Prevention of neonatal hypothermia in Himalayan villages. Role of the domiciliary caretaker.

Given severe winters at high altitudes, prevention of environmental neonatal hypothermia is of particular importance in Himalayan villages. This is a retrospective study of traditional concepts and practices for the prevention of neonatal hypothermia. 202 babies were studied from a population of 16,425 in three districts of a Himalayan state of North India. The community was found to believe that newborns, especially if underweight are vulnerable to cold induced disease for the first few months of life. A warm heated room for delivery and lying-in, early rooming in, oil massage and layers of warm clothing are traditional means for thermo-regulation as practiced by mothers, birth attendants and relatives. The ritual practice of bathing immediately after birth and then upto three times each day even in winter is not perceived by them to provoke hypothermia. For upto one month postpartum mothers are believed to be at risk for cold induced disease.