Bullous impetigo in a newborn: what to know

The baby may develop delicate fluid-filled blisters that rupture with handling, leaving red, moist, or crusted areas. They can appear on the body, in folds, or around the nappy area. Blistering in a newborn can also result from conditions other than impetigo, so a clinician should examine the baby rather than relying on photographs or home diagnosis. Crusting skin, poor feeding, or a change in behaviour adds useful information for the assessment.

Contact a healthcare professional promptly and explain the baby’s age, the number and location of blisters, and any temperature or feeding change. Until advice is given, wash hands before touching the baby, keep nails short, avoid squeezing blisters, and use clean loose clothing. Do not apply leftover creams, antiseptics, or medicines unless directed. Keep towels, clothing, and bedding separate from siblings’ items and wash them regularly. Treatment may involve antibiotics for skin infection, chosen by the clinician for the baby’s situation.

Seek urgent medical help if the newborn has a fever or feels unusually cold, is difficult to wake, feeds poorly, vomits repeatedly, has fewer wet nappies, breathes unusually, or develops rapidly spreading redness or blisters. Emergency help is needed for breathing difficulty, marked limpness, or a baby who cannot be roused. Do not delay care while waiting to see whether a blister settles.

Ask how the skin should be washed, whether a sample is needed, how to protect other household members, and which signs mean the baby should return immediately. Confirm how prescribed treatment should be given and when feeding or skin changes should be reviewed.