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Approaches to incubator humidification at <25 weeks’ gestation and potential impacts on infants

Journal of Perinatology (2025)Cite this article

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Abstract

As neonatal care has advanced and more immature infants are admitted to the neonatal intensive care unit, we must reevaluate fundamental management practices originally developed for infants born at later gestational ages. Studies have investigated the use of various incubator humidification levels in the care of preterm infants of older gestational ages, but evidence regarding management of ambient humidity for infants born at <25 weeks’ gestation using contemporary technology is limited. Uncertainty about the best approach to incubator humidification is reflected in major variation in practice around the world. This article summarizes existing evidence about the use of humidity in incubators and its relationship with neonatal skin maturation, fluid management, temperature regulation, and morbidities. It also describes approaches to starting humidification, duration of humidification, and reducing humidification over time. It concludes with a list of important questions requiring future research.

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Fig. 1: Initial incubator humidity at hospitals in the Tiny Baby Collaborative and Neonatal Research Network.

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Author information

Authors and Affiliations

  1. McGovern Medical School at McGovern Medical School at UTHealth Houston, Houston, TX, USA

    Caitlin M. Stoll, Matthew A. Rysavy & Matthew A. Rysavy

  2. Children’s Memorial Hermann Hospital, Houston, TX, USA

    Caitlin M. Stoll & Matthew A. Rysavy

  3. University of Sydney, Sydney, NSW, Australia

    Pranav R. Jani

  4. Westmead Hospital, Westmead, NSW, Australia

    Pranav R. Jani

  5. Uppsala University, Uppsala, Sweden

    Johan Ågren

  6. University of Iowa, Iowa City, IA, USA

    Edward F. Bell

  7. Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia

    Deanne L. August

  8. University of Queensland, Brisbane, QLD, Australia

    Deanne L. August

  9. Nationwide Children’s Hospital, Columbus, OH, USA

    Carl H. Backes

  10. University of Cologne, Köln, Germany

    Angela Kribs

  11. Kyorin University, Tokyo, Japan

    Satoshi Kusuda

  12. Duke University Hospital, Durham, NC, USA

    Noelle Younge

  13. University of Alabama at Birmingham, Birmingham, AL, USA

    Ashley N. Battarbee

  14. Parent Representative, Ames, IA, USA

    Kourtney Vier

Authors
  1. Caitlin M. Stoll
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  2. Pranav R. Jani
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  3. Johan Ågren
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  4. Edward F. Bell
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  5. Deanne L. August
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  6. Carl H. Backes
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  7. Matthew A. Rysavy
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Consortia

Tiny Baby Collaborative Steering Committee

  • Matthew A. Rysavy
  • , Angela Kribs
  • , Edward F. Bell
  • , Satoshi Kusuda
  • , Noelle Younge
  • , Johan Ågren
  • , Ashley N. Battarbee
  • , Kourtney Vier
  •  & Carl H. Backes

Contributions

CS and MR conceptualized the article and wrote the first draft. PJ, JA, EB, DA, and CB contributed content expertise and made critical revisions. Members of the Tiny Baby Collaborative Steering Committee helped with content development and editing of the manuscript. All authors approved the final manuscript and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Matthew A. Rysavy.

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The authors declare no competing interests.

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Stoll, C.M., Jani, P.R., Ågren, J. et al. Approaches to incubator humidification at <25 weeks’ gestation and potential impacts on infants. J Perinatol (2025). https://doi.org/10.1038/s41372-025-02294-1

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  • DOI: https://doi.org/10.1038/s41372-025-02294-1

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