Looking after your baby's skin

This information sheet explains why your baby’s skin needs special care to reduce the chance of developing a pressure injury (pressure ulcer) or a breakdown in the skin surface.

A newborn baby’s skin helps to insulate and keep them warm, and also acts as a guard against infections. Small, preterm and sick babies admitted into the Neonatal Intensive Care Unit (NICU) may be prone to developing a skin or pressure injury. On admission, all babies have an assessment to check their skin condition. It is then decided whether they are ‘at risk’ of developing a skin or pressure injury. This does not mean they will develop one, rather it will alert staff looking after your baby to use special equipment and assess the skin more frequently.

What is a pressure injury?

Pressure injuries, or pressure ulcers happen when there is pressure on an area of skin. This can happen for a number of reasons:

• If your baby is unable to move his/her position due to being born preterm or ill.
• Due to the effects of medications that cause sedation and limits baby’s movement.
• Due to the placement of monitoring devices on the skin.
• Small and preterm babies have underdeveloped skin layers.

What we do to help

• Every day, we will check all areas of your baby’s skin and note any areas that look ‘at risk’.
• Turning and repositioning – this helps to relieve pressure on specific parts of the body. We aim to reposition every three to six hours. There will be times when this is not an option so we use special mattresses, ‘gel’ pads and wedges, positioning bolsters and special dressings to relieve the pressure on vulnerable parts of the body eg. on the back of the head, ears and the nose (if on nasal CPAP).
• Moving monitoring leads frequently - some every hour, others every two to four hours.

What you can do

When you are touching, washing or cuddling your baby you can help by looking closely at you baby’s skin and telling us if you are concerned about any areas.

Nappy rash

The most common cause of nappy rash in babies is chemical irritation. Urine and faeces contain irritating substances which may lead to a rash. The signs and symptoms are:

• Skin looks red and raw or may look cracked or spotty.
• Skin can be sore when the area is wiped.
• Your baby may be unsettled or irritable during nappy changes.

How to prevent nappy rash

• Change nappies as soon as possible after they become wet or soiled and preferably every three to four hours. There will be times when this is not an option so we may apply or advise you to apply a barrier cream with nappy changes.
• Clean the nappy area with cotton wool or wipe with luke-warm water and pat dry. 
• If the rash persists for more than a few days after using protective creams and ointments it may mean that there is an underlying skin infection present such as thrush or a bacterial infection. Thrush is a fungal infection which thrives in warm, moist areas. The doctor will prescribe a cream to treat the infection if this is the case.
• Some nappy rashes are difficult to treat and in these cases we will give you further instructions on what to use and when. If you have any other concerns or questions please ask your nurse or doctor for more information. 

Disclaimer This publication is for general education and information purposes. Contact a qualified healthcare professional for any medical advice needed.  © State of Western Australia, Child and Adolescent Health Service Produced by: Neonatology Reference: 1210 Last reviewed: 2019

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