1. Beal, Judy A. DNSc, PNP, RN
  2. Freda, Margaret Comerford EdD, RN, CHES, FAAN

Article Content

Thomas, K. A. (2003).Journal of Obstetric, Gynecologic, and Neonatal Nursing,32 (6), 745-752.

FIGURE. No caption a... - Click to enlarge in new windowFIGURE. No caption available.

In the NICU, an infant's body temperature is maintained within the thermal neutral zone (TNZ) by routine monitoring and a stabilized environmental air temperature. While a priority when hospitalized, little is known about the adequacy of thermal care of the NICU graduate at home. This study recorded continuous abdominal skin temperature at 1-minute intervals for a 24-hour period in 24 preterm and 16 fullterm infants at approximately 44 weeks postconceptual age. The infant's ambient temperatures were controlled; parents did not change typical infant care routines, but the infants were not bathed during the study period. Results showed that smaller preterm infants were too warm, bigger preterm infants were too cool, larger fullterm infants were too warm, and smaller fullterm infants were too cool. The investigators offered several explanations for these findings including: a difference in preterm infants' thermoregulation prior to 40 weeks postconceptual age as well as parental perceptions of thermal vulnerability and related choices of clothing and blankets. Smaller premature infants may have been perceived by parents as needing more thermal support and as a result tended to be overwarmed; while parents of larger premature infants provided less warming measures and these infants remained too cool. The warming needs of fullterm infants were also misinterpreted by parents, resulting in overheating of smaller fullterm infants and under-heating of larger infants. Previous research has confirmed that smaller infants are typically more heavily wrapped by parents (Anderson, Wailoo, & Petersen, 1989). While this study did not explore parent's warming practices, this would be important for future research. NICU nurses need to include strategies on home thermal regulation in parent discharge teaching protocols.


Comment by Judy A. Beal




Anderson, C. E. S., Wailoo, M. P., & Petersen, S. A. (1989). Keeping babies warm: Have we got it right?Health Visitor, 62, 372-373, 386. [Context Link]