermia.^vi  

To overcome these challenges and give infants the very best chance of health in those critical first few hours and days after birth, professionals should consider the SafeWarm Mobile Neonatal Patient Warming System from HMG Medical, now available from Getz Healthcare in New Zealand.

This portfolio of warming blankets and mattresses includes the following key features:

• Designed to prevent newborn hypothermia during transport
• Uniformly warms swaddling blanket in just 10 minutes
• Lightweight swaddling blanket 
• Precise 0.1ºC increments for meticulous temperature control (32-39ºC) with LED display
• Enhanced safety includes audio-visual alarms and high-temperature cut-off

 

Request a DEMO today to find out more!

 

---

ⁱ World Health Organization. WHO_RHT_MSM_97.2_Thermal protection of the Newborn.pdf. 1997.

ⁱⁱ MSD Manual. Hypothermia in neonates. Revised November 2023. [Accessed November 2023]

ⁱⁱⁱ Lunze K, Bloom DE, Jamison DT, Hamer DH. The global burden of neonatal hypothermia: systematic review of a major challenge for newborn survival. BMC Med. 2013 Jan 31;11:24. doi: 10.1186/1741-7015-11-24. PMID: 23369256; PMCID: PMC3606398.

^iv Singh, T.S., Skelton, H., Baird, J., Padernia, A.-M., Maheshwari, R., Shah, D.M., D'Cruz, D., Luig, M. and Jani, P. (2022), Improvement in thermoregulation outcomes following the implementation of a thermoregulation bundle for preterm infants. J Paediatr Child Health, 58: 1201-1208.

^v The Children’s Hospital. Thermoregulation in neonatal care – CHW. Practice Guideline. Guideline no. 2007-0006 v4. [Accessed November 2023]

^vi World Health Organization 1997. WHO_RHT_MSM_97.2_Thermal protection of the Newborn.pdf