Neonatal Pressure Ulcers

What is a pressure ulcer?

A pressure ulcer is an area of skin damage usually caused by lying in one position for too long without moving or by rubbing or dragging the skin across a surface. In babies, the most common cause of pressure ulcers is the use of equipment such as nose masks, monitoring equipment and splints. The back of a baby’s head is also at risk of pressure damage as this is the heaviest area of their body.

A pressure ulcer can develop in only a few hours and usually starts with the skin to the affected area changing colour. It may appear slightly redder, warmer or darker than usual. If we do not take measures to address the cause(s), it can develop into a blister or an open wound.

N.B. in most cases, the equipment used is vital to your baby’s health and so cannot be removed.

Other factors that can contribute to pressure damage developing are:

• It is unsafe to move your baby
• They are on medicines that make the skin more at risk
• They have had a long surgical operation
• They are on Extra Corporeal Life Support (ECLS)
• They are not on milk feeds
• Your baby is premature
• Your baby has a heart condition

All babies cared for in the neonatal unit are at risk of pressure damage. The nurse or midwife caring for your baby carries out an assessment every day and follows a plan of care to minimise, where possible, the risk of damage.

What parts of the body are most at risk?

The shaded areas on Figure 1 show the areas most at risk where a pressure ulcer could develop. These areas are at risk when lying in bed or if there is equipment being used. If you have any concerns or questions about pressure ulcers please discuss this with the staff caring for your baby.

Figure 1: Child body map

What happens if your baby gets a pressure ulcer?

Wherever possible, we do everything to reduce the risk of your baby getting a pressure ulcer.

We will refer your baby to the Tissue Viability Nurse Specialist (TVNS) who will come to see them within 2 working days. The TVNS is a nurse who takes care of wounds.

The TVNS will review the documented care of your baby and discuss care with staff.

Wherever possible the TVNS will discuss this with you and give you time to ask any questions. If this has not happened yet and you would like to speak to the TVNS, please ask the staff caring for your baby to arrange this.

If the pressure ulcer has resulted in an open wound, staff will use dressings to manage this until it has fully healed. The pressure ulcer may leave a scar and the TVNS can advise you on how to manage this once the wound has healed.

Notes and Reminders

Your child’s healthcare professionals

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