The infant who assumes an extended position should be left in this position in order to encourage heat loss. Skin surfaces can be left exposed to enhance evaporative loss. Active temperature reduction methods should be kept at a minimum to prevent a dramatic loss of heat, potentially leading to cold stress and shock. Proper maintenance of a neutral thermal environment for infants from 500 grams to 5 kilograms involves diligence, patience and an understanding of the mechanisms for heat loss and heat gain as well as the physiological response to the stress of hypothermia and hyperthermia.
Neonatal nurses are the most vital factor in maintaining the neutral thermal environment.