Plastic Bags Prevent Hypothermia in Tiny Infants

June 03, 2013

By Will Boggs, MD

NEW YORK (Reuters Health) Jun 03 - Enclosing low birth weight infants in plastic bags from the neck down can reduce hypothermia in the early hours after birth, according to research conducted in Zambia.

"This is a very simple, low technology, low cost intervention that can be easily implemented in preterm infants, not just extremely preterm infants, to prevent hypothermia," Dr. Waldemar A. Carlo from the University of Alabama at Birmingham told Reuters Health by email.

In a randomized trial of 104 preterm and low birth weight infants born at University Teaching Hospital in Lusaka, Zambia, Dr. Carlo and colleagues investigated whether plastic (polyethylene) bags starting at birth would reduce hypothermia without causing hyperthermia.

Forty-nine infants were enclosed in plastic bags at birth. The other 55 were managed with a standard thermoregulation care strategy, as reported online June 3rd in Pediatrics.

An hour after birth, 59% of the plastic bag infants had a temperature in the normal range, compared with only 33% of control infants (p=0.007).

The mean temperature at one hour was significantly higher in the intervention group than in controls (36.5 vs 36.1 degrees C; p<0.001). No baby in either group had hyperthermia.

The plastic bags were associated with a 26% absolute reduction in the risk of hypothermia and a number needed to treat of four.

There were no differences in any of the secondary outcomes.

"The use of plastic bags or polyethylene wrapping in very low birth weight infants in the delivery room is a common practice in the developed world," the researchers note. "The relatively high prevalence of hypothermia, even in the larger infants enrolled in the current trial, suggests that these infants may benefit from placement inside a plastic bag shortly after birth."

"It is not known how long the plastic bags should be used to prevent hypothermia," Dr. Carlo said. More research is needed to determine that, he said, and also to evaluate the bags' impact on other important outcomes as well as to test its safety.

Still, he added, "This intervention has the potential to reduce neonatal hypothermia worldwide."

Dr. Rohana Jaafar from The National University of Malaysia, who has conducted similar research, told Reuters Health by email, "It is also important to control other factors that affect the infants' body temperature, especially environmental temperature."

"We usually keep the babies (wrapped) until they are in a neutral thermal environment, i.e., in an incubator, and their body temperature has stabilized," Dr. Jaafar said. "On average it takes about an hour."

Dr. Jaafar believes this approach is sufficiently inexpensive to apply to all infants at risk for hypothermia.


Pediatrics 2013.


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