The American Academy of Pediatrics has released a clinical report updating guidance on the use of therapeutic hypothermia treatments for children born with neonatal hypoxic-ischemic encephalopathy. The report, “Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy,” published in the February 2026 Pediatrics (published online on Jan. 26), updates an AAP policy originally released in 2014. The treatment includes a special cooling therapy that helps protect the brains of newborns who have experienced a lack of oxygen and blood flow to the brain, known as hypoxic-ischemic encephalopathy. During treatment, the infant’s temperature is lowered to about 92.3°F within the first six hours after birth, when the benefit for the brain and survival is greatest. In infants where therapeutic hypothermia has not been able to be started within 6 hours after birth, treatment still has a small benefit when initiated after the six-hour mark, as long as it starts within the first 24 hours. From there, infants are kept at that temperature for 72 hours. Infants who have been given this treatment are more likely to survive and experience fewer long-term disabilities. This treatment has not shown benefit for infants with mild hypoxic-ischemic encephalopathy and is also not recommended for preterm infants born less than 36 weeks' gestation. For those born at 35 weeks, studies have not demonstrated conclusive benefit or harm from this therapy, and clinicians in select cases may decide with families to use therapeutic hypothermia. Infants treated with this therapy need to be cared for or transferred to specialized facilities where they can be monitored continuously. Follow-up care is crucial for these infants to ensure they receive all the support they need to live fulfilling, healthy lives. Since most hospitals don’t have avenues for this kind of care, the AAP encourages hospitals and all delivery care providers to work closely with specialized facilities and train medical providers to recognize the signs of hypoxic-ischemic encephalopathy. This report was written by the AAP Committee on Fetus and Newborn and Section on Neurology. Clinical reports that are created by AAP are written by medical experts, reflect the latest evidence in the field, and go through several rounds of peer review before being approved by the AAP Board of Directors and published in Pediatrics.
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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.