Reduction of skin water loss in the newborn. II. Clinical trial of two methods in very low birthweight babies.
Two methods of reducing evaporative water and heat loss in the newborn, the thermal blanket and topical paraffin, were compared in a clinical trial. Forty-four babies weighing less than 1.5 kg, nursed in incubators since birth, were either covered with a plastic bubble blanket or had a paraffin mixture applied to their skin at 6- and 8-hour intervals for the first 2 weeks of life. There was no significant difference between the two groups in terms of mortality, morbidity, weight gain or loss, and temperature control. Two babies in the blanket group were removed from the study because of persistently low body temperatures. Five babies in the paraffin group had minor skin rashes and a further 2 had more extensive rashes which led to their removal from the study. Both methods resulted in good temperature control in babies after the first day of life. In the first 24 hours however, neither method of treatment could prevent subnormal body temperatures in the babies weighing less than 1.0 kg, even though the incubator air temperature was on average more than 1 degree C above the rectal temperature. Other methods are necessary to achieve normal body temperatures in these vulnerable babies.