Weaning to open crib

Specialties NICU

Published

Specializes in NICU.

I was just wondering... How low do you wean your isolettes before moving baby to open crib? At what temp do you dress and/or swaddle baby? We typically wean to 28C and then place babies in open crib. This seems much warmer than room temperature and I wonder if we should wean down farther like 25-26C.

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Specializes in neonatal, pediatric and hospice.

I think HillRom incubators wouldn't cool lower than 27C especially if the humidity is still on. When a babe reaches 33 weeks corrected age and steadily gained weight to min. 1.6kg AND stable clinically, our policy states nurses can start weaning from incubator to a cot. Of course there are exemptions and that's why the principle of individualized care is so wonderful.

Hope this helped.

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Specializes in Community, OB, Nursery.

If ours are stable at 27, they can go to the OC.

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1.6kg. Monitor isolette trends, if baby has been using less than 30degrees to maintain temp then we dress/swaddle them and continue to monitor x24 hours on baby mode. If less than 30degrees continues to be needed we turn isolettes to "air mode" @ 27 degrees x24 hours. If stable then we pop the top off x 24 hours. If temps are stable then they may go to an open crib. If at any time they fail we must wait 48 hours before reattempting to wean

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Specializes in NICU, PICU, PACU.

Usually we go to 27C, around 1.5kg and nippling at least once a shift.

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Specializes in Nurse Scientist-Research.

In the unit where I work there are "guidelines":

1. >1500 grams

2. 34 weeks adjusted gestational age

3. Weight gain for last 5 days

4. Temp stable in 28C (or lower) isolette/giraffe

Since these guidelines came out there was much confusion that these are "guidelines" and not absolutes. Much is left to the discretion of the bedside nurses taking the above guidelines in consideration. Having giraffes are very helpful in that we can trial open crib and quickly place the infant back in an isolette environment if needed.

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Specializes in PICU, ICU, Transplant, Trauma, Surgical.

Our policy states that the baby must be 1)at least 1700g; and 2) at least 34 weeks. If the criteria has been meet and the baby has been in a 28 degree isolette (with clothes on) for atleast 24 hours with temp consistently >97.5 the baby can be placed in an open crib. Then, axillary temps Q1H x4, temp must remain >97.2. Hope this helps!

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