Which may be an early warning sign that an infant is cold-stressed?

• A. Decreased central temperature
• B. Increased central-peripheral temperature difference
• C. Shivering
• D. Jaundice

Answer: (B)

Cold stress in newborns triggers peripheral vasoconstriction to preserve core warmth, so the skin and extremities feel cooler while the core temperature can remain normal. This creates a larger gap between central (core) and peripheral (skin) temperatures, which serves as an early warning sign that the infant is cooling. Shivering is not typical in newborns because their thermoregulatory system is immature, and jaundice has no direct relationship to temperature regulation. Thus, the increasing central-peripheral temperature difference best signals early cold stress.