Reusable Mattress Warmer Treats Neonatal Hypothermia

A low-cost, non-electric, reusable infant mattress based on the concept of a heating pad can help prevent and treat hypothermia in newborns, according to a new study.

The Dream Warmer, developed by researchers at Partners In Health/Inshuti Mu Buzima (PIH/IMB; Kigali, Rwanda), Boston Children’s Hospital (BCH; MA, USA), and other institutions, is based on a mattress containing 12 phase change material “candles” designed by PureTemp (Minneapolis, MN, USA) that melt to skin temperature and remain so for up to six hours. Once cooled down, the mattress can be cleaned and reused multiple times. It was specifically designed to complement skin-to-skin care (SSC) kangaroo mother care (KMC), either when it provides insufficient heat or if the mother needs to take a break.

To test the mattress, the researchers conducted a cluster-randomized stepped-wedge trial to assess its effect on euthermia and mortality, compared to standard of care in rural Rwandan hospitals. Ten district hospitals enrolled 464 unique infants who used the warmer 892 times. The results showed euthermia rates rose from 51% to 67%; among the encounters in which the warmer was used, only 11% remained hypothermic. Mortality rate among those who used the warmer (0.9%) were also significantly lower than among those who did not (2.8%). The study was published on April 16, 2021, in eClinicalMedicine.

“Infant hypothermia is a silent killer, but it's a modifiable risk factor, and this study shows that reducing it can have a large impact on survival and also likely on the long-term neurodevelopment of these babies,” said senior author Anne Hansen, MD, MPH, of BCH. “This is a good option for treatment in setting where incubators are not the right solution, whether it is because they are too expensive, require electricity, or require extensive training to correctly use and maintain.”

KMC was introduced in 1978 by Edgar Rey Sanabria, MD, in Bogotá (Colombia) as an alternative to incubators for low birth weight infants. KMC has four components: early, continuous, and prolonged SSC between the newborn and mother; exclusive breastfeeding; early discharge from the health facility; and close follow-up at home. It is thought to improve neonatal outcomes by maintaining infant temperature through SSC and by providing the benefits of breastfeeding, which are beneficial for all newborns, but may be especially advantageous for preterm infants.

Related Links:
Partners In Health/Inshuti Mu Buzima
Boston Children’s Hospital
PureTemp