ABSTRACT
The neonate has to initiate thermal control at birth. When born early, the physiological pathways necessary to commence this are not fully established; nor are there sufficient reserves in the premature infant to maintain thermal stability without compromising other body systems. To manage this situation successfully, the neonatal nurse must have a thorough knowledge of the systems involved in maintaining thermal stability and the means of assisting the infant in that vital transition time after birth, especially when the birth has been difficult or early. The role of the neonatal nurse is crucial in limiting heat loss at birth and in establishing a suitable environment in which the infant can be nursed. This caring begins before the infant is delivered by ensuring adequate facilities are available in the delivery suite, that equipment is ready for use to speed any resuscitative measures and that adequate warmth is provided (see p. 47). The nurse also has the responsibility to provide the right environment within the unit, ready to receive the infant after delivery. Without a thorough understanding of the systems of thermoregulation and the likely stage of development, dependent on the infant’s gestational age, the nurse is not empowered to make these choices. The neonatal nurse is at the ‘front-line’ when it comes to thermal management of infants and it is one of the few domains of therapy over which nursing can claim to have a firm grasp.
