Baby with Low Core Body Temperature – Causes, Symptoms, and Prevention

Introduction

The normal body temperature of a baby lies between 36 to 37 degrees Celsius, which may vary 0.6 degrees F above or below this limit for different babies. Any further changes in the temperature range may result in fever or hypothermia. The temperature of the bodies of children fluctuates with their activity levels, nutrient intake, and various other ailments. Your baby is suffering from fever if the body temperature goes above 37.5 degree Celsius or 99.5 degrees F. If the body temperature dips below 35 degrees C, then this condition is known as Hypothermia.

Newborn babies or infants are more prone to developing the condition of hypothermia as their body has more surface area as compared to the weight and can reduce the body heat more easily than adults and term or preterm babies also have higher water loss from the skin (1). Among these neonates, the babies with low birth weight have a higher risk of developing the condition and are prone to decreased core temperature.

Causes

To maintain normal temperature, several systems of the body have to work together and therefore, low body temperature is attributed to many factors such as:

  • Cold Environment:
    If the surroundings are cold or the temperature is low then it may result in hypothermia. Excessive air conditioning is also harmful to the infant.
  • Infections:
    If your child has low immunity levels, then he may develop the condition due to infections and it may also be a side effect of medications.
  • Deficiencies:
    Nutritional deficiencies may also lower the temperature of the body. It is a common thing to observe that the body of the kid feels cold to touch when he’s hungry.
  • Neurological Issues:
    Toddlers suffering from neurological problems may also experience low body temperatures and may suffer from hypothermia.

Other Causes:

  • Abnormal oxygen or food supply.
  • Abnormalities in the functioning of thyroid glands which regulate the metabolic activity.
  • The skin structure, body hair, and weight of the body are the factors that are responsible for reducing the amount of heat loss from the body.
  • Anemia, an iron deficiency may also lower the body temperature.
  • Diseases related to the immune system are also responsible for lowering the body temperature.
  • Wearing clothes that aren’t warm enough or improper attire in the cold environment.

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Types

There are three types of hypothermia depending on the drop in temperatures of the body as given by WHO. These ranges may vary slightly, but these can serve as a guideline for determining and assessing the level of hypothermia in your kid.

1. Cold or Mild Hypothermia

When the body temperature of the baby dips slightly and is between 36.0 C to 36.4 degrees C (96.8 F – 97.5 F), then he/she is suffering from mild hypothermia.

2. Moderate Hypothermia

When the temperature of your baby is between 32.0 C to 35.9 degrees C (89.6 F to 96.6 F), then he/she is suffering from moderate hypothermia.

3. Severe Hypothermia

When the temperature dips further below 32 degrees, then this condition is of severe hypothermia.

Symptoms

To know whether the baby is suffering from hypothermia or not, parents, caregivers, and medical personnel should look at the sign and symptoms that the baby shows.

The symptoms of mild hypothermia may include:

In case of moderate hypothermia:

  • Violent, uncontrollable shivering
  • Slurred speech
  • Shallow breathing
  • Difficulty moving around

If your baby is suffering from chronic or severe hypothermia, then in addition to above symptoms, he may show these symptoms:

  • Weight loss
  • Failure to thrive
  • No weight gain
  • Dilated pupil
  • Weak, irregular or low pulse
  • unconsciousness
  • No shivering
  • Abnormal ECG reading
  • Heart rate below 60 per minute.
  • Faint pulse, sometimes even difficult to detect.

Measures to be Taken at Home

  • Remove any wet clothing, if at home.
  • Use room heater and warm the room to 25 degrees or more.
  • If the baby is more than 6 months old, give him a warm drink.
  • Swaddle the neonate in a warm blanket.
  • To minimize the metabolic rate, keep the infant or neonate in the neutral thermal environment.
  • Use hot packs, chemical heating pads on the chest, neck, back, and other areas of the body.

Prevention

WHO has given a set of 10 interlinked procedures called “Warm Chain”, which is carried out right from birth to after birth in order to minimize the risk of hypothermia and prevent it (2).

  • Delivery must be conducted in a warm room (> 25°C)
  • Adapt warm resuscitation process
  • dry the baby immediately
  • There must be skin-to-skin contact between baby and the mother
  • Timely Breastfeeding
  • Postpone bathing and weighing
  • Proper clothing and bedding
  • Keep the mother and baby together
  • Ensure warm transportation
  • Training/awareness of health-care providers

Now, these steps are followed as:

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During Delivery

  • The delivery must be conducted in a warm room and s/he should be immediately dried with a soft and warm towel. Simultaneously use another towel to cover the body of the newborn.
  • Cover the head and keep the baby beside the mother because the temperature of the mother helps keep the baby warm.

Bathing

  • Avoid bathing the baby immediately after birth and if the baby is normal, bathe him on the second day in summers.
  • Give a longer time gap in winters.
  • Use warm room and warm water and bathe them gently.
  • After it, wrap the baby in a warm and dry towel and ensure that the head is also covered.

Cot-Nursing in Hospital

  • Clothe the baby properly and adequately.
  • Keep ambient temperature warm according to the weight and post-natal age of the baby.
  • Monitor the temperature of baby’s body frequently (preferably every 3 hours) during initial days.

Skin-to-skin Contact (The Kangaroo Method)

Kangarooing is a technique that helps maintain the temperature of the newborn, increases the time of breastfeeding, and also improves mother-infant bonding. If the baby is born with no sign of distress or without extreme prematurity, then this method can be administered to him at home apart from the hospitals. But, if the baby is born LBW (less than 2500 gms), then he needs special care.

  • Keep the baby naked (or with nappy) over the mother’s chest inside her clothing.
  • Let the baby feed as often as s/he wants, but in every 2 hours, and the position of the mother must be in such a way that the baby stays upright.
  • Keep the baby in warm temperature, and if the temperature of surroundings is low, properly dress the baby and make sure to cover his/her head.
  • If the mother is not close to the baby, any other family member must perform the method and the baby must be covered in a warm blanket or several layers of clothing.
  • Visit a doctor time to time for regular checkups, vaccinations, and weight record.

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Maintaining Temperature During Transport

This is the most crucial task of the “Warm Chain” method as less number of equipments and medical care is available during the transport. To prevent the condition of hypothermia during travel:

  • Ensure that the temperature of the baby is stabilized before travel.
  • Measure the temperature and always take remedial measures before traveling. If no equipment is available to record the temperature, use touch to judge the temperature and the temperature of hand, feet, and abdomen must be same and warm.
  • While traveling, keep the baby on the chest of the mother.
  • Dress the baby suitably and cover his hands, feet, head properly. Don’t change the clothes or undress often.

When to See a Doctor?

When the body temperature of the kid drops below 32 degree C or he/she is suffering from chronic or severe hypothermia, then immediate medical attention should be provided or emergency care should be administered to him. As any temperature below this level is life threatening and may lead to organ failure and other problems. Also, the thermometers at this low level are generally not accurate and may give wrong readings; therefore, special low-temperature thermometers known as rectal thermometer are used in hospitals for measuring the accurate temperature.

If a baby who usually has normal temperature witnesses a sudden fall in temperature, then he must be taken to a doctor immediately.

If the condition is getting worse, even when the preventive measures are being taken, then also you must take your toddler to a doctor immediately.

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