It was a cold and drizzly February night earlier this year when Beijing police officers dropped a baby off at Little Flower Orphanage. Staff gasped as they peered into the blanket that swaddled the abandoned boy, named Long. He weighed just 2 pounds, so small he could be held in the palm of one hand.
The premature boy had many health issues that would require medical attention, including bowel obstructions and respiratory difficulties, but that night the most pressing concern for the Little Flower staff was his dangerously low internal temperature. If they didn't find a way to warm him up, he wouldn't make it through the night.
If Long had been brought to Little Flower just a week earlier, he would have been wrapped in layers of blankets and placed in a crib with hot water bottles tucked under the mattress. It's not a terribly effective way to keep premature infants warm, but lacking access to incubators and radiant heaters, it's the best Little Flower staff could do.
In the past when Little Flower took in babies Long's size, they never lived more than a few days, typically dying from complications related to hypothermia. Without medical equipment it is impossible to keep premature and low birth weight babies at the temperature they need to safely grow and develop.
But things were going to be different for Long. Two days before he arrived at Little Flower, Linus Liang, an American friend of the orphanage manager, dropped off an invention he'd been working on. Though it just looked like a preemie sized sleeping bag, Little Flower staff were about to find out this was no ordinary blanket.
Every year, 20 million preterm babies like Long are born around the world. A quarter of them will die within the first four months of birth, according to Dr. Karsten Lunze, assistant research professor at Boston University School of Medicine. Preterm delivery makes infants vulnerable to all kinds of health issues. Underdeveloped lungs lead to respiratory infections, and immature livers cause jaundice. Many also suffer from urinary tract infections and gastrointestinal difficulties.
Notwithstanding the severity of these complications, the biggest threat to the health and viability of preterm babies is actually room temperature, which is literally freezing for a full-term infant. "A newborn placed naked in an environment of 23 centigrade at birth suffers the same cold as does a naked adult at 0 centigrade," Lunze said.
Preemies' underdeveloped physiology makes them feel the cold even more profoundly than the average newborn. Lacking the muscle mass needed to shiver, preterm infants cannot create their own heat. Moreover, the absence of body fat makes it difficult for them to retain what heat they have.
In the more prosperous countries, preterm infants like Long are placed in high-tech incubators that maintain the environmental conditions necessary for continued growth and development. But only a small portion of the preterm infants born into the world receive this care.
More than 60 percent of preterm births occur in Africa and South Asia where incubators, not to mention the electricity to run them, aren't available, according to data from the Partnership for Maternal, Newborn and Child Health, a Switzerland affiliate of the World Health Organization.
Not surprisingly, there is a dramatic survival gap for premature babies depending on where they are born. More than 90 percent of infants born before 8 months in low-income countries die within the first four weeks of life, while just 10 percent of babies at this gestation die in high-income countries, according to the World Health Organization. "The simple fact of babies getting cold is a huge threat to their survival everywhere except the developed world," Lunze said.
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