:  Forced-air warming can prevent hypothermia after cesarean section and skin-to-skin contact after birth. (Image source: Thinkstock)

Forced-air warming can prevent hypothermia after cesarean section and skin-to-skin contact after birth. (Image source: Thinkstock)

Those of us who care for neonates know the importance of keeping the infant warm.  Warming mattresses, forced-air warming systems, and a conventional incubator all reduce the risk of neonatal hypothermia.  The same is true of skin-to-skin contact between the mother and her newborn.  Skin-to-skin contact is effective in preventing hypothermia for infants born after vaginal delivery. Are infants born via cesarean section at risk for hypothermia? What methods keep them warm?

Dr. Jan Höcker, Department of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany, and colleagues compared neonatal core temperature after cesarean delivery under spinal anesthesia of 40 mothers and children who were randomized to be warmed either using passive insulation or with 44°C forced-air skin surface warming during the surgical procedure and in the first 20-min period of bonding after birth.  Their results are summarized in the article “The Incidence and Prevention of Hypothermia in Newborn Bonding After Cesarean Delivery: A Randomized Controlled Trial,”which appeared in this month’s issue of Anesthesia & Analgesia.

After bonding, the babies were placed on a table and skin temperature was measured.  Maternal core temperature was measured with a sublingual temperature probe. When mothers were passively warmed 81% of newborns were hypothermic after the skin to skin contact of bonding. Only 5% of newborns were hypothermic if the mothers were actively warmed. Active warming also increased the skin temperatures of neonates and the mothers’temperatures.  Mothers were more comfortable and had less shivering if they were actively warmed.

This is an interesting and well-designed study and timely given the hospitals that emphasize skin-to-skin bonding during the first hour after birth, even during cesarean delivery. Keeping mothers warm is important to the mother as well as her newborn infant.