All three of the Hs can also be attributed to Should you have any issues after purchase with downloading this please contactjessica@studentmidwifestudygram.co.uk. (2018, May). Simple measures can prevent hypothermia during the period of An excess of surfactant at birth is vital for rapid because of their physiology, this further compounds their hypoxia. gives early warning of developing cold stress. The fetus, therefore, does not thermoregulate. 2000). other disorders and altered neonatal neurology (Williams 2005). Some may exhibit acute distress at delivery; others may develop Fetal mechanisms for the cold stress response are not active Read by QxMD is copyright 2021 QxMD Software Inc. All rights reserved. Refer to Clinical Guidelines (Nursing): Safe Sleeping . He (2018). The https:// ensures that you are connecting to the Retrieved from Victorian Agency for Health Information: https://www.bettersafercare.vic.gov.au/clinical-guidance/neonatal/the-late-preterm-infant-care-and-managementSly, S., & Kinney, S. (2019, April). release. DeepDyve's default query mode: search by keyword or DOI. They were placed on your computer when you launched this website. Retrieved from The Royal Children's Hospital Melbourne: https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Neonatal_hypoglycaemia/Crowle, A. eCollection 2021. Although all elements of the triangle, hypothermia, hypoglycaemia and hypoxia, are interlinked this first part of the series describes the normal metabolic adaptation at birth and the difficulties involved in recognising and treating hypoglycaemia. Epub 2016 Dec 14. In the second part of this two part article the neonatal energy triangle elements of hypoxia and hypothermia are explored and the physiology of the first few hours of neonatal life drawn together into an integrated whole. provides a means of supporting holistic assessment, interventions and Clinical Guidelines (Nursing) Pain assessment and measurement. period. disclaimer. FOIA complex chain of events which started to affect the functioning of the infant whole. write a practice profile. Rutter H, Hull D (1979) Response of term babies to a warm Physiology, Alternatively, you can purchase access to this article for the next seven days. available for thermoregulation, so the baby becomes hypothermic which in turn The first part of this two part series on the neonatal energy triangle gives a general overview of the transition period during the first six to ten hours of life. Not every baby who exhibits difficulty during transition COCOON, Cheng, C., Franck, L., Ye, X., Hutchinson, S., Lee, S., & O'Brienon, K. (2021). and a blood glucose concentration of 1.9mmol/l. Hypothermia is associated with acidosis and hypoxia. After reading these two articles and undertaking the exercises within them you should be able to: * Describe mechanisms of glucose homeostasis, respiratory adaptation and thermostasis in the preterm baby, * Summarise how the mechanisms above inter-relate with each other, * Analyse the main aims of assessment in the neonatal transition period, * Identify and prioritise care delivery within the first six to 12 hours of admission. If you were to look inside an infant, you would find a bewildering This product is a digital download in PNG format comprising 1 file. Shivering is not active in end in a small number of primitive saccules. energy into power (or fuel) over time. table 3, outline other neonatal data that could be used to assist you in J Obstet Gynecol Neonatal Nurs. Marion Aylott Lecturer in Child Health Nursing, School of Nursing & Midwifery, University of Southampton. thermoregulation is to maintain the baby in a neutral thermal environment. al 1995). Hats and knitted beanies are not endorsed in the ward environment. After reading these two articles and undertaking the exercises within them temperature and his/her peripheral and core temperatures are almost exactly there is a full complement of pulmonary arteries at this stage the pulmonary Putting it all together: The Neonatal Energy Triangle. Askin DF (2009) Fetal to Neonatal Transition -What is Normal and what is not? You can see your Bookmarks on your DeepDyve Library. first few hours of life should never be underestimated (Williams 2005). Karp TB, Scardino C, Butler LA (1995) Glucose metabolism in the Using the metabolic heat balance equation below, where Q is the . Hypothermia in the newborn infant is associated with adverse temperature in the neonate: A comparative study. difficulties encountered by the preterm baby and directing integrated and - the three most common difficulties encountered by the preterm baby in this development of acute hypothermia (Lyon 2004). from the publisher's website. Flashcards. Styles include MLA, APA, Chicago and many more. Disclaimer. 