Incubator is an apparatus for maintaining an
infant,especially a premature infant, in an
environment of controlled
temperature, humidity, and oxygen
concentration.(Online medical dictionary).
Incubators have simple alarm system to
alert the clinical staffs if there is any danger of
overheating of the device.In some cases power is
reduced automatically to prevent overheating
Principle of Incubator
Infant incubator is in the form of trolley normally
with mattress on the top covered by plastic cover.
This chamber provides a clean environment and
helps to protect the baby noise, infection, and
Principle of Incubator
A temperature sensor is tapped into the baby’s
skin and the incubator heater adjusts to maintain
the baby at a constant temperature or the
temperature is controlled by thermostat in the
heated air stream.
Purpose of Incubator
An infant may require an incubator for the
When they are not maintaining their own temperature
with clothing and wrapping.
When they are acutely unwell and close observation is
When they are at risk of abnormal heat loss.
They have a known infection/ or the potential to develop
Purpose of Incubator
Main purpose of keeping and caring a neonate in
1. Maintenance of thermoneutral ambient
2. Provision of desired humidity and
3. Observation of very sick neonates
4. Isolation newborn babies from
infections, unfavorable external environment
Main functions of infant incubators are:
4.Breathing gas filtration
Indications of incubator
Indication of incubation care depends on ability of
neonates to sustain and adopt in external
environment. But generally all premature
babies, babies with low birth weight(<1000g) may be
stable, hypothermic child (<32˚c), Sick children need
luenbotor and its care.
Frequently incubator is used to transport babies from
one place to another, like referral to another
hospital, within the hospital for various investigations
e.g. CT scan & MRI. Neonates who need close
observation are also kept in the incubators.
Incubation can be of various types
1. Portable and non portable– Portable incubation can
be used to shift the patient to another area of hospital
2. Open box type- It is also known as Armstrong, here
neonate is keep on the Plexiglas bassinet to keep
unstable babies or newly born babies. A radiant
warmer can be attached if child needs.
The main disadvantage of this type of incubator is it
can not maintain thermoneutral environment if lids are
open frequently. Despite it can not filter the air and
neonate is directly in the contact with external
environment. It has only advantage that neonate in
this incubator can be observed well and can be
3. Close type - Close type of incubator has special
function to concentrate fresh air after filtration. It
prevents water loss from radiation. As neonate
remain inside the box the
risk of infection is minimum.
4. Double walled- The incubator has two walls. As
air is not good conductor of heat the incubator
prevents heat and fluid loss.
STEP 1.Prepare the incubator
Pre-warmed to a temperature appropriate to the
infant’s age, size and condition.
Use in Air mode and must always be switched on
with the motor running if in use for a baby.
Check and record the incubator temperature
Position away from draughts or direct sunlight.
Note: Ensure alarms self-test has been completed
(automatic). If the unit fails the self test, the alarm
sounds, and one or more messages are
displayed in the trend/alarm window.
STEP2:Care of Baby
Maintain axilla temperature between 36.5°C and 37.2°C
Access baby by using the portholes, limit opening of large
door as this interferes with air temperature.
Ensure baby is nursed naked apart from a nappy.
Position baby utilizing rolled towels/cloth nappies to
provide boundaries that support ‘nesting’ and flexion of
limbs but keeping face clear
Explain to parents/caregivers the purpose of an
incubator for their baby
Ensure they are familiar with how to access baby as it
is optimal for parents to continue to touch and provide
Maintain a quiet environment
There is no tapping on the canopy.
No equipment is placed on top of the canopy.
Careful opening and closing of doors.
STEP 3:Adjusting incubator temperature
Default incubator temperature in NICU is 35
Adjust the incubator temperature by no more or
less than 0.5 of a degree at a time.
Re-check the temperature within half an hour of
making any adjustment.
Axilla temperature is taken on admission into the
incubator and rechecked in the first hour.
Temperature is documented 4-6 hourly as per the
STEP 5: Use of Humidification Is utilized for
incubator care of preterm babies only – NOT
required for babies >32weeks.
Cleaning and sterilization
When the incubator is occupied, it should be cleaned
daily with mild detergent.
Humidifier chamber must be emptied and cleaned
daily, fill with fresh distilled water.
After seven days neonate should be sifted to another
incubator and used incubator should be cleaned with
1-2 ml of Glacial acetic acid or vinegar can be added
to water in the humidifier to prevent bacterial growth.
1. It is important that the incubator should not
interfere with observation of the neonate and
quality of care.
2. Sensory stimuli like light and pain should be kept
to the minimal.
3. When neonate develops fever, the incubator
modes have to be changed in normal modes.
4. When the neonate is nursed in prone
position, skin sensor is placed over the flank and
it should not touch the bed.
5. The neonate in the incubator should not be
6. The daily linens should be kept within the
Nursery to keep warm.
7. No alarm should be ignored.