newborn temperature considerations

Newborn Temperature Guidelines and Immunity Build-up

The temperature-regulating system of a baby is by no means as efficient as that of an adult, especially in low birth-weight babies and those under 3.6 kg (8 lb). They are best in a room which is at a constant 20-1°C (68-70°F). As the baby gets bigger and develops a layer of fat, he is also better able to control his body temperature, and he will be quite happy, if well wrapped up, at temperatures of 16°C (60°F).

A baby’s body temperature can drop very rapidly and he can quickly develop hypothermia (very subnormal body temperature) if he is left outside in his pram or in an unheated room and there is a sudden drop in temperature. The baby’s head is large in relation to his body, so it has a relatively large surface area which loses a lot of heat. He should have several layers of lightweight garments or bedding, rather than heavy clothing or blankets that constrict his movements. His extremities, i.e., hands, feet and ears, need extra protection and should always be covered in cold weather. Small babies can be kept warm by being held very close to their mother. Mothers of low birth-weight babies are encouraged to keep them as close to their bodies as much as possible to take advantage of the natural, constant warmth.

If the heating used indoors produces a very dry heat the baby’s breathing passages may be affected, and a humidifier should therefore be used, or a container of water placed in front of the heat source.

The baby’s cot or pram may be preheated with a hot water bottle, but it should always be removed before the baby is put to sleep to avoid burning the child. Babies can get overheated, especially in summer, but also in winter if the room is overheated and they have too many covers. The baby will then develop a heat rash and be almost as uncomfortable as if he is too cold.

Attention should be given to the fibres used for the baby’s clothing and bedding. Natural fibres such as wool and cotton are absorbent, soft and good insulators. Synthetic fibres can be non-porous, cold and clammy.

Prior to birth, a baby is in a fairly stable environment with little fluctuation in temperature.  But to the newborn, temperature variations can cause problems.  In the womb, a baby is to some extent protected from extremes of temperature because of the warm amniotic fluid (waters) which surround him. He is, in fact, about 1 deg C warmer than his mother. Immediately after birth a baby’s temperature falls a little before becoming stable. Anybody who has stepped out of a warm bath on a winter’s morning will understand this!  To a baby it can feel even worse, like stepping out in to the Antarctic!

NEWBORN TEMPERATURE – ROOM SETTINGS

We can avoid a baby becoming too chilled by making sure that the delivery room is warm and by drying and wrapping the baby in a soft towel, and sheltering the cot from draughts. Before leaving the delivery room the midwife usually takes the baby’s temperature by placing a thermometer under the baby’s armpit or gently into his rectum (back passage). The baby’s temperature will subsequently remain stable if he is lightly clothed, the cot covered by one or two light blankets, and the room kept at about 20 deg C to 22 deg C (68 deg F to 71.5 deg F). After a few weeks, if he wears an extra woolly and has another blanket on the cot, he will tolerate a room temperature of 16 deg C (6o.8 deg F).

GETTING USED TO GERMS – IMMUNITY BUILD-UP

Although certain maternal infections, such as German measles, can affect the unborn baby, he is to a large extent protected from germs by

newborn temperature considerations

the membrane which encloses him. As pregnancy advances, special proteins, called ‘antibodies’ build up in baby’s blood and, as a result, his white blood cells become skilled at mopping up any dangerous germs that dare to invade his territory. A baby is, therefore, born with the ability to ward off certain types of infection that might threaten him.

Not all germs are harmful, however, and by the third day of life, a baby’s breathing passages, bowel and skin become inhabited by different bacteria, many of which serve a useful purpose. just the same, it is only common sense not to rely on a very young baby’s defences to ward off every dangerous germ, and you will notice that the staff of the maternity ward, who handle many different babies, wash their hands carefully each time before doing so.

Eye infections, commonly called ‘sticky eyes’, are quite common in newborn babies. If you notice any discharge coming from the eye, mention it to the Sister or health visitor. It is very easily treated by a short course of eye drops. Not all “sticky eyes’ are caused by infection. Sometimes the eyelashes get stuck together by a temporary accumulation of mucus. This can be removed by gently wiping the eyelid and surrounding area with damp cotton wool.