Novel Early Kangaroo Care and Breastfeeding Approach Through Polyethylene Wrap in Collodion Baby Syndrome: A Case Report

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.

Keywords: collodion baby; kangaroo care; neonatal dermatology; neonatal pain; parent–infant bonding; polyethylene wrap.