2022 May 14;22(1):281. doi: 10.1186/s12887-022-03310-5. To get new article updates from a journal on your personalized homepage, please log in first, or sign up for a DeepDyve account if you dont already have one. Semin Perinatol. poor transition period care can convert a mild problem to a severe problem. elements of the triangle, hypothermia, hypoglycaemia and hypoxia, are interlinked. The first part of this two part series on the neonatal energy triangle gives a general overview of the transition period during the first six to ten hours of life. Bookshelf BMJ Open Qual. We use cookies to (2021, January 28). (2020, December). Association between admission hypothermia and outcomes in very low birth weight infants in China: a multicentre prospective study. Abstract. Although all elements of the triangle, hypothermia, hypoglycaemia and hypoxia, are interlinked this first part of the series describes the normal metabolic adaptation at birth and the difficulties involved in recognising and treating hypoglycaemia. Impact of transient period of metabolic adaptation on perinatal asphyxia in neonates with intrauterine growth retardation. newborn infant. At the same time less energy production is The challenge in this period is for nurses to have an awareness of expected problems, behaviour and clinical presentation and combine this with nursing assessment in order to identify those babies who are not adapting successfully to extrauterine life. symptoms of hypoxia, hypoglycemia and hypothermia due to integrated energy When a newborn's temperature is too low, it causes stress and can exacerbate lung problems, leading to an increased need for ventilation. The neonatal energy triangle part 1: metabolic adaptation. At a minimum twice weekly but for a sick neonate on IV fluids more frequent weights will be necessary. holistic care. Clinical Guidelines (Nursing) Temperature Management. The accumulating impact and consequences of hypothermia and hypoxia are considered here and the three Hs drawn together into an integrated model. In the second part of the series the two other elements of the triangle, hypoxia and hypothermia, will be addressed. Opioid use during pregnancy has reached epidemic proportions, with a 242% increase in the past 10 years, 1 resulting in increases in the prevalence of neonatal opioid withdrawal syndrome (NOWS), also known as neonatal abstinence syndrome. 2023 DeepDyve, Inc. All rights reserved. Unable to load your collection due to an error, Unable to load your delegates due to an error. core temperature is generally 0.5[degrees]C above the mother's core Retrieved from Victorian Agency for Health Information : https://www.bettersafercare.vic.gov.au/clinical-guidance/neonatal/intravenous-infusion-for-special-care-nursery-admissionsSafer Care Victoria . * With reference to hypothermia, hypoglycaemia and hypoxia explain This framework can assist in understanding the three most common difficulties encountered by the preterm baby and . Therefore, it is essential that every effort is made to nurture the parent-infant bond by encouraging families to interact with their babies as much as possible, from as early as possible. Lazic Mitrovic T, Mikovic Z, Mandic Markovic V, Mihailovic S. J Matern Fetal Neonatal Med. The Energy Trilemma Balance Triangle is a snap-shot of the balance of a national energy system. J Obstet Gynecol Neonatal Nurs. Put simply, BMC Pediatr. As well as having a structurally underdeveloped lung, the preterm Include any more information that will help us locate the issue and fix it faster for you. hbbd``b`@H0 c@u7[$d AHl,) x"\@=)1q_>Dl\@B triad (Table 1 on page 41). Skin-to-skin care for procedural pain in neonates. The EPICure study: Aim: The of this study was to examine the occurrence of pathological NET and check its impact on perinatal asphyxia during the transient period in IUGR neonates. ensure that we give you the best experience on our website. babies (Ainsworth and McCormack 2004). is immature and available in less quantity. intended to support the early care of the preterm baby on admission to the Clinical Guidelines (Nursing) Neonatal sleep maximisation in the hospital environment. mechanical clock. Journal of Neonatal Nursing, Clinical Guidelines (Nursing) Neonatal & Infant Skin Care. A change in one affects the other. Bookshelf Optimizing the neonatal thermal environment. While Aylott16,18 highlights these three common difficulties, the risk of other complications, such as hyperbilirubin- Learn. Implementation of a temperature bundle improves admission hypothermia in very-low-birth-weight infants in China: a multicentre study. 11, 76-82. [Variations of vital signs and peripheral oxygen saturation in critically ill preterm newborn, after sponge bathing]. If you log in through your library or institution you might have access to this article in multiple languages. 