Neonatal Cold Injury

Neonatal cold injury usually occurs in abandoned infants or those in inadequately heated homes during damp cold spells when the outside temperature is in the freezing range .

Clinical Features:
The initial features are apathy, refusal of food, oliguria, and coldness to touch. The body temperature is usually between 29.5 and 35°C (85–95°F), and immobility, edema, and redness of the extremities, especially the hands, feet, and face, are observed. Bradycardia and apnea may also occur. The facial erythema frequently gives a false impression of health and delays recognition that the infant is ill. Local hardening over areas of edema may lead to confusion with scleredema. Rhinitis is common, as are hypoglycemia and acidosis. Hemorrhagic manifestations are frequent; massive pulmonary hemorrhage is a common finding at autopsy.

Treatment :
Consists of warming and paying scrupulous attention to recognizing and correcting hypotension and metabolic imbalances, particularly hypoglycemia.

Prevention :
Consists of providing adequate environmental heat.

The mortality rate is about 10%; about 10% of survivors have evidence of brain damage