By Lucia Raatma
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Extra resources for Caring
Hyperbilirubinemia 37 day or two following delivery. They immediately have the risk factor of prematurity and may exhibit numerous other risk factors, such as infection, hypoxia, metabolic acidosis, hypothermia, and hypoglycemia. Many other risk factors, as listed earlier, may also be present in this population of infants. Temperature Instability and Its Affect on Bilirubin As discussed in Chapter 4, “Temperature Instability, Hypoglycemia, and Increased Metabolism,” metabolism of brown fat, which occurs in the first few hours after birth as a mechanism of heat production, results in the release of fatty acids.
The shivering helps increase core temperature. Likewise, increased metabolic activity, such as exercise, helps to increase core temperature. Sweating helps to cool us down when core temperatures become higher than normal. Neither of these autonomic responses to heat or cold is present in the newborn, so regulation of temperature becomes much more difficult and complex for them. BROWN FAT: ITS ROLE IN THERMOREGULATION Fetuses begin producing a specialized tissue called brown fat at 26 to 28 weeks gestation, and stores continue to increase throughout pregnancy and until 3 to 5 weeks postnatally (Verklan & Walden, 2010).
Teaching parents about the brain maturation process will better enable them to understand the progression of breastfeeding success and will likely curb their feelings of inadequacy in feeding the late preterm infant. indd 24 18/10/13 11:51 AM FOUR Temperature Instability, Hypoglycemia, and Increased Metabolism T emperature instability, hypoglycemia, and increased metabolism are all common conditions experienced by the late preterm infant. Each condition on its own creates issues with homeostasis and adaptation to extra-uterine life, but when combined, as is often the case with late preterm infants, their consequences can be exponential.