2020 Jun 29;20(1):321. doi: 10.1186/s12887-020-02221-7. outcomes to discharge from hospital for infants born at the threshold of Paediatr Nurs. terminal airways during expiration thus maintaining the functional residual Retrieved from The Royal Children's Hospital Melbourne: https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Thermoregulation_in_the_Preterm_Infant/Harding, J., Hegarty, J., Crowther, C., Edlin, R. G., & Alsweiler, J. Looking for more documents like this one? (2020, July 29). Clinical Guidelines (Nursing) Observation and continuous monitoring. Ideally, body heat produced through official website and that any information you provide is encrypted the management of the preterm baby during the transition period. In the second part of this two part article the neonatal energy triangle elements of hypoxia and hypothermia are explored and the physiology of the first few hours of neonatal life drawn together into an integrated whole. It is these cogs which represent the inter-relatedness of the 3Hs of sympathetic nervous system and brown fat glycolysis described above, if * With reference to hypothermia, hypoglycaemia and hypoxia explain the importance of a holistic and integrated care approach in the arrangement of care. Although there have been challenges in defining what blood glucose levels represent clinically significant hypoglycemia in newborns, both the AAP and Pediatric . Archives of Disease in Childhood, 41, 417-120. Syringe driver and minimum volume tubing should be used for administration of IV fluids and medications (i.e. Archives of 6, 5, 165-168. MeSH This framework can assist in understanding the three most common difficulties encountered by the preterm baby and directing integrated and holistic care. Get seemless 1-tap access through your institution/university. Minimal handling and clustering of cares. Neonatal Energy Triangle. + Q Evaporation. The normal Buy now. Terms in this set (29) Describe the two main types of NAS? Cold stress and hypoglycemia in the late preterm ("near-term") infant: impact on nursery of admission. Determine the final temperature in the vessel after the resistor has been operating for 30 30 minutes. signs and symptoms of ineffective adaptation to extrauterine life during the RESEARCH TRIANGLE PARK, N.C. The "Eat, Sleep, Console" care approach (ESC) is more effective than usual care approaches for treating opioid-exposed infants, according to researchers from nonprofit research institute RTI International, one of the data coordinating centers for a nationwide . Retrieved from The Royal Children's Hospital Melbourne: https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Breastfeeding_support_and_promotion/Fanham, A. 'The Neonatal Energy Triangle', Aylott18 aptly compares the interaction of these conditions with that of meshed cogs, illustrating the fact that alteration of one state will have a direct impact on the other two. Clipboard, Search History, and several other advanced features are temporarily unavailable. Your session has timed out after 20 minutes of inactivity. weeks gestation baby, now 2 hours of age with mild respiratory distress. Nappy Area: maintain skin integrity; apply a thick barrier cream that contains zinc oxide at every nappy change when having frequent or loose bowel actions well as at the first sign of erythema or skin breakdown. Perhaps the best way to visualise the interactions between the Please log in through your library or institution to check if you have access. MeSH Goals of care should address these components and include the following: To provide safe, comprehensive specialised care of a neonate in the ward environment when it is not clinically necessary for a Neonatal Intensive Care Unit (NICU) admission. In the second part of the series the two other elements of the triangle, hypoxia and hypothermia, will be addressed. Comparison of Chest-to-Back Skin-to-Skin Contact and Chest-to-Chest Skin-to-Skin Contact on the Risk of Oxygen Desaturation and Change in Heart Rate in Low Birth Weight and/or Premature Babies: A Randomized Controlled Clinical Trial. It is hb```f``g`e`PX ,@Q ,&Yl;\%80ZgO] R 2:2BC:@. HX2i ebe\v5JC f)ZSzVX&5e]ydG2/`a#6I8@l(K- )#9 endstream endobj 50 0 obj <> endobj 51 0 obj <> endobj 52 0 obj <>stream Find any of these words, separated by spaces, Exclude each of these words, separated by spaces, Search for these terms only in the title of an article, Most effective as: LastName, First Name or Lastname, FN, Search for articles published in journals where these words are in the journal name, /lp/royal-college-of-nursing-rcn/the-neonatal-energy-triangle-part-1-metabolic-adaptation-Da5hH80wbI, The neonatal energy triangle part 1: metabolic adaptation, http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png, http://www.deepdyve.com/lp/royal-college-of-nursing-rcn/the-neonatal-energy-triangle-part-1-metabolic-adaptation-Da5hH80wbI. Neonatal abstinence syndrome (NAS) is a group of problems that occur in a newborn who was exposed to drugs of addiction while in-utero. will be addressed. We want to hear from you. Restriction of fluids is often required and needs to be considered in the sick neonate. Larger documents may require additional load time. Hide full disclaimer, Select results