Children's doctors concern over number of premature babies at hypothermia risk


Leading children's doctors have raised concerns over the number of premature babies being put at risk of hypothermia.

The Royal College of Paediatrics and Child Health (RCPCH) said that it was "concerning" that one in 20 premature babies are not having their temperature recorded in a timely manner.

A new audit by the college reveals that 5.5% of babies born at less than 32 weeks did not have their temperature recorded within an hour after birth.

The report highlights the importance of taking a baby's temperature on admission to the neonatal unit as low admission temperature has been associated with an increased risk of illness and death in pre-term infants.

It also shows that hypothermia remains a "common problem" in neonatal care across the UK.

More than a quarter (28%) of babies born in 2015 at less than 32 weeks had a temperature below the recommended range of 36.5C to 37.5C.

"Hypothermia is an easily preventable condition, even in vulnerable newborns, so if a baby is too cold, neonatal unit staff need to know so that they can take action to get the temperature back to normal," the National Neonatal Audit Programme (NNAP) report states.

Meanwhile, the audit also highlighted problems with communication between senior doctors and the parents of premature babies.

More than one in 10 (12%) did not have a documented consultation with a senior member of the neonatal team within 24 hours of their baby's admission.

The authors wrote: "Involving parents in their baby's care is crucial for achieving the best long-term outcomes; engaging them in the first 24 hours is an essential part of doing this.

"It is therefore vital that neonatal unit staff take the time to explain to parents how their baby is being cared for and also listen to parents, try to understand how they are feeling and respond to any questions that they may have."

The RCPCH said that the report showed very little or no improvement has been made over the last year in meeting several care standards across neonatal care.

Dr Sam Oddie, clinical lead for the audit and member of the RCPCH said: "Some units are doing remarkably well when it comes to meeting the care standards measured by the NNAP; however there are others that are simply not delivering on these yet. These units need to be looking at improving this."

Dr Oddie said: "100% of babies should have their temperature taken within an hour of birth and the fact this isn't happening is very concerning.

"If not monitored closely, low admission temperature can lead to hypothermia and severe illness, so getting this right is essential.

"Solutions to this problem can be remarkably simple. For example, many units use the combination of plastic bags, radiant warmers, hats and warm delivery rooms to maintain a newborn baby's temperature, and do it very well. Good practice like this needs to be shared."

On the findings relating to a lack of consultation with parents, Dr Oddie said: "When a baby is admitted to a neonatal unit, it can be a daunting time for parents. Having a doctor speak to them early about what is happening and the support on offer to them is extremely important."

Dr Oddie added that "27% of units did this for all their families, showing that there is no excuse for not providing this key element of support for parents. This is something I hope to see improved very quickly."

Around 750,000 babies are born each year in England, Scotland and Wales and of these nearly one in eight, or around 95,000, will be admitted to a neonatal unit.

Commenting on the audit, Caroline Davey, chief executive of Bliss, the charity for premature and sick babies, said: "These figures are very concerning.

"In order to prevent avoidable illness, units must ensure that all babies receive these check-ups within the timescales set down in national standards.

"Moreover, it is vital to involve parents in their babies' care to ensure the best possible health outcomes for them, and it is deeply disturbing that in so many cases this is still not happening."