Extremely low-birthweight infants have inefficient thermoregulation due to immaturity and may exhibit cold body temperatures after birth and during their first 12 hours of life. Hypothermia in these infants can lead to increased morbidity and mortality. Anecdotal notes made during our recent study revealed extremely low-birthweight infants' temperatures decreased with caregiver procedures such as umbilical line insertion, intubations, obtaining chest x-rays, manipulating intravenous lines, repositioning, suctioning, and taking vital signs during the first 12 hours of life. Therefore, nursing interventions should be undertaken to prevent heat loss during these caregiver procedures. Nurses can improve the thermal environment for extremely low-birthweight infants by prewarming the delivery room and placing the infant in a plastic bag up to the neck during delivery room stabilization to prevent heat loss.