In this section
Infants born at
<30 weeks gestation have an immature epidermis and stratum corneum and are at an increased risk of transepidermal water loss (TEWL). The use of environmental humidity assists to reduce TEWL and in turn supports temperature regulation, fluid and electrolyte management and skin integrity. Prolonged use of high humidity has been shown to delay maturation of the stratum corneum and increase the incidence of TEWL. Therefore, use of environmental humidity outside these criteria should be discussed with the Consultant and/or specialties ie. Dermatology.
The aim of this guideline is to provide all clinical staff with the criteria, settings and weaning regime required for the provision of environmental humidity for preterm infants.
All neonates <30 weeks gestation AND <2 weeks of age should be nursed in an incubator with environmental humidity and servo control thermoregulation functions.
A water bag needs to be attached to the humidification system with the connection kit via the leur lock on the rear sensor wall. On the BabyLeo®, humidity therapy control should be set manually in the therapy bar (see table below).
How to set up humidity
There is no evidence to support humidity higher than 80% or the continuation of humidity past day 14 of life. Practice outside these parameters should be discussed with the consultant.
After successful staged reductions, environmental humidity can then be ceased after 2 weeks of life, as the epidermis will then have matured to act as an effective barrier. The table below demonstrates the commencing and weaning process for humidification.
Environmental humidity is an order, and observations are documented in flowsheets.
Skin-to-Skin Care for the Newborn
View the Environmental humidity for premature neonates evidence table
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read the disclaimer
The development of this nursing guideline was coordinated by Julia McKeown, RN/RM, Butterfly Ward, and approved by the Nursing Clinical Effectiveness Committee. Updated August 2023.