Management of neonatal cold stress and hypothermia
THE CONTEXT
Management includes removing cold exposure, restoring warmth, providing feeding or metabolic support, and monitoring for illness; severe hypothermia requires urgent treatment.
Cold stress or moderate hypothermia
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Remove the neonate from cold surroundings, cold clothes, or wet clothing.
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Provide skin-to-skin contact or warm clothing and keep the baby close to the mother in a warm room. A radiant warmer or incubator is an alternative.
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Monitor temperature frequently and ensure adequate warmth if the baby does not warm up.
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Ensure frequent feeding to prevent hypoglycemia, monitor vital signs, and rule out sepsis if the neonate remains cold.
Severe hypothermia
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Treat urgently because severe hypothermia is life-threatening. Remove cold exposure and nurse the neonate in an incubator or preheated radiant warmer; a room heater is an alternative.
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Monitor oxygen saturation with a pulse oximeter and provide oxygen if required. Give a saline bolus if the neonate is in shock.
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Give intravenous dextrose infusion and vitamin K, 1 mg.
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Rewarm rapidly until the baby's temperature reaches 34°C, then slow the rewarming process.
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Measure body temperature and other vital signs frequently. Take a blood culture and give empiric intravenous antibiotics.