Rethinking the First Basic Steps of Newborn Care—Cold and Wet!

Drying the newborn promptly after delivery is one of the most important early steps of neonatal resuscitation.The sudden temperature change can lead to hypothermia quickly.Thermal management is foundational to delivery-room stabilization of preterm infants.Despite progress, hypothermia at neonatal intensive care unit (NICU) admission remains common and is associated with adverse outcomes, prompting continuous studies aimed at improving newborn temperatures at birth.While drying is recommended for more mature newborns, current guidance for very preterm infants favors immediate plastic wrapping without drying to minimize evaporative heat loss. 1 The NEODRY trial tested whether adding drying before wrapping improves normothermia in very preterm infants, and it also examined safety signals, including mortality.Elsewhere in JAMA Network Open, Cavallin and colleagues 2 report on the NEODRY trial, the largest randomized clinical trial to date evaluating whether drying before plastic wrapping improved temperatures compared with plastic wrapping alone.This was a multicenter, individually randomized, unblinded clinical trial conducted across 21 Italian tertiary hospitals (February 2023 to July 2024).Eligible infants were very preterm (