Water and heat--the priority for the newborn infant

Maintaining fluid and heat balance is of vital importance to the newborn infant. At birth, the infant is exposed to a cold and dry environment, and preterm neonates in particular, are then at risk of dehydration and hypothermia. These conditions may have serious consequences and significantly influence mortality and morbidity. Preterm neonates have a high rate of water and heat loss mainly as a consequence of their immature skin. The care environment influences the magnitude of water and heat exchange and needs to be individually tailored on the basis of the infant's clinical status, maturity at birth and postnatal age. This paper reviews data obtained from series of studies on neonatal water and heat exchange using non-invasive measurements of insensible water loss and calculations of different modes of heat exchange. These studies have influenced the way in which newborn infants are being nursed today.