We lose heat through four different mechanisms: convection, radiation, conduction and evaporation. When a newborn’s temperature is too low, it causes stress and can exacerbate lung problems, leading to an increased need for ventilation. Metabolic acidosis increases and growth is affected, which can increase the length of hospital stay. Bilirubin is displaced from albumin binding sites, raising the risk of kernicterus. All these issues can lead to increased rates of morbidity and mortality. Minimising all four types of heat loss and preventing cold stress is therefore a necessity.

External stimuli strongly influence the development of the brain and emotional maturation of premature babies. A holistic developmental care concept should enable babies in Neonatal Care to complete their interrupted intra-uterine development with as little harm as possible by minimising external stress while promoting physiological stimuli. Specifically, it includes the following aspects:

• Reducing noise levels (high frequencies in particular) 
• Adjusting lighting conditions to assist the developing sleep-wake rhythm
• Avoiding, or at least reducing, pain
• Tailoring every aspect of care to the infant's physiological and emotional needs
• Involving parents in the entire daily routine
• Taking the emotional needs of parents into account