Thermoregulation in the Neonate

After the delivery, the heat from the mom’s body can warm the baby and maintains the baby’s body temperature. For instance, when nursing students were at the operating room at Saint Peter’s Hospital during the C-section delivery, as soon as the baby was out, the doctor placed the newborn on the mother’s chest. When the mother was alert and awake during the C-section made it possible for the baby to stay on her chest on the first hours after the birth. It was one of the most beautiful moments in life. Nevertheless, there was another C-section birth of diabetic mother. She was not fully awake during the C-section and the doctor only did not promote skin-to-skin mother and the newborn. The doctors and nurses at Saint Peter’s Hospital support and encourage skin-to-skin for mother and newborn right after the birth if there is no complication on mother or baby or when the condition is possible. Saint Peter’s Hospital has policy for vaginal delivery, “all infants that meet the criteria for initiate skin-to-skin care shall have skin-to-skin care implemented as the standard of care immediately after birth and as needed thereafter regardless of feeding preference”. They promote skin-to-skin contact between mother and baby immediately after delivery. However, mothers and babies have a physiologic need to be together during the minutes, hours, and days following birth, and this time together significantly improves maternal and newborn outcomes.

In this article, DiBlasi argues that the conventional method used to provide ventilatory support to preterm neonates with respiratory distress syndrome; nasal continuous positive airway pressure (CPAP) is ineffective. The author bases the claim on the fact that almost half of the infants supported by this technique often develop respiratory failure that warrants invasive ventilatory support and endotracheal intubation that is injurious in nature. According to the author, invasive ventilatory procedures should be avoided to minimize the excessive complications that are usually associated with them.

Induction Phase. This is the first phase of therapeutic hypothermia. The aim of this phase is to deliberately reduce the patient’s core body temperature to a degree where mild hypothermia is induced. The target temperature for this phase of therapeutic hypothermia is roughly 32-34 °C, although the exact target temperature varies between healthcare facilities. The induction of mild hypothermia can be achieved through a variety of different methods, including ice packs, cold saline infusion, external cooling pads, and intravascular cooling. Sedatives and neuromuscular blockers are often administered in conjunction with these cooling methods to prevent shivering thermogenesis, which could otherwise increase the amount of time required to reach

The initial step was a broad search of several online databases. The databases included: CINAHL, Cochrane Library, Medline, PubMed, Google Scholar, and Ovid. The subject heading search was hypothermia as it relates to surgery and the use of a warming device prior to induction or an operation. To further expound this search, key terms and/or phrases that were used included: pre-warming, warming prior to surgery, warming before operation, and use of force air warmer prior to induction. These terms were used in various combinations. The time period searched was between the years of 2012-

Increases in heart and respiratory rate can lead to increased oxygen consumption and caloric requirements, which will allow for fewer calories available for growth and healing. If stress continues, the initial increase in heart and respiratory rates will cease, and the infant can become bradycardic and apneic, which could lead to a possible hypoxic event and decreased pulmonary function. Premature infants are exceptionally vulnerable because their neurologic systems are still very immature and they cannot selectively limit stimuli or its physiologic impact. During noisy periods, apnea was found most frequently in very preterm babies, and oxygen saturation averaged 90 percent compared to 93 percent during quiet periods (Brown, 2009).

The hypothalamus is the part of the brain that controls the core temperature of the human body. This organ which is located above the brainstem ensures that the body is kept at a temperature between 97.5 and 98.9 °F (36.4°C and 37.2°C). Small proteins known as pyrogens can stimulate prostaglandin release in the body and increase body temperature beyond this range. 1 These increases can be medication induced or due to other underlying pathophysiology. An increase beyond this temperature range can be classified as a fever. In infants, the gold standard for classification of a fever is a rectal temperature greater than 100.4°F. It is important to treat fever in an appropriate manner because infants with elevated body temperatures are at an increased risk of having febrile seizures especially if they have a history of these episodes. Acetaminophen is an over the counter medication that can be used to reduce fever in patients by inhibiting cyclooxygenase.

