The Effect of Bundling on Neonatal Body Temperature

ABSTRACT

PURPOSE: Fever in newborn might be an indicator of serious bacterial infection. Differentiating environmental from disease-related temperature elevations in newborn is clinically important, because neonate with environment-related temperature elevation might be subjected to an unnecessary work-up to detect occult disease. But there are exists no consistent conclusions about environmental effect in previous literatures. We prospectively evaluated the effect of bundling on body temperature. METHODS: Twenty-five well, full-term newborns within 1 week old were assigned to the control group (one blanket) or to the study group (five blankets and hat). Rectal and axillary temperatures and arousal states were measured at 15-minute interval for 2 hours. RESULTS: There were 13 control and 12 study newborns. The mean axillary temperature of contol group increased by 0.21 degrees C; mean rectal temperature increased by 0.23 degrees C. The mean axillary temperature of study group increased by 0.63degrees C; mean rectal temperature increased by 0.56 degrees C. Comparing study newborns to controls, there were significant rises in both axillary temperature and rectal temperature. One newborn of the study group reached 38.3 degrees C in rectal temperature. CONCLUSION: Bundling can cause significant elevations in axillary and rectal temperature in newborn within 1 week old. Therefore, physicians treating neonates with elevated temperature should question whether to use bundling to differentiate endogenous from exogenous causes.