Temperature monitoring and control in the newborn baby

The importance of keeping the newborn baby warm has been known for centuries but worldwide in the 21st century hypothermia remains a major contributor to neonatal mortality. Although less of a problem in high income countries there is evidence that low temperatures have an impact on outcome at vulnerable times, particularly in the baby born preterm. It is clear that if we are to see further improvements in mortality and morbidity in the most immature babies there must be careful attention given to all aspects of basic neonatal care, including thermoregulation. Continuous dual temperature monitoring has advantages over intermittent measurements and is the method of choice in the immature and sick newborn. There is no evidence of any differences in outcome between radiant heaters or incubators. Whichever device is used fluid and heat loss from evaporation due to high transepidermal water loss remains a problem. This is best managed by increasing environmental humidity but the optimum level of added humidity, and the length of time that this should be applied, is still unknown.