- Neonatal hypoglycemia is a global health problem and a preventable cause of neurological injury in newborn period. Approximately 1/5th of neonates have a risk of being hypoglycemic. Some of these infants fail to normalize their blood glucose by feeds alone and require intravenous (IV) dextrose therapy. In our institution, IV dextrose therapy is offered in the neonatal intensive care unit (NICU). This leads to separation of mother from baby and undue anxiety affecting bonding and breastfeeding.

The ultimate goal in neonatal healthcare is not to simply “save babies,” but to improve the quality of life for the infant and parent. The child is being treated, but the family must live with the long-term consequences of the daily decisions made in caring for the baby. The two main issues in this decision making process include the stake of survival and the future quality of life. Even the smallest decisions, such as mode of ventilation or environment the baby is kept, can and will affect the infant’s transition to normal. The most famous case of neonatal decision-making involves a baby born in 1982. He was born with Down’s syndrome and a tracheoesophageal fistula, or abnormal connection between the upper parts of the esophagus and windpipe.

One group of infants received KMC which was created by Ray and Martinez in Bogota, Colombia to serve as an additional and/or alternative tool to infant incubators. KMC provides the infant with tactile and kinesthetic stimulation along with the mother’s familiar scent and her body heat. The KMC infants were placed directly on their mothers’ chests, allowing skin-to-skin contact, for 15 minutes three times a day

The nurse must be mindful of each intervention initiated and the possible benefits of the intervention against its potential harmful effects for both mother and fetus. Not providing basic comfort measures for the mother can cause serious physical and emotional problems and could lead to possible fatigue and feelings of failure from the mother. The priority of this nursing intervention is to provide the mother and fetus with the least discomfort as possible and

(2011). Comparison of Radiant Warmer Care and Kangaroo Mother Care Shortly after Birth on the Neurobehavioral Responses of the Newborn. Journal of South Asian Federation of Obstetrics & Gynecology, 3(1), 53-55. Retrieved from

The study, published in the Environmental Health Perspectives linked 223,375 births at 12 clinical centers throughout the US to hourly temperature records for the region surrounding each center. Knowing each women will have varying degrees of what constitutes too hot or too cold, the researchers defined extreme cold temperatures as below the 10th percentile of average temperatures, and defined extreme heat as above the 90th percentile. Although it isn’t clear why extreme temperatures may cause preterm risk or delivery, they speculate the stress of extreme temperatures could impede the development of the placenta or alter blood flow to the uterus, which could lead to early labor.

Even though the term neonatal strictly define the newborn period from birth to 28 days of age , it includes everything from routine care of the normal newborn infant, all the way through to provision of intensive care for the smallest and sickest of infants. In many cases this will involve premature infants who are often older than four weeks of chronological age but less than 44 weeks corrected gestational age. This type of care is complex and generates large amounts of clinical, monitoring and laboratory or imaging data (David & Emma Parry,2009).

The proper yet least invasive route to perform the measurement of a core temperature in children has been an ongoing debate. Common methods or routes include axillary or in the armpit area, oral, rectal, tympanic, and temporal. Proper temperature measurement with an accurate result is important for diagnosis and treatment, especially in febrile children. False positive measurements can lead to extensive and unnecessary diagnostic testing while false negatives can lead to under treatment in a fragile population, which is why the

Newborn babies are considered to be premature if they are born before 37 completed weeks of gestation. (Petrini et al., 2009) Early intervention (EI) for premature infant means providing interventional therapy specified for them. (Meena et al., 2012) EI encourages child health, reduces developmental delays, cures existing disabilities and inhibit functional deterioration. (Meena et al., 2012). In this essay, we will discuss about 2 common conditions seen in premature infants, respiratory distress syndrome and metabolic bone disease.