Prevalence and risk factors for hypothermia on admission in Nigerian babies <72 h of age.

BACKGROUND: Hypothermia is a major contributor to early neonatal deaths especially in the developing world. Factors which predispose babies to hypothermia need to be identified for intervention purposes. OBJECTIVES: To determine the prevalence and risk factors for neonatal hypothermia at admission in the first 72 h of life. METHODS: Babies hospitalized within the first 72 h of life in a Nigerian Neonatal Unit were surveyed. Data collected included age, sex, weight, place of delivery, history of breastfeeding, recent bath, oil cleansing of the skin and presence of asphyxia. Babies with skin (axillary) temperature <36.5 degrees C were considered hypothermic. RESULTS: Of the 111 babies, 75 (67.6%) were hypothermic. The prevalence of hypothermia was high among babies aged <6 h (80.6%), preterm infants (88.9%), low-birth-weight babies (89.1%), babies with birth asphyxia (76.3%), babies without recent oiling of the skin (90.6%) and babies who had not been breastfed (79.2%). Using logistic regression, significant risk factors for early neonatal hypothermia at admission included low-birth-weight (P=0.000) and lack of breastfeeding (P=0.028). CONCLUSION: Most of the identified risk factors are preventable. The warm chain should be strictly applied in-hospital and be taught to mothers and community health workers.

Non-puerperal induced lactation: an infant feeding option in paediatric HIV/AIDS in tropical Africa.

A major problem in the management of infants exposed to HIV is the issue of feeding, which stems from the need to avoid transmission of the virus via breast milk. Other important issues in the nutrition of infants exposed to the virus include severe maternal illness, which makes suckling extremely difficult, and feeding orphans. Wet nursing is one of the recommended steps in addressing the feeding problems of such infants but for reasons of sociocultural disapproval, it appears not to be popular in traditional African settings. Non-puerperal induced lactation or re-lactation of a close relation, usually a grandmother, which hitherto has been used to rehabilitate severely malnourished motherless infants, may be equally useful. The procedure of re-lactation and the limitations of the method are highlighted. Also, the need to employ information, education and communication in improving the sociocultural acceptability of this veritable infant feeding method in tropical Africa is discussed.