 Thus the brain injury may be more chronic and already established, such that the window period for cooling may be already lost by the time baby is born. Two recent NICHD hypothermia workshops 2011 and 201314 involving experts in therapeutic hypothermia have recommended that rigorous evaluation of cooling therapy should be urgently conducted in LMIC, to ensure that the benefits of one of the most important discoveries in neonatal medicine are not lost to the population that needs it most. Without such rigorous evaluation there may be a creeping introduction of cooling therapy, which is constantly sabotaged by residual safety concerns, and it will never be widely used in India and other LMIC. 