Recent discussions
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ANA CAVANHA
It seems reasonable to me to try to use a temperature of 23 degrees Celsius in the delivery room to reduce cases of hypothermia, as it would be a low-cost action. -
Gabriel Variane
Despite the paucity of evidence, our center recommends that room temperatures of 23oC be used at birth for late preterm ( ≥34 weeks' gestation) and term infants and also that skin to skin care be used immediately after birth. We do not routinely recommend the use of a plastic bag or wrap in addition to skin to skin care in this population, as the risk-benefit of specific interventions is unknown. I agree that studies examining the effectiveness of interventions are necessary to make these treatment recommendations and that standardizing the timing and method of temperature recording for all infants would be an important step. -
Luciane Berti
I agree with the agent -
José Roberto Ramos
Very relevant and difficult topic to comment on. I believe there are 2 important variables in addition to all those mentioned: different preterm and term physiologies and resuscitation needs or not, making it difficult to maintain the desired temperature for a long time. The successful experience of skin-to-skin contact in Brazil has played an important role and the decision to put all terms in the plastic bag still seems to me to have an uncertain risk-benefit -
Andrea Lube
Maintaining the proper temperature is a major challenge. We have been practicing golden hour with maintaining skin-to-skin contact for about 1 hour or more. Yet we face problems with colleagues who want a low ambient temperature in these late preterm and especially term deliveries. Maternal temperature is often low, and we don't know how much this can impact the newborn's temperature. We occasionally use gel mattresses. But we are afraid of burning the skin or causing hyperthermia, as we have no control over the temperature of the mattress. The imported thermal mattress is expensive and single-use. The use of plastic bags may help us to maintain the proper temperature. -
LEONARDO DE SIQUEIRA
Very important maintaining a normal temperature after birth to all preterm and term infants. -
Jaqueline Tonelotto
I agree with recomendation of operating room temperature to 23ºC, we already practice it. -
Bettina Figueira
The maintenance of the adequate temperature of the newborn(NB) is an important issue in stabilization at birth, since both hyper and unscheduled hypothermia are able to negatively modify the evolution of the neonate. The early skin-to-skin contact of the NB with his/her mother has been shown to be importante not only in maintainnig body temperature but also in the humanization, bonding, initiation and maintenance of breastfeeding with its beneficial both in the neonatal out come and in the future life of this small being. Considering a tropical country like ours, most newborns with gestational age of 34 weeks or more who do not require resuscitation interventions, stay well with skin-to-skin contact with their mother, covered (not wrapped) by a sterile cloth. In the impossibility of performing skin-to-skin contact due to some maternal limitation, for example, the routine measures of receiving the NB in pre warmed cloth, drying, removing the wet clots and positioning under radiant warmer, apparently has not been shown to be effective in preventing hypothermia in these newborns (Lunze 2013). Additional measures for temperature maintenance should be based on the assessment of local reality and ideally on the monitoring of the newborn`s body temperature. The increase in ambiente room temperature from 20° to 23°C is an objective measure that may contribute to the prevention of hypothermia in those births that occur in a surgical hospital environment. Wrap the NB or put him in a plastic bag before placing on the skin-to-skin contact with the mother, results in the loss of exactly the skin-to-skin contact and we do not know if there will be or not a lost of the benefits described by this technique in breastfeeding and mother-baby bonding. In babies who, for some reason, are not eligible for this early contact, wrapping or placement in plastic bag, may be a good option to maintain temperature. -
Jamson Barreto
Maintenance of temperature in all the newborns, regardless the gestacional age is clearly important. I think that the most effective strategy to avoid low temperatures at the admission in NICUs or postnatal ward must be combined, since the admission of the mother inside the surgical room, maintaining her normothermia, till the control of temperature of the admission rooms or the use of adequate devices to keep the newborn warmed.