Even though researchers have studied ways to reduce heat loss in premature infants for more than 100 years, hypothermia remains a widespread problem in this population, especially after birth and through the first weeks of life. This review focuses on current research findings that are being translated into practice to reduce heat loss after birth and during neonatal intensive care unit hospitalization. Recommendations for practice are given to minimize heat loss during care and promote thermal stability for very low birth weight infants. More research is needed to combine evidence-based interventions into thermoregulation bundles and to assess morbidity and mortality when such bundles are implemented. It is essential to continue to focus on thermal stability and eliminate hypothermia in the very low birth weight population.

Neonatal hypothermia is a worldwide problem and leads to increased morbidity and mortality in newborn infants. This paper describes a program of research to examine thermoregulation in premature infants and to decrease neonatal hypothermia. Our studies include 1) examining an intervention to reduce heat loss in premature infants by placing them in polyurethane bags after birth; 2) a descriptive study examining central and peripheral temperatures during the first 12 hours of age; 3) and a study examining central and peripheral temperatures over premature infants' first two weeks of life. Currently we are using an esophageal tube with an imbedded thermistor (Philips Healthcare) to display continuous central temperature in a randomized controlled trial to see if this intervention will lead to warmer temperatures during the stabilization period than monitoring temperatures intermittently using axillary temperatures and skin probes. Future research will include expanding collaborative studies into low to moderate resource countries to help reduce infant hypothermia and infant mortality.