Fluid overload (FO) is a common and modifiable risk factor in critically ill neonates, associated with prolonged mechanical ventilation, multiorgan dysfunction, and increased mortality. Despite observational evidence and consensus-based guidelines, standardized fluid management strategies are inconsistently implemented in neonatal intensive care units (NICUs). A critical knowledge gap exists between evidence and practice. Early studies from a single center show the feasibility and effectiveness of the package of measures. Incorporating implementation science frameworks and integrating electronic health record (EHR) data can enhance the adoption, fidelity, adaptation, and sustainability of these interventions in various NICUs. Pragmatic multicenter studies using EHRs are needed to determine the best implementation of fluid management strategies. These packages integrate interventions to identify high-risk patients, follow-up, prevent and treat FO. Collaborative research can reduce the morbidity and mortality associated with FO.