Key learning point: The first step in neonatal resuscitation is to provide the neonate with warmth.

Very-low-birth-weight (VLBW) infants are at increased risk for hypothermia because of an increased surface-to-body-mass ratio and minimal subcutaneous adipose tissue. Hypothermia has been linked to increased mortality in VLBW infants and in infants born at less than 26 weeks’ estimated gestational age. Suggested means of minimizing heat loss at birth include warming the delivery room, removing wet blankets, and using warmed air, a polyethylene wrap, and a warming mattress.