In the premature baby, the outer layer of skin (the epidermis) may be very thin and not well attached to the lower level of skin (the dermis). As a result, the baby may be at increased risk for the following problems:
- dehydration and difficulties in maintaining body temperature (because the baby loses water and heat through the skin);
- infection (because bacteria and other germs can more easily penetrate the skin); and
- breakdown of the skin (particularly when tape is applied and removed).
NICU staff take special precautions to protect the baby's skin and prevent breakdown. Babies are always handled very gently. They are usually bathed with warm water (not hot) and only when necessary. The baby's body may be covered with a sheet of plastic that helps contain heat and reduces the amount of moisture lost from the skin. Special tape that is very gentle is used and only when necessary.
Even more precautions are taken when the baby is very premature. The baby's skin is covered with a special ointment that helps protect the skin from breakdown, serves as a barrier to germs, and reduces loss of heat and water. The staff may try to avoid using tape but if they must, they use a protective barrier between the tape and the infant's skin.
It usually doesn't take much time for a premature baby's skin to get stronger. However, even the special measures described above are not enough to prevent skin irritation and breakdown in some babies.
