Newborn temps

[lmc512]

The temp policy at one hospital I have worked at was 96.5 or less then baby goes under the warmer and you do a sugar. Otherwise just wrap the baby well and have parents hold. I went by this policy for 5 years and seriously probably only had to put a babies under the warmer a total of 5 times. The place I am working now, any baby less than 98 goes under the warmer and then you have to do sugars until you get 3 greater than 45. I have always felt that a baby dropping their temp is an important clue that something is wrong with the kid if they aren't maintaining their temp. But now if you never let the kid get below 98 how do you really know if they are dropping their temp. I mean their normal temp may be around 97.6 which seems totlly reasonable to me. the two hospitals seem to go by such drastically different policies. which one seems more reasonable to you?

[SewHeather]

Our unit's policy is try a variety of things if the infant's temp is below 97.6, such as skin to skin contact, double wrapped in warm blankets or placing under the warmer. We are only to take a blood sugar if there are more hypoglycemia symptoms such as lethargy or jitteryness (or if we simply suspect low bs). I have had several newborns in my care that simply run lower core temps, no matter what interventions you try, and with no underlying cause. Doing three blood sugars on infants with temps lower tha 98.0 does seem a little extreme, not to mention heartbreaking to skick an infant any more that needed.

[Love_2_Learn]

We become concerned and start doing things like you mentioned when the temp is 97.5. First we try skin-to-skin if possible, or a hat and double bundle and check the temp again in about 30 minutes. They buy a warmer warm-up if their temp has not gone up over 97.5 (axillary). We will often check one bedside-drop-of-blood machine blood sugar (not a lab draw requiring 0.5 ml) just as a precaution since babies with hypoglycemia do not always show obvious symptoms of low blood sugar. I personally feel 98.0 is a bit high of a cut off. After all, in intensive care, we allow a 97.7 as our lower limit of normal.

[Halinja, BSN, RN]

Our line in the sand is 97.7, but we don't go straight to blood sugars unless they are a little symptomatic, or had risk factors. We start with warming tricks, back to the warmer, double hats, making sure they're bundled well.