Newborn Shiver

[Emily Suzanne]

This is my first post here, so hopefully I'm in the right place. If not...please, someone gently guide me the right direction.

I'm a first year nursing student and am assigned to crease a nursing care plan (for the postpatrum patient). Part of out plan includes patient teaching. I'm creating a care plan on newborn thermoregulation. My question is in regards to newborn "shivering". As we learning in lecture, newborns do not shiver to keep warm...correct? Can someone please explain to me what it means if they do shiver. The texbook says shivering means, "the metabolic rate has doubled." How can I explain this to the family without confusing them, or leading them to believe that a shiver=seizure? If a newborn doesn't shiver to keep warm, then under what circumstance would they ever shiver?

Thanks so much to anyone who can help me understand this concept!

Emily

[XB9S, BSN, MSN, EdD, RN, APN]

Emily, even though your question is related to patient education I wonder if it would be answered better in the neonatal forums

I will move it there for now as I think you will get a better response.

[Jolie, BSN]

You are correct that newborns don't shiver to increase warmth. They burn brown fat to do that. In my experience, (11 years of OB and NICU), I've yet to see a newborn shiver at all. Many are tremerous (Is that a word?) Often due to low blood sugar, elicitation of the startle reflex, and even just plain old immaturity of the nervous system. But true "shivering", I've never seen.

[dawngloves, BSN, RN]

If I see a baby "shiver" I think hypoglycemia or hyperactive moro.

[prmenrs, RN]

I agree w/Jolie and Dawn. Babies are usually described as "tremorous" or "jittery", not shivering, since shivering is not a newborn behavior. The etiology is usually hypoglycemia; it could also be 2nd to drug w/drawal.

[preemieRNkate, RN]

:yeahthat:

[ElliShay]

Babies can also be tremulous due to neonatal hypocalcemia~however this isn't very common.

[texas2007, BSN, RN]

I've seen some babies possibly shivering while on a cooling blanket (temp kept ~91 ax), but it was more likely to be some neuro thing since that's why they are in the cooling blanket in the first place.

[Elvish, BSN, DNP, RN, NP]

Would go with those who don't call it shivering.

Mostly we see it for the reasons named above - hypoglycemia, withdrawal, immature neuro.

[bradyman]

i learned in class that babies dont shiver untill they are one yo because it requires smooth muscle development, that baby just does not have enough of. by crawling and moving they develop the muscle tone nessary for shivering.

[NicuGal, MSN, RN]

Newborns don't shiver...and the kids on the cooling blankets sometimes do that jittery movement, but it is usually related to electrolye and glucose issues. If you see a baby with tremors think low blood sugar or neuro.

[dawnebeth]

As others have said, babies don't shiver due to brown fat. Preemies, in particular, are often jittery or tremble simply because they are preemies and their movements are not smooth.