8.4  Special care to keep preterm and low birth weight babies warm

Preterm and low birth weight babies have great difficulty in maintaining their body temperature. They very easily lose heat, and hypothermia is life-threatening in their delicate condition. You should always follow the warm chain principle for any baby, whatever its weight or age, as you learned in Study Session 7, but in addition, early and tiny babies should get the following special care:

• Immediately after the birth, put the baby in skin-to-skin contact with the mother, followed by Kangaroo Mother Care, which is described below.
• Extra blankets or any extra local cloth made of cotton are needed to cover both the mother and the baby. An important thing to remember (which is often forgotten) is that the baby’s head needs to be well covered. This is because more than 90% of the heat loss is through the head if it is left uncovered.
• There should be an extra heat source in the room where the preterm baby is looked after.
• Delay bathing for at least 48 hours after delivery, and always use warm water.
• Initiate breastfeeding or cup feeding as early as possible and feed the baby at least every two hours.