Neonates are not as adaptable to temperature changes in comparison to adults. Preterm neonates are even more so at risk:

• A neonate’s surface is about three times greater (and about 4 times greater in preterm deliveries) than an adult's, compared to the weight of his/her body. Therefore, more heat is lost.
• Neonates do not use the same mechanisms of heat generation and temperature regulation as adults. They utilize non-shivering thermogenesis (NST) , burning oxygen and adipodse tissue to generate heat. Premature and low-birth-weight babies usually have little body fat and may be too immature to regulate their own temperature, even in a warm environment. *This is incredibly important as neonates (with preterm and low-birth-weight, especially) are at risk of hypoglycemia from trying to stay warm using this NST. When considering long transport times, ensure you are utilizing every tool at your disposal to reduce heat loss, and consider rechecking a blood glucose after long transport times following delivery.

  What can we do to help? Mitigate heat loss and rewarm our patient with the tools at our disposal:

• Dry off your patient immediately following birth and during rapid assessment • Increase the ambient air temperature within the room or ambulance • Cover the neonate’s skin (swaddle with blankets, dress with hat/tuke, apply clothing) • Apply passive rewarming with heating pads outside of the clothing or blankets • Reassess the patient’s temperature when taking vital signs • Plan your extrication and reduce skin exposure to the elements

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