Weaning small babies from incubator to cot: A systematic review

Aims: To review and assess the literature about the safety and appropriateness of weaning small babies from incubators to open cots weighing less than 1600 g. Design: A systematic review. Review methods: The Critical Appraisal Skills Programme tool was used to assess the relevance and quality of the available literature from May 1994 until November 2023. Data sources: Google Scholar, PubMed, Ovid, Scopus, Cumulative Index of Nursing and Allied Health, and PsycInfo. Results: A total of 164 articles were retrieved, of which 14 studies met the inclusion criteria and are included in this review. Randomised controlled trials have proven that babies could safely wean from incubators to cots at 1600 g. Retrospective chart review studies have shown that babies can successfully transition from a crib into an open cot at 1500 g or even 1400 g. One retrospective study also identified babies transitioning successfully at 1200 g. Eight studies showed no adverse outcomes for early weaning. Eight studies showed no difference or a shorter length of stay in smaller babies. Conclusions: With the improving capacity of incubator technology to maintain a stable temperature in babies, it seems evident that using a specific and controlled approach to weaning small babies from an incubator to an open cot can lead to earlier discharge. Small babies can be weaned safely from an incubator to a cot, and those who are weaned more effectively and expediently may have better outcomes, such as better weight gain, reduced length of stay, and earlier discharge home. Tweetable abstract: Small babies can be weaned successfully from an incubator into a cot at 34 weeks gestation or 1600 g or less without any adverse effects @Vskinner9.