Abstract
Objective: To study if continuous temperature monitoring helps to prevent excessive postnatal weight loss in healthy newborns during hospital stay.
 Design: Prospective randomised controlled trial
 Setting: Postnatal ward of a tertiary level hospital in south-west India, between July 2018 and October 2018.
 Participants: 515 healthy newborns born in the hospital during the study.
 Intervention: Mothers were given the BEMPU device within 24 hours of delivery and taught to recognize alarms and take measures to treat hypothermia when the device alarmed till the baby was discharged from the hospital. All healthy newborns born in the hospital were included in the study and random allocation was done to either the intervention or control group. Babies who were sick and admitted in NICU and babies with congenital anomalies were excluded. 
 IEC approval was obtained prior to the study. 
 Outcome measures: postnatal weight loss.
 Results: 515 babies were included in the analysis. For vaginal deliveries; 163 babies were in the intervention group and 168 were in the control group. The mean lowest weight was higher and the mean weight loss was lower for the intervention group. For caesarean deliveries, 91 babies were in the intervention and 93 were in the control groups. The mean lowest weight was higher and the mean weight loss was lower for the intervention group for cesarean deliveries as well.
 Conclusions: Continuous monitoring of the temperature helps to prevent excessive postnatal weight loss in healthy babies born by spontaneous vaginal deliveries.
 Keywords: Hypothermia, Newborn, Temperature, Weight loss
Highlights
It is well known that some degree of early neonatal weight loss is normal
All healthy newborns born in the hospital were included in the study and random allocation was done to either the intervention or control group
Using a type 1 error of 0.05, the power of the study was calculated as 96%. 254 babies received the intervention and 261 babies were controls. 24.8% babies had excessive weight loss among the intervention group compared to 37.5% in the control group
Summary
It is well known that some degree of early neonatal weight loss is normal. On the first 2-3 days of life, neonates that are exclusively breastfed lose on average between 5% and 7% of their birth weight. There are some well-documented factors that are correlated with increased weight loss after birth. For a small percentage of infants, excessive weight loss may indicate a problem including poor breastfeeding management, undiagnosed metabolic disorders, neurological disorders, or other infant morbidities that cause poor feeding [3]. A serious consequence of persistent feeding problems and excessive weight loss can be hypernatremic dehydration, complications of which may include renal and liver failure, disseminated intravascular coagulation, intracranial hemorrhage, seizure, and death [4]. Apart from these there are other influential factors of hypothermia in new-borns that include inadequate clothing, unregulated environmental temperature and delayed breastfeeding. Apart from these there are other influential factors of hypothermia in new-borns that include inadequate clothing, unregulated environmental temperature and delayed breastfeeding. [17]
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