Neonatal Thermoregulation Audit on the Special Baby Unit at Jinja Referral
Hospital , Uganda March 2014
Objective: By 6 months, to have conducted 2 audits of temperature control in
preterm babies with the aim of avoiding hypothermia in neonates’ pre and post
teaching about kangaroo mother care and importance of thermoregulation in a
neonate
Rationale behind the audit
Growth and development of low birth weight and premature babies is highly
dependent on good temperature control. The recommended optimal
temperature range for a neonate is 36.5–37.5 °C. Temperature below 36.5
degrees is defined as hypothermia. Hypothermia in neonates results in poor
growth and poor weight gain. This babies born with a low birth weight or born
too soon (premature) are at risk of hypothermia secondary to several factors
such as increase surface area, lack of brown fat, and iatrogenic causes such as
wrapping in wet clothes or inadequate external thermoregulations e.g. lack of
Kangaroo Mother Care or poor heat control in incubators.
In an otherwise well baby no longer requiring respiratory support, research have
shown that Kangaroo Mother Care is the single most effective way of preventing
hypothermia in low birth weight/premature babies
The aim of the audit is to review the temperatures of babies on the neonatal unit
on a given day, in correlation with their birth-weight and gestations; with the
aim of optimizing assess thermoregulation by advocating Kangaroo Mother Care.
Initial Audit- March 2014
Sample Size
10 patients, data collected on the same day of all the patients admitted on the
neonatal unit. All the babies were stable off respiratory support and were on the
neonatal unit completing antibiotic treatment as well as establishing feeds.
Criteria
1. Temperature
2. Gestation
3. Birth Weight
4. Participation in Kangaroo Mother Care
Results
Sample- 10 patients, 8 preterm babies and 2 term babies
Gestation-
2* 28 weeks gestation
4* 34 weeks gestation
Dr. Yetunde Odutolu- Global Link Volunteer Feb 2014
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1* 34 weeks
2* Term Babies
1* Gestation unknown
5
4
4
3
2
2
2
1
1
1
0
28 weeks
32 weeks
34 weeks
Term
Unknown
Birth weight- Range 0.88kg to 2.5kg
1* <1kg
4* 1kg to 1.5kg
3* 1.5kg to 2kg
2* 2kg to 2.5kg
Birth Weight
<1
1- 1.5
20%
1.5-2.0
2.0-2.5
10%
40%
30%
Dr. Yetunde Odutolu- Global Link Volunteer Feb 2014
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Participation in Kangaroo Mother Care
2 babies participating, 8 not participating
Percentage actively carrying out KMC
Yes
No
20%
80%
Temperature in correlation to birth-weight and gestation
Weight
<1
1- 1.5
1.5-2.0
2.0-2.5
No
1
4
3
2
Average Temp in °C
35.5
34.9
34.8
36.4
Gestation
28 weeks
28-32weeks
32- 34weeks
Term
Doing KMC
1
1
0
0
37
36.4
36.5
36
35.5
35.5
34.9
35
34.8
34.5
34
<1
1- 1.5
1.5-2.0
2.0-2.5
Temperature
Conclusion
All the preterm babies were hypothermic with temperature as low as 34.8, only
2 babies had near normal body temperature at 36.4 both were above 2 kg.
Dr. Yetunde Odutolu- Global Link Volunteer Feb 2014
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Recommendations
1. All babies should have a temperature measured at least once a day.
2. Keep young infants dry and wrapped
3. Ensure that the room temperature does not fall 25°C
4. Aim to maintain babies temperature between 36.5- 37.5°C
5. Exclude other causes of hypothermia such as sepsis by taking a thorough
history and examination
6. Once a baby is stable and off any respiratory support, parents should
learn KMC and commence KMC as soon as possible.
Action Plan
1. Improve temperature measurements
2. Teach all parents of low birth weight and premature babies Kangaroo
Mother Care
3. Re-audit before August 2014.
Dr. Yetunde Odutolu- Global Link Volunteer Feb 2014
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