Thermoregulatory effects of swaddling in Mongolia: A randomised controlled study

Tsogt, Bazarragchaa; Manaseki-Holland, Semira; Pollock, Jon; Blair, Peter S; Fleming, Peter

Abstract

Objective To investigate thermal balance of infants in a Mongolian winter, and compare the effects of traditional swaddling with an infant sleeping-bag in apartments or traditional tents (Gers).

Design A substudy within a randomised controlled trial.

Setting Community in Ulaanbaatar, Mongolia.

Subjects A stratified randomly selected sample of 40 swaddled and 40 non-swaddled infants recruited within 48 h of birth.

Intervention Sleeping-bags and baby outfits of total thermal resistance equivalent to that of swaddled babies.

Outcome measure Digital recordings of infants’ core, peripheral, environmental and microenvironmental temperatures at 30-s intervals over 24 h at ages 1 month and 3 months.

Results In Gers, indoor temperatures varied greatly ( < 0– > 25°C), but remained between 20°C and 22°C, in apartments. Despite this, heavy wrapping, bed sharing and partial head covering, infant core and peripheral temperatures were similar and no infants showed evidence of significant heat or cold stress whether they were swaddled or in sleeping-bags. At 3 months, infants in sleeping-bags showed the ‘mature’ diurnal pattern of a fall in core temperature after sleep onset, accompanied by a rise in peripheral temperature, with a reverse pattern later in the night, just before awakening. This pattern was not related to room temperature, and was absent in the swaddled infants, suggesting that the mature diurnal pattern may develop later in them.

Conclusions No evidence of cold stress was found. Swaddling had no identifiable thermal advantages over sleeping-bags during the coldest times, and in centrally heated apartments could contribute to the risk of overheating during the daytime.

Trial registration number ISRTN01992617.

Citation

Tsogt, B., Manaseki-Holland, S., Pollock, J., Blair, P. S., & Fleming, P. (2016). Thermoregulatory effects of swaddling in Mongolia: A randomised controlled study. Archives of Disease in Childhood, 101(2), 152-160. https://doi.org/10.1136/archdischild-2014-307908

• Journal Article Type: Article
• Acceptance Date: Sep 26, 2015
• Online Publication Date: Oct 29, 2015
• Publication Date: Feb 1, 2016
• Deposit Date: Mar 9, 2016
• Publicly Available Date: Mar 9, 2016
• Journal: Archives of Disease in Childhood
• Print ISSN: 0003-9888
• Electronic ISSN: 1468-2044
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 101
• Issue: 2
• Pages: 152-160
• DOI: https://doi.org/10.1136/archdischild-2014-307908
• Keywords: Mongolia, swaddling
• Public URL: https://uwe-repository.worktribe.com/output/923987
• Publisher URL: http://dx.doi.org/10.1136/archdischild-2014-307908