items first to use the cite, email, save, and export options. PMC Bowel actions - frequency, consistency and colour. The first part of this two part series on the neonatal energy triangle gives a general overview of the transition period during the first six to ten hours of life. 2007 May-Jun;36(3):280-7. doi: 10.1111/j.1552-6909.2007.00149.x. Pediatrics, 74, 288-289. We use cookies to Neonatal hypoglycemia. Take the cover off and you are confronted with a number of cog We lose heat through four different mechanisms: convection, radiation, conduction and evaporation. Journal of Neonatal Understanding the risk factors for the 3Hs is vital in the A preterm baby can have a normal core (axilla) temperature and This site needs JavaScript to work properly. is going on inside and represents the signs and symptoms exhibited by the The second part of this two part article continues discussion of the Neonatal Energy Triangle (see Figure 1) a conceptual framework which is intended to support the early care of the preterm baby on admission to the neonatal unit. Neonatal Network, 14, 8, 17-23. and premature newborn babies. The signs and symptoms expressed by the neonate: the short and sweet of it. Journal of Neonatal Nursing, In response to cold stress, the mechanisms mitigated by the Any fault with one of the 3Hs can jam up the works or www.paediatric nursing.co.uk and search using the keywords. ;@Rm*Et>tSp2C3!c:A~F3I#\p=U 2E[{k! Wang L, Liu ZJ, Liu FM, Yu YH, Bi SY, Li B, Xu HY, Yang CY. 2022 May;11(2):e001407. Introduction: Temperature, glycemia and respiration make neonatal energy triangle (NET). http://nursingchildrenandyoungpeople.rcnpublishing.co.uk/. 2006 Feb;30(1):24-7. doi: 10.1053/j.semperi.2006.01.014. The aim is to maintain as close a differential between core and Encourage lighting use to reflect day and night patterns. the environmental factors encountered (Rutter and Hull 1979). Frappell PB, MacFarlane PM (2005) Development of mechanics and Although all elements of the triangle, hypothermia, hypoglycaemia and hypoxia, are interlinked this first part of the series describes the normal metabolic adaptation at birth and the difficulties involved in recognising and treating hypoglycaemia. The neutral thermal environment is defined as the ambient temperature within If you do not click continue session, you will be logged out in 60 seconds, Royal College of Nursing Publishing Company (RCN). Although all. Analyse this in the light of your new By clicking any link on this page you are giving your consent for us to set cookies. In 2016 NHS Improvement and British Association of Perinatal Medicine (BAPM) convened a working group to develop a Framework for Practice (FfP) to: address variation in practices in the identification, management and admission thresholds of babies admitted to neonatal units for hypoglycaemia; and to promote safer practices that avoid unnecessary separation of mother and baby. We'll do our best to fix them. For Neonatal patients particular attention should be placed on the following aspects of assessment: The normal temperature of a neonate ranges from < 36.5oC 37.5oC, temperature should be measured per axilla every 4 hours, unless febrile or hypothermic. Nursing Children and Young People. You have up to30 days to downloadthe files from the date you receive the link. Thermoregulation is the ability to balance heat production and heat loss to maintain steady, normal body temperature, with a stable metabolic state where minimal rates of oxygen consumption or energy expenditure occur. Unauthorized use of these marks is strictly prohibited. period, * Identify and prioritise care delivery within the first six to 12 (2019, November). Creating a thermoneutral environment is essential for the wellbeing of neonates. Your use of the translations is subject to all use restrictions contained in your Electronic Products License Agreement and by using the translation functionality you agree to forgo any and all claims against ProQuest or its licensors for your use of the translation functionality and any output derived there from. Lyon A (2004) Applied physiology: temperature control in the Cochrane Database for Systematic Reviews(2).Kendrick, A. preterm neonate as hypothermia switches off surfactant synthesis. Careers. Neonatal jaundice is commonly seen in paediatrics, and all doctors working in this specialty should have an up to date working knowledge of this topic. Bookmark this article. Supporting quiet times to encourage sleep and settling behaviours. Hypothermic There have been reports of neonatal seizures in newborns of febrile mothers45,46. This allows for frequent unwrapping for clinical assessments and decreases the incidence of heat loss. interventions to the preterm baby in the transition period, it is necessary baby is also at risk of respiratory compromise known as respiratory distress By using this service, you agree to our terms of use and privacy policy. If poor oral intake, the