Objectives To determine if polyethylene occlusive skin wrapping of very preterm infants prevents heat loss after delivery better than conventional drying and to evaluate if any benefit is sustained after wrap removal.

Study design This was a randomized controlled trial of infants <28 weeks' gestation. The experimental group was wrapped from the neck down. Only the head was dried. Control infants were dried completely. Rectal temperatures were compared on admission to the neonatal intensive care unit immediately after wrap removal and 1 hour later.

Results Of 55 infants randomly assigned (28 wrap, 27 control), 2 died in the delivery room and 53 completed the study. Wrapped infants had a higher mean rectal admission temperature, 36.5°C (SD, 0.8°C), compared with 35.6°C (SD, 1.3°C) in control infants (P=.002). One hour later, mean rectal temperatures were similar in both groups (36.6°C, SD, 0.7°C vs. 36.4°C, SD, 0.9°C, P=.4). Size at birth was an important determinant of heat loss: Mean rectal admission temperature increased by 0.21°C (95% CI, 0.04 to 0.4) with each 100-g increase in birth weight.       

Conclusions Polyethylene occlusive skin wrapping prevents rather than delays heat loss at delivery in very preterm infants.

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Comment:  It appears that placing small premature infants in a plastic bag after delivery does a better job of keeping them warm than does drying them.    Be careful that the plastic bag you are using does not contain any of the plasticizer materials (like DEHP) that are thought to cause neurotoxicity and other untoward effects in patients.  ABK