Wrapping newborn infants in cloth and newspaper after delivery led to higher temperatures on arrival at the neonatal intensive care unit

Aim: Neonatal hypothermia is a preventable cause of neonatal mortality and morbidity, and wrapping neonates in newspaper sandwiched between cotton sheets is a simple intervention. This 2017 Indian pilot study tested the heat insulating property of sandwiched sheets. Methods: At birth, we randomised 100 neonates who were more than 32 weeks of gestation and needed neonatal intensive care unit (NICU) observation or care without a ventilator or bilevel positive airway pressure support into two groups of 50. The intervention and control groups were wrapped in two prewarmed sheets at birth that did or did not contain a layer of newspaper. Their axillary temperatures on arrival at the NICU and one hour after arrival were measured. Other environmental factors were similar. Results: The neonates wrapped in the sandwiched sheets showed significantly higher temperatures on arrival at the NICU than the control group (35.9 degrees C versus 35.4 degrees C, p < 0.01) and after one hour (36.5 degrees C versus 36.3 degrees C, p < 0.01). No change in behaviour or training was required for the healthcare staff to implement this initiative. Conclusion: Wrapping newborn infants in two cloth sheets with a newspaper layer resulted in a higher body temperature on arrival at the NICU and after one hour.