During stress states in neonates, insensible losses are reduced. This leads to what effect on energy needs?

• A. Increased energy needs
• B. Decreased energy needs
• C. No change in energy needs
• D. Energy needs become unpredictable

Answer: (B)

Energy needs in neonates are driven not only by growth and baseline metabolism but also by the energy required to replace fluid and heat lost as insensible losses. When insensible losses are reduced, the body spends less energy on evaporating water and maintaining core temperature. That lowered maintenance cost translates to decreased overall energy requirements during stress. Keep in mind that illness can drive energy needs up through fever and increased metabolic rate, but in this scenario the reduced insensible losses lower the caloric demand.