Babies born earlier than 37 weeks are considered premature. Low birth weight and breathing problems are well-known concerns, but skin problems can also be an issue in the premature baby.
These range from general discomfort to potential life-threatening symptoms that require prompt medical attention. Since the skin is an organ that needs full development, being born too early can increase the risks of associated problems.
If your baby is born prematurely, you may notice that they have extremely red skin. This is a common trait of premature babies — especially those born before 34 weeks. The skin appears red because it’s actually translucent. Since the skin hasn’t been able to fully develop, it’s extremely sensitive.
Extremely red skin in premature babies is normal. This is not considered a problem unless your baby still has redness once they reach term, or if sores and rashes accompany the redness.
If your baby has yellowish skin and eyes, they may have jaundice. This is usually a temporary condition caused by an influx in bilirubin in the blood. The liver is responsible for removing this substance, but your baby might not have the capacity to do it on their own. This causes a buildup. The substance itself is yellow, which is why the skin appears yellow.
An estimated 60 percent of newborns experience jaundice within the first few days of life. The incidence is even higher in premature babies because their livers aren’t fully developed yet. Jaundice is confirmed with a blood test. Depending on the severity, your doctor might let the condition resolve on its own or recommend phototherapy. Phototherapy involves the use of light to eliminate bilirubin in the blood.
Some babies might require blood transfusions to get rid of the excess bilirubin. Untreated, ongoing jaundice can lead to permanent developmental and physical disabilities.
Due to extra skin sensitivity, you might notice more frequent rashes on your baby. Premature babies may be more prone to diaper rash. More rashes can develop when the skin comes into contact with irritants, such as clothing made from synthetic fibers.
Persistent rashes may be attributed to eczema. Also called atopic dermatitis, eczema is a skin condition marked by inflammation (swelling), redness, and extreme itchiness. In babies, these rashes tend to appear most on the:
- cheeks
- chin
- neck
- wrists
- knees
For many babies, eczema is a short-term concern that they outgrow. Others with allergies might have eczema longer throughout childhood. Introducing solid foods too early to premature babies can increase these risks.
Temporary forms of eczema, however, may be soothed with over-the-counter creams and ointments free of dyes and perfumes. You should also take extra care to bath your baby with lukewarm (not hot) water, and use cotton clothing and bedding only.
Aside from rashes, you may also see sores on your baby’s skin. These can develop from scratching or rubbing against their extremely sensitive skin. Regardless of the exact cause, it’s crucial to monitor sores for signs of infection. Premature babies are more prone to infections because they have weaker immune systems. Signs of a skin infection can include:
- raised bumps or welts
- an open sore that is bright red
- a sore that looks like it’s spreading or becoming bigger
- pus or ooze
Since your baby might not be equipped to fight off germs as efficiently, it’s crucial to treat the infection immediately before it develops into a more serious illness. Premature babies are also more prone to sepsis. This is a life-threatening complication of infection in which bacteria spreads through the bloodstream, and then to vital organs. Depending on the original cause of the infection, your doctor may prescribe:
- antibiotics for bacterial infections
- antivirals
- anti-fungal medicines
Topical medications, or ointments, may also be helpful for infected sores on the skin.
Rather than having any one particular type of skin problem, some premature babies simply have itchy, irritated skin. This will resolve as your baby grows and develops. In the meantime, you can make your baby more comfortable by:
- bathing them in lukewarm water with soaps free of perfumes
- applying soothing ointments to rashes
- washing clothes separate from the rest of the family’s
- using gentle laundry detergents, such as Dreft
- not using fabric softener on your baby’s clothes
- applying fragrance-free cream frequently to protect their skin if it’s dry
You may also notice your baby’s skin is especially sensitive in places where bandages, IVs, and blood testing was performed. Take extra care in washing and moisturizing these areas to prevent further irritation and damage.
Skin problems in premature babies are usually resolved with prompt medical treatment, and there are few long-term risks. Skin issues are normal in preemies, but you should always consult with your doctor about any changes in your baby. Not only can you prevent complications, but you can also help your baby feel more comfortable.