PRACTICAL APPROACH TO PREVENT HYPOTHERMIA IN NEWBORN
Dr. Alka Singh*, Dr. A. K. Jha**, Dr. Saroj Kumar***, Dr. Deepti Narayan****
Assistant Professor, Dept of Pediatrics *, Lecturer Pediatrics, PMCH, Patna **, Junior Resident, Pediatrics ***, Junior Resident, Pediatrics ****
Insufficient thermoregulatory efforts in pre-term and LBW babies makes them functionally poikilothermic excessive heat loss, poor ability to conserve heat and poor metabolic function are the chief factors responsible for the increased occurrence of hypothermia in newborn babies, additional factors include hypoxia, hypoglycemia, transport and various bed side procedures that are performed on newborn babies. From the mother womb, the best incubator in the world the baby comes out in an environment of cold winds, cold hands and harsh realities.

Can we do something to make the transition easier?
Can we do something to prevent hypothermia in the newborn?
Management of Thermal Environment


Labour room - Received the baby on prewarmed bassinet having radiant heat source.
  - Dry and drape with prewarmed blanket
  - Avoid baby bath for 24 hrs
  - Avoid weighing the baby on day 1

Lying in ward - Put baby next to mother
  - Skin to skin contact with mother-Kangaroo care
  - Clothe the baby properly not forgetting to cover the head and feet with cap and socks
  - Can apply oil or liquid paraffin
  - Use heater in severe cold

Nursery - Maintain temprature around 28±2C
  - Can nurse baby in open care system with overhead radiant warmer and servo control   (mostly practiced now)
  - If warmer is not available 200 watt bulb can be used
  - Incubator care
  - Prewarm cot linen, clothes, infusate and even X-ray plates!

Transport - Transport covered in woolen or wrapped in cotton or tin foil
  - Can use a thermocol box with hot water bottles and a transparent plastic lid
  - If a transport incubator is available all the better

Home care - Form cold penetrating lights, white coats and cold needles and syringes warm hands of the mother   and care provider warm smiles and a warm house!! What else can a newborn baby ask for?

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Singh A D, Jha K A D, Kumar S D, Narayan D D.. Available From : http://www.pediatriconcall.com/fordoctor/ Conference_abstracts/report.aspx?reportid=464
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