Hypothermia and Occlusive Skin Wrap in the Low Birth Weight Premature Infant: An Evidentiary Review

Low-birth-weight (LBW) premature infants are born without the adaptive mechanisms needed for survival outside of the womb. These fragile infants require thermoprotective interventions that begin in the delivery room. Current heat preservation interventions such as a pre-warmed delivery room, warm blankets/towels, drying, radiant warmer tables, and skin-to-skin with mother are not as effective in preserving heat in the smallest of infants. Despite the use of current heat preservation strategies, LBW premature infants remain vulnerable to hypothermia and associated morbidities and mortality. The use of an occlusive skin wrap has been studied since the late 1960's as a method for heat loss prevention in infants at birth. This evidentiary review will explore the most recent research on occlusive skin wrap in the delivery room for heat preservation in the LBW premature infant and propose a guideline for use.