Novel Early Kangaroo Care and Breastfeeding Approach Through Polyethylene Wrap in Collodion Baby Syndrome: A Case
Enrico Perre1, Elisa Pasquali1, Morena De Angelis2
1Alma Mater Studiorum, University of Bologna, Bologna, Italy.
Insights
Sterile polyethylene wrap safely enables kangaroo care and breastfeeding for collodion baby syndrome (CBS) neonates. This method reduces pain, maintains skin integrity, and enhances parent-infant bonding during NICU stays.
Area of Science:
- Neonatal Dermatology
- Neonatal Intensive Care
- Pediatric Pain Management
Background:
- Collodion baby syndrome (CBS) presents a critical challenge due to a restrictive membrane causing pain, thermoregulation issues, and infection risk.
- Fragile skin in CBS infants complicates essential practices like parent-infant bonding and breastfeeding.
- Limited evidence exists on safe methods to support these crucial interventions in neonates with CBS.
Purpose of the Study:
- To explore the efficacy and safety of using sterile polyethylene wrap.
- To facilitate kangaroo care (KC) and breastfeeding in a neonate diagnosed with CBS.
- To address the challenges of skin fragility and pain management in CBS.
Main Methods:
- A neonate with CBS was managed with humidified incubator care and topical emollients.
- Sterile polyethylene wrap was employed as a protective barrier for KC initiation on day two.
- Pain was systematically assessed using EDIN and N-PASS scales during KC sessions.
Main Results:
- Kangaroo care sessions using polyethylene wrap were safely performed with cardiorespiratory monitoring.
- Significant reductions in pain scores were observed during KC compared to baseline.
- The wrap maintained thermal stability and skin integrity, facilitating breastfeeding and parental bonding without adverse events.
Conclusions:
- Sterile polyethylene wrap offers a safe and effective method for early KC and breastfeeding in neonates with CBS.
- This approach successfully mitigates pain, enhances thermal stability, and promotes parental bonding.
- Further research is needed to develop standardized protocols for managing this vulnerable population.
Abstract:
Background: Collodion baby syndrome (CBS) is a rare neonatal dermatological disorder characterized by a restrictive membrane covering the infant's skin, impairing thermoregulation, increasing infection risk, and causing significant pain. Early parent-infant bonding and breastfeeding are challenging due to the fragile skin barrier, with limited evidence on safe approaches to enable these critical interventions. This report explores the use of sterile polyethylene wrap to facilitate kangaroo care (KC) and breastfeeding in a neonate with CBS. Materials and Methods: A full-term female newborn diagnosed with CBS was admitted to the NICU in stable condition. Skin was encased by a shiny, tight membrane with mild ectropion. Initial management included humidified incubator care, fluid and electrolyte monitoring, and topical emollients. From day two, KC was initiated using sterile polyethylene wrap as a protective barrier to prevent skin trauma. Pain was assessed systematically using the EDIN and N-PASS scales at baseline, during, and after KC sessions. Results: Kangaroo care sessions under polyethylene wrap were safely conducted with continuous cardiorespiratory monitoring. Both pain scales demonstrated a significant reduction in pain scores during KC compared to baseline. The polyethylene wrap maintained thermal stability and skin integrity while allowing safe breastfeeding and enhancing parental bonding. No adverse events or infections occurred and the neonate was discharged with good clinical condition after progressive skin healing. Conclusion: Sterile polyethylene wrap is a feasible, safe, and effective method to enable early kangaroo care and breastfeeding in neonates with CBS, addressing the unique challenges of skin fragility and pain management. This approach supports optimal pain control, thermal stability, and parental bonding, bridging medical care with psychosocial needs. Further studies are warranted to establish standardized protocols for this vulnerable population.
