Epidermolysis bullosa

No additional complications have been described during childbirth for children affected by EB beyond those that can occur for children unaffected by the condition. What is known, however, is that even before a final diagnosis is made, special care must be taken in handling newborns and infants due to their skin's fragility. In severe cases, blisters and wounds may already be present at the time of birth.

Regarding newborn management in the delivery room and neonatal unit, all standard newborn care should be provided while considering special precautions to prevent injuries. Particularly in the early months of life, it is essential to prevent infections. Ensuring appropriate analgesia, and protecting limbs and vulnerable areas (especially the diaper area, which should be covered at its edges with bandages and/or petroleum jelly) to reduce injuries from the baby's movements and kicks is recommended. For umbilical cord fixation, avoiding cord clamps and using ligatures (or protecting the clamp to prevent skin injury on the abdomen if clamps are unavoidable) is advised. Incubator care should be minimised whenever possible as heat and humidity can exacerbate blister formation. Especially in severe cases, the first full bath should be delayed until the initial lesions have healed. Note that medical devices used in intensive care units need to be properly protected. Finally, heel pricking for neonatal screening should be avoided, and venous puncture should be used instead.

For general care, where parents should be educated early on, particular attention should be given to techniques for holding, feeding, changing diapers, dressing, wound care, and bandaging. Most forms of EB primarily affect the back of babies' hands and feet, as these areas are the most exposed and subjected to friction in their environment. However, it is important to remember that their skin is fragile all over the body, so caution is essential for all areas.