thermoregulation in the neonate

[cyndbirn]

I had a baby with an axillary temp of 97.2 at 2 hrs old after his bath which was done in the radiant warmer, and quickly dried and dressed him with t-shirt, diaper and warmed hat then swaddled him in 3 warmed blankets, he was also at term and had such a great latch that i had to break his seal in order to get him over to the warmer for bath and meds. Was this an appropriate intervention for thermoregulation for a mild hypothermic neonate? He was of average weight.

[loving2024, BSN, RN]

I think the normal range for a baby like that is 98 to 101. However check on the baby often because you covered him with three blanket which seems to much due to the data given. He is going to be sweating any time soon and his temperature would go up

[SusanSykesSparling]

There is no rush to give a bath. Baby should stay skin-to-skin with mom to bond and breastfeed! NEVER bathe until after 2 hours of age. After bath, back to mom for skin-to-skin time and more breastfeeding. Mom's body is the perfect "warmer" for baby. Our hospital uses these techniques and doesn't even bathe baby under a warmer. Staying a little bit dirty is much less of a big deal than is cold stress!

[twinkletoes53]

He was very mildly hypothermic after his bath. I would check his axillary temp. in 30 minutes X 2. What you are looking for is an increase in and his ability to maintain his temp. at a range of approximately 97.3-99 degrees Fahrenheit axillary.

If his temp. is WNL after an hour, then continue with routine monitoring. If his temperature is below normal, I would personally turn his warmer back on and notify the on-call physician. My background is strictly NICU. So I worry about hypothermia in an otherwise healthy TNB being an early sign of sepsis.

[Elvish, BSN, DNP, RN, NP]

I wouldn't have bathed him at 97.2, personally. I'd have kept him skin to skin or under the warmer. We don't bathe anyone under 6 hours old unless there are extenuating circumstances (example, mom is HepB +).

[Seas]

Breaking the latch and stopping the breastfeeding for a bath is a very wrong practice and a big no no. At least in my hospital, you would get a warning from the manager if this was complained by mom. Bath is never a priority over breastfeeding.

For temperature, we do skin-skin after a bath, and after 1 hour, if it is still low, we take them under the warmer, We don't dress them. Because if mom's body couldn't warm them, dresses won't either.

[laynaER]

I agree with others. The bath should be delayed until at least 6 hrs after birth. There is no rush to bathe a baby. Skin to skin should be initiated immediately and the temp shouldve been taken prior to giving the bath.