From the Guidelines
The ideal room temperature for neonates should be at least 23°C, as suggested by the most recent evidence. This temperature is recommended to maintain normal temperature in preterm infants (<34 weeks’ gestation), as well as late preterm and term infants (≥34 weeks’ gestation) 1.
Key Considerations
- Maintaining appropriate environmental temperature is crucial because neonates have immature thermoregulatory systems, limited subcutaneous fat for insulation, and a large surface area relative to their body mass, making them vulnerable to heat loss.
- Temperature stability directly impacts a newborn's oxygen consumption, metabolic rate, and overall health.
- Signs of cold stress in babies include cool extremities, mottled skin, lethargy, poor feeding, and in severe cases, respiratory distress.
Additional Recommendations
- Beyond room temperature, consider appropriate clothing (typically one more layer than adults would wear in the same environment), avoiding drafts, keeping the baby away from air conditioning vents or cold windows, and monitoring the baby's temperature periodically, especially during the first few days of life.
- In preterm infants (<34 weeks’ gestation) immediately after birth, in whom hypothermia on admission is identified as a problem, it is reasonable to consider the addition of a thermal mattress, but there is a risk of hyperthermia 1.
Prioritizing Morbidity, Mortality, and Quality of Life
- The recommendation to maintain a room temperature of at least 23°C is based on the most recent and highest quality study 1, which prioritizes the well-being and safety of neonates.
From the Research
Ideal Room Temperature for Neonates
- The ideal room temperature for neonates is a crucial factor in maintaining their body temperature and preventing hypothermia.
- A study published in 2022 2 found that a room temperature of 23°C compared to 20°C improved normothermia and body temperature in late preterm and term neonates.
- The same study also found that skin-to-skin care (SSC) increased body temperature and reduced hypoglycemia and hospital admission in neonates.
Comparison of Incubators and Radiant Warmers
- A study published in 1983 3 compared the use of incubators and radiant warmers in maintaining the body temperature of newborn infants.
- The study found that incubators and radiant warmers have different effects on the partition of body heat loss, with radiant warmers increasing convective and evaporative heat loss.
- Another study published in 1982 4 found that both incubators and radiant warmers provided acceptable thermal environments for most preterm babies, but that incubators without humidification may be inadequate for immature babies with high skin water loss.
Radiant Warmers vs Incubators
- A systematic review published in 2002 5 compared the effects of radiant warmers versus incubators on neonatal fluid and electrolyte balance, morbidity, and mortality.
- The review found that radiant warmers resulted in increased insensible water loss compared to incubators, which needs to be taken into account when calculating daily fluid requirements.
- A more recent study published in 2020 6 found that a Cocoon warmer was comparable to a servo-controlled Radiant warmer in thermoregulation of hospitalized stable preterm babies.
Key Findings
- A room temperature of 23°C is recommended for neonates to prevent hypothermia 2.
- Skin-to-skin care (SSC) is effective in increasing body temperature and reducing hypoglycemia and hospital admission in neonates 2.
- Incubators and radiant warmers have different effects on the partition of body heat loss, and the choice of device depends on the individual needs of the neonate 3, 4.
- Radiant warmers result in increased insensible water loss compared to incubators, which needs to be taken into account when calculating daily fluid requirements 5.