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The Globe and Mail

Plastic bags may help preemies keep warm

Stefanie Timmermann

As a fashion statement, it's somewhat lacking. But making a baby's first outfit a plastic bag may have some health advantages if the baby is a preemie.

A Canadian-led study is looking at whether placing premature infants in plastic bags for the first hour or two of life will not only reduce heat loss for these tiniest of babies, but also improve their long-term health and chances of survival.

In the high-tech world of neonatal intensive care units, it's a three-cent solution to a common and potentially dangerous problem - the rapid loss of body temperature when the amniotic fluid that babies are covered with at birth starts to evaporate, cooling their skin.

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"Everything out there now is a million-dollar piece of equipment. It's not often you get a three-cent bag that [can]make potentially an impact around the world," said Maureen Reilly, a respiratory therapist and a principal investigator of the Heat Loss Prevention Trial.

Ms. Reilly and co-investigator Sunita Vohra, both based at Toronto's Sunnybrook Health Sciences Centre, are collaborating with neonatal intensive care units around the world on the trial. The research is funded by the Canadian Institutes of Health Research.

When babies are born, they are typically cleaned up and placed naked under a heat lamp while a number of necessary procedures are done. But preemies have more medical needs and less ability to regulate their heat.

"As soon as the babies are born we dry them off. And a bigger baby can tolerate the wetness. But the little ones - they're so fragile. Even though we dry them off really quickly, they still do get cold," Ms. Reilly said.

Small pilot studies have shown that wrapping these babies in plastic - either plastic bags or even cling wrap - can keep them from cooling down while they undergo X-rays, have intravenous lines inserted, sometimes are even put on a ventilator to help them breathe. "Basically, you could use anything. But what it has to do is prevent the evaporative heat loss, but still allow the heat from the over-bed warmer to penetrate through the bag to the baby," she said.

What isn't clear, though, is whether there are any long-term gains. Are babies that have been wrapped in plastic less likely to become sick in the period after birth? Are they more likely to survive than other preemies? Does it make a difference to their long-term neurological development?

That's what this trial is designed to find out. Over the five or six years it will take to gather all the data, 1,685 premature babies born at 28 weeks gestation or lower will be randomly assigned - with the consent of their parents - to either receive standard treatment or to be put in a plastic bag.

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The bag, which does not cover the head, has an opening that gives health professionals access to the umbilical cord. Babies placed in a bag are worked on under a heat lamp, as are non-bagged babies. Bagged babies are eventually cleaned up when they are placed in a heated incubator.

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