Collodion baby is the neonatal expression of different disorders of
keratinization. Perhaps the best know is  lamellar ichthyosis.  These
babies are pretty scary looking when they are born, due to the presence
of a membrane  covering their body something like saran wrap.  They look
monsteresque...eyelids and lips sometimes inside out, almost like
someone with a stocking over  his head.  This membrane is usually shed
within a few days and dry scaly skin typical of ichthyosis remains.
Prognosis depends on the severity of the situation.

I don't know why this baby was not breastfed since I was only brought
into the case at 3 wks after her birth, but of course I asked and the
doc said that the mom tried pumping for a few days and gave up. It
sounded like no one really tried to persuade her.    I think the mom is
a physician.  I am sorry that I wasn't aware of this baby earlier. ( I
have no time to give to the NICU these days, unfortunately.)  Maybe
breastfeeeding her early on, may have facilitated bonding.

She was on nasogastric feedings of ABM.  She sucked well on a pacifier
and on a doc's finger, but the minute someone put a bottle in her mouth,
she refused to swallow.  Given the smell of the stuff, I am not sure I
blame her!!

I will go in tomorrow afternoon to see what is happening with her.

As for "fish mouth"  I am not sure if that is a proper medical term or a
description the doc used.   I am of course translating from Hebrew, so I
am not sure what you would call it.  Her mouth looks like a fish mouth
and moves in a similar manner.

This is the second case of ichthyosis we have had in the last two
months.  The previous baby died after two weeks, but this little girl
seems to be pretty strong.

Will try to provide more info tomorrow.

Esther Grunis, IBCLC

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