Hypothermia is still a problem in newborn babies born in lower middle income countries. Technologies manufactured in the industrialised nations are too expensive and difficult to repair and maintain. Simple warming devices (e.g. hot water mattress) and strategies (e.g. the 'kangaroo method') are of some benefit, but the problem of hypothermia remains. New simple approaches are therefore still needed.
Many thanks Subhamoy. Yes, the work of Embrace is very good and provides a neat package that can supplement the various swaddling methods that are traditional in several nations. Drying and wrapping after delivery is so important, and swaddling can be useful in some situations, including transport.
Some appropriate methods are: delaying the baby's first bath (72 hrs is recommendation), wearing a hat or other head covering, warming the room where the baby is kept, covering baby in plastic wrap (so far only used in high resource countries), and warming mattresses (via electricity, heated hot water, or special gel). Thorough drying, discard wet towel, wrap with dry towel immediately after birth is also effective, as well as KMC which you mentioned. Delay weighing the baby (scales are cold metal, plus usually weighed naked).
Hope this is helpful,
-Heather
Thank you, Heather, for your comments. This is a nice summary of the procedures that we have been promoting in a variety of ways not only on the LMICs but also in the industrialised nations. Traditional Birth Attendants receive instruction and are provided with teaching aids on the basic means whereby the four key processes of heat exchange - evaporation, conduction, radiation, and convection - can be managed to minimise heat loss and achieve safe thermal balance. So, drying, wrapping, head covering and weighing with improved procedures now appear to be recognised as being safe, easy to use and effective approaches. Despite this there is still a long way to go before actual "devices" emerge that fit the bill. Warm air incubators and radiant warmers are electrically operated and so these have down time due to power outages that are very common. The water-filled heated mattress, developed by Prof Ragnar Tunnell in Stockholm, is electrically heated but has some thermal mass and so provides a buffer against power outages. The transport incubators developed by Prof Peter Lemburg and by my own group use waxes and other thermal storage materials that can provide sufficient warmth during quite long periods of transport. However, in the field we still do not see much practical evidence of the use of these kinds of devices.
- Peter
Tim Prestero at MIT works on finding medical device solutions for developing nations.
His website: http://www.designthatmatters.org/
Tim's website is very good and describes a sound way to create medical technologies that have a chance of meeting needs despite limited resources. It still amazes me that we have all been trying hard over the last 4 decades to produce a good neonatal incubator for LMICs but have not yet truly succeeded!
- Badges
- Science method
- Similar topics
- Mathematics
- Statistics
- Statistical Techniques
- Meta-Analysis