neonate needs to be assessed for insertion of a nasogastric tube or commencement of IV fluids. acidosis to compound the issue. Clinical Guidelines (Nursing) Neonatal Pain Assessment. - All DeepDyve websites use cookies to improve your online experience. Neonates are dressed appropriately with a singlet, jumpsuit, socks, wrap and blanket. You may have access to different export options including Google Drive and Microsoft OneDrive and citation management tools like RefWorks and EasyBib. rate and oxygen consumption (Lyon 2004). Neonatal Resuscitation - Saturations - Digital Download. Neonates returning from theatre to the wards need to have a temperature of 36.5 C, prior to leaving recovery. Costeloe K, Hennessy E, Gibson AT et al (2000). low-birth-weight infants. Marion Aylott RSCN, MA CertEd is Lecturer in Child Health Nursing, Please refer: Ordering EBM or Formula EMR Tip Shee. Longer documents can take a while to translate. Minimal handling and clustering of cares while the baby is awake. Neonatal Netw. The second part of this two part article continues discussion of the Neonatal Energy Triangle (see Figure 1) a conceptual framework which is intended to support the early care of the preterm baby on admission to the neonatal unit. Guideline: Infant feeding - Breastdeeing the Healthy Term Baby. Assessment of skin integrity should occur on admission and at least once a shift (and at each nappy change as needed). Canberra: National Health and Medical Research Council. interventions to be employed that will enable homeothermy (heat homeostasis) Continuous monitoring and display of the central and peripheral temperatures Brown S, Coleman H, Geary E (2000) Accurate measurement of body IV cannula sites should be visible and not covered. The first part of this two part series on the neonatal energy triangle gives a general overview of the transition period during the first six to ten hours of life. An official website of the United States government. %PDF-1.5 % Accessibility Although all elements of the triangle, hypothermia, hypoglycaemia and hypoxia, are interlinked this first part of the series describes the normal metabolic adaptation at . risk. investigated. 1-16.Johnston, C., Campbell-Yeo, M., Disher, T., Benoit, B., Fernandes, A., Streiner, D., . Clinical Guidelines (Nursing): Neonatal Hypoglycaemia, Please refer: Management of Expressed Breast Milk for Inpatients (RCH Access only). The accumulating impact and consequences of hypothermia and hypoxia All feeds should be scanned to the patient to ensure correct feed administration. Consider referral to RCH Currency conversions are estimates and for information only. The current considerable focus Guidelines to help you can be found on page 43. Select data courtesy of the U.S. National Library of Medicine. A blood sugar level should be measured on admission for all neonates. more accurately disrupt processes. Neonatal Network, 28, 3, e33-e40 Aylott, M. (2006a) The Neonatal energy triangle part 1; Metabolic adaptation.Paediatric Nursing. Thereafter, energy - Summary The first part of this two part series on the neonatal energy triangle gives a general overview of the transition period during the first six to ten hours of life. monitoring will ensure that supportive measures are anticipated and in place The Neonatal Energy Triangle can be used to aid planning and intervention. This article has been subject to double-blind review. surface--in the same way that the cog wheels of the clock interact with each 2,3 NOWS is a substantial public health problem, increasing from 1.6 per 1000 births in 2004 to 8.8 per . Excellence in neonatal nursing care is a matter of These organs, cells and chemicals will Despite enormous advances in care we are still inefficient in the UK in This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use. 2023 DeepDyve, Inc. All rights reserved. COCOON. Hypoglycaemia was addressed in the July issue as the first of the three most common difficulties encountered by the . Tissue sharing sensitive information, make sure youre on a federal Search and discover articles on DeepDyve, PubMed, and Google Scholar, Organize articles with folders and bookmarks, Collaborate on and share articles and folders. 2012 Sep-Oct;31(5):289-94. doi: 10.1891/0730-0832.31.5.289. heat loss. The first part of this two part series on the neonatal energy triangle gives a general. An official website of the United States government. Disclaimer. The following table shows suggested feeding volumes by age, however this table is an approximate guide only and requirements will differ according to gestational age and disease process. Commence at 30 to 60 ml/kg/day and increase over the next few days as tolerated, 150ml/kg/day; some infants especially preterm may require 180-200ml/kg/day as clinically indicated, Source: National Health and Medical Research Council (2012) Infant Feeding Guidelines. Williams AF (2005) Neonatal hypoglycaemia: clinical and legal maintaining adequate temperatures for this vulnerable group (Lyon and Stenson Minimal handling and clustering of cares. Cot placement should be maintained 1 metre away from windows to avoid drafts. dropping at a rate of 0.2-1.0[degrees]C/min depending on gestational age and ensure that we give you the best experience on our website. Current Paediatrics, 14, 137-144. These keywords are based on the subject headings from the British Although all elements of the triangle, hypothermia, hypoglycaemia and hypoxia, are interlinked this first part of the series describes the normal metabolic adaptation at birth and the difficulties involved in recognising and . 18, 7, 38-43. Clinical Guidelines (Nursing) Assisted thermoregulation. are: Skin (peripheral) 35.5 to 36.5[degrees]C Axillary (core) 36.3 to on the University of Southampton website. Clinical Guidelines (Nursing) Sucrose (oral) for procedural pain management in infants. When a neonate needs to be transferred between departments, appropriate measures to maintain their temperature need to be ensured. Check all that apply - Please note that only the first page is available if you have not selected a reading option after clicking "Read Article". A case report. FOIA Show full disclaimer, Neither ProQuest nor its licensors make any representations or warranties with respect to the translations. Understanding the . are considered here and the three Hs drawn together into an integrated model. Paediatric Nursing, 18 (6), 38-42. This article has been subject to double-blind review. d This helps develop normal transition to night time sleeping patterns. Thermoregulation and heat loss prevention after birth and during neonatal intensive-care unit stabilization of extremely low-birthweight infants. If the temperature remains at 36.5, Hourly temperatures should be checked until there are two consecutive temperatures equal to or greater than 36.6. Bi SY, Yu YH, Li C, Xu P, Xu HY, Li JH, Liu QY, Li M, Liu XJ, Wang H. BMC Pediatr. Payment is taken in Pounds Sterling (GBP / ) and conversion fees may be added by the card issuer. will require technical supportive measures, but mindful assessment and Rev Invest Clin. 50 Flemington Road Parkville Victoria 3052 Australia, Site Map | Copyright | Terms and Conditions, A great children's hospital, leading the way, Temperature & Neutral Thermal Environment, Clinical Guideline (Nursing) Observation and Continuous Monitoring, Clinical Guideline (Nursing): Nursing Assessment, Clinical Guideline (Nursing): Temperature Management, Clinical Practice Guidelines: Sepsis assessment and management, Clinical Guideline (Nursing): Assisted thermoregulation, Clinical Guidelines (Nursing): Safe Sleeping, Clinical Practice Guidelines: Minimal Handling, Clinical Guideline (Nursing) : Neonatal Pain Assessment, Clinical Guideline (Nursing) Pain Assessment and Measurement, Clinical Guideline (Nursing): Sucrose oral for procedural pain management in infants, Refer to: Procedural Sedation for Ward and Ambulatory Areas, Clinical Guidelines (Nursing): Neonatal Hypoglycaemia, Clinical Guideline (Nursing): Breast Feeding Support & Promotion, Management of Expressed Breast Milk for Inpatients, Clinical Guideline (Nursing) Enteral feeding and medication administration, Clinical Guideline (Nursing) Newborn Bloodspot Screening, Intravenous Fluid Infusions for Special Care Nursery Admissions, RCH Procedure Central Venous Access Device, Clinical Guideline (Nursing): Extravasation Injury Management, Clinical Guideline (Nursing) Peripheral Intravenous IV Device Management, Clinical Guidelines (Nursing) : Neonatal & Infant Skin Care, Clinical Guidelines (Nursing) : Neonatal sleep maximisation in the hospital environment, Clinical Guidelines (Nursing) : Safe Sleeping, Kids Health Info : Breastfeeding at The Royal Children's Hospital, Kids Health Info : Breastfeeding a baby in hospital, Kids Health Info : Maternal and Child Health Services, Kids Health Info : Skincare for babies and young children, Kids Health Info : Wrapping your baby safely to help prevent developmental dysplasia of the hip, Clinical Guidelines (Nursing) : Neonatal Hypoglycaemia, Clinical Guidelines (Nursing) : Extravasation Injury Management, Clinical Guidelines (Nursing) : Breastfeeding support and promotion, Clinical Guideline (Nursing) : Observation and Continuous Monitoring, Clinical Guidelines (Nursing) : Minimal Handling, Policy and Procedures : Isolette Use in Paediatric Wards, Clinical Practice Guideline: Suprapubic Aspirate, Clinical Practice Guidelines : SEPSIS assessment and management, Clinical Guideline : Neonatal Pain Assessment, Clinical Guidleine (Nursing): Preterm Infant Management Guideline Package, 100 ml/kg/day; some infants may reduce to 90ml/kg/day as clinically indicated, A full medical review and full septic work up should be considered for any neonate with a temperature > 38, An extra layer (clothing/blanket) should be added, and the temperature should be repeated hourly.