Neonatal Hypothermia

Neonatal hypothermia is a dangerously low body temperature in a newborn, occurring because newborns, especially those who are preterm or low birth weight, lose heat quickly and have a limited ability to generate warmth on their own.

• Cold skin, particularly on the hands, feet, and trunk
• Lethargy and reduced activity
• Poor feeding or refusal to feed
• Weak cry
• In more severe hypothermia: slow heart rate, breathing difficulty, and reduced consciousness

• Newborns, particularly those who are preterm or low birth weight, lose heat quickly due to a relatively large body surface area, thin skin, and limited fat stores.
• Risk is increased by delayed drying and wrapping after birth, delayed skin-to-skin contact, birth in a cold environment, and delayed initiation of breastfeeding.
• Underlying illness, such as infection, can also contribute to difficulty maintaining body temperature.

• Diagnosed by measuring the newborn's body temperature, with hypothermia generally defined as a temperature below the normal range for newborns.
• Assessment for an underlying cause, such as infection, is important, particularly if hypothermia is unexplained or the baby appears unwell in other ways.

Immediate warming is essential, ideally through skin-to-skin contact with the mother (kangaroo mother care), which is highly effective at both preventing and treating mild to moderate hypothermia.

The baby should be dried thoroughly and kept covered, including the head, in a warm environment away from draughts.

Moderate to severe hypothermia, or hypothermia in an unwell-appearing baby, requires prompt hospital-level care, which may include additional warming methods and assessment for underlying illness such as infection.

Feeding is supported and encouraged as soon as possible, as feeding itself helps generate warmth and provides essential energy.

Any newborn with hypothermia should also be assessed for low blood sugar and signs of infection, as these commonly occur together.

• Dry and wrap the newborn immediately after birth, and delay the first bath for at least 24 hours.
• Practise immediate and prolonged skin-to-skin contact between mother and newborn after birth.
• Keep the newborn's head covered and ensure the room where the baby is cared for is adequately warm, particularly in cooler climates or seasons.
• Initiate breastfeeding as soon as possible after birth.
• Seek prompt medical care if a newborn feels unusually cold, is feeding poorly, or seems unusually sleepy.