Plastic bags to increase skin-to-skin care and thermoregulation in low birth weight and preterm infants

Hypothermia is a serious risk for increased morbidity and mortality in newborn infants, especially low birth weight and preterm. In developed countries, expensive incubators and radiant warmers have effectively reduced hypothermia in newborns. However, in developing countries, inexpensive alternative approaches of skin-to-skin care is under-utilized. An innovative, low-cost solution to increase skin-to-skin care and prevent hypothermia is necessary for low- and middle-income countries. We propose to pilot a new bold idea to enhance thermoregulation in low birth weight and preterm infants using non-medical polyethylene plastic bags to increase the effectiveness of skin-to-skin care as part of the warm chain contents recommended by the World Health Organization in its thermal protection guidelines (WHO/FHE/MSM/97.2). We will train health care personnel and parents to prevent hypothermia in these infants by using plastic bags to increase effectiveness and duration of skin-to-skin care. The impact will be an approach to increase the practice of skin-to-skin care. Our preliminary data show almost a 50% reduction of hypothermia (Leadford et al Pediatric Academic Societies Abstract, April, 2012) yet little effort has been made to optimize use. With current standard practice including skin-to-skin care, around 50% of low birth weight infants develop hypothermia (Darmstadt et al J Perinatology 2006). These pilot studies will determine if optimal use of a plastic bag increases the effectiveness and duration of skin-to-skin care, preventing hypothermia in this high risk population.