Francesco Cavallin and colleagues performed a randomised controlled study in 15 Italian tertiary hospitals. They studied infants with estimated birthweight <1500 g or gestation <30+6 weeks. In one group manually adjusted thermal control was provided during initial stabilisation, with the heater set on full. In the other group servo control was used. There were 450 infants in the study. There was no difference in the rate of normothermia (temperature 36.5–37.5 C) at the time of neonatal unit admission. All infants were placed in plastic bags. Normothermia rates were relatively low in both groups (39.6% and 42.2%), with hypothermia being more frequent. Very few infants were hyperthermic. Servo control of temperature during initial stabilisation offered no advantage. Low normothermia rates show that initial thermal care is a complex dynamic process challenge that is not solved simply by choice of equipment